What Causes Frequent Hear Palpitations Followed By Bowel Movement And Anxiety?
5'10
135lbs
Somewhat active lifestyle
Non smoker
non drinker
no recreational drug use
10mg of Paxil daily since I was 17
Zantac 150 daily
I have GERD and gastritis
Recently diagnosed with mvp in may of 2015
I've been having issues with my HR spiking randomly. This mostly happens during sleep and awakens me in the middle of the night. I've had HR of 160 up to 210 bpm. Usually, I have a bowel movement once I get out of bed and shortly after that, my heart calms down. When I check my blood pressure, it's typically really high during and after this event. 140/100 or higher at times. I experience pvc's on a daily basis, but they don't bother me too much anymore. My cardiologist said that my mvp is very negligible and it shouldn't be causing these problems. He also said that my heart is structurally sound. Sometimes when I first lay down, I'll get a skipped beat, followed by a racing heart and then it subsides within 5 or 10 minutes. Last night I woke up at 12 am and I felt my heart racing. When I checked my pulse it was around 160bpm and then shot up to around 205bpm. It stayed elevated for about 25 minutes and then slowly came back down to around 100bpm. My resting HR is typically 60-70 bpm. Once my heart rate came down, I had a heavy bowel movement. I still haven't been asleep since this episode as its very frightening to me. This is causing a lot of anxiety for me which makes it all worse. Any ideas what may be causing this? By the way, I drink lots of water throughout the day, I'm caffeine free and I eat pretty healthy almost everyday. My thyroid checked out OK. My adrenal glands have been checked and came back good too. Is it possible that this could be tied to my gastrointestinal system and the vagus nerve? I feel like I don't have a quality of life anymore and this is causing a lot of stress for me and my wife and 3 month old daughter. Any insight would be greatly appreciated.
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I carefully passed through your medical history and complaints, and would like to explain that, there are at least three main reasons why you are experiencing those bouts of tachycardia, and ectopic beats (PVCs):
(1) Mitral valve prolapse, through it may be not severe (and even not associated with mitral valve regurgitation), is a non-negligible source of palpitations, extrasystolic arrhythmia, supraventricular paroxysmal tachycardia, and also sudden bouts of normal sinus tachycardia.
Individuals with MVP frequently experience palpitations and the above arrhythmic phenomena.
Coming to such point, an ambulatory 24 to 48 hours ECG monitoring (Holter) test would be highly recommended, to definitely clarify your cardiac rhythm issues.
You need to discuss with your attending cardiologist on the above mentioned strategy. Probably a low dose beta-blocker could be helpful (at least intermittently).
(2) Gastrointestinal disorders, like GERD, gastritis and even a possible irritable bowel syndrome (IBS) may be another source of exacerbating tachycardia and cardiac ectopic beats. The fact you experience abdominal discomfort (heavy bowel movement, etc) means that an important digestive component is firmly associated with your current symptomatology. I recommend consulting with your internist to possibly address spastic bowel components by using any spastic medications, also anxiolytics, etc. Also the appropriate gastric anti-secretor therapy (PPIs like pantoprasole, omeprasole, ranitidine, etc) should be continued as well.
(3) Anxiety, may be a source of repeated bouts of both tachycardia and IBS (irritable bowel syndrome). The fact you are experiencing unpleasant feelings with your current XXXXXXX issues, including sleep disorders, increased stress, and strong abdominal component (also by engagement of vagal tone modulation), means anxiety is already present. Probably, besides Paxil, addition of a fast anxiolytic drug such as Xanax at least intermittently, would be of valuable help in reducing those unexpected bouts of palpitations.
At, the end, I would like to conclude by assuring you that nothing dangerous seems to be present for your health (you have a structurally normal heart, and this is very important).
I recommend discussing with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, do not hesitate to ask me again.
Kind regards,
Dr. Iliri
Also, I forgot to mention that I wore an event recorder for 4 weeks back in XXXXXXX of 2015 which found nothing out of the ordinary. However, the issues that I listed in my question, were not present when I was being monitored. Do you think a second monitor should take place?
Thank you so much in advance.
A new heart rhythm monitoring is necessary.
Detailed Answer:
Hi again,
Yes! I think a new ambulatory ECG monitoring should be part of the differential diagnostic work up of your actual complaints.
If your palpitations continue to be frequent, then a 24 to 48 hours Holter monitoring would yield important conclusions regarding your increased heart rate bouts.
It is important to properly address digestive and anxiety components implicated in your currents symptomatology, in order to achieve a stable success with your heart rate variability.
Please let me know how things are going on, after the recommended investigations.
Wishing you all the best!
Regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Your sleep problems are probably related to anxiety and psychological stress.
I would recommend taking zolpidem 10mg half a tablet or an entire tablet (if half a tablet doesn't help you fall asleep).
It will help you sleep well and without any consequences (sleepiness, headache,etc.) for the next day.
Hope you will find this answer helpful!
If you have any other uncertainties, you can ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Wishing all the best,
Dr. Iliri