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What Causes Sudden Tachycardia With Muscle Pain In The Arm?
Question: Since a few years my heart suddenly can go extremely fast.
I had one episode today.
I came out of a restaurant, full stomach, and went into the car.
When I was sitting down I felt that it started, my heart started pumping really fast, I had to get out of the car and ofc I was full of adrealine.
I didn't pannick, although not really, so I just waited till it was over.
It took 20 minutes to calm down (after doing a few breathing exercises and just sitting down and talking a bit).
I didn't have any side-complaints such as dizzy, chest pain, or shortness of breath. Only a bit of musscle pain in my arms but that is because I made so many movements with them. I only sometimes had a extrasystole (which I have every day an average of around 500).
This problem I already have for quite some time. I also have it when doing sports sometimes. It normally has something to do with a sudden movement, breathing, or full stomach. Also when I am stressed it happens faster.
I have been to the hospital a few times, but as far as I know they didn't record an episode or find anything wrong, they know that I have a lot of extrasystoles but state this is not dangerous.
The tachycardia episode today took 20 minutes. Normally it goes away within the minute. So I am quite worried.
Ofc I started looking online and saw that SVT has many of the symptoms. But I am afraid that it can also be VT. I have had holters, ECG tests, and photo's have been made of my heart in the past. I don't know what to do next or to be sure that it is ok.
My questions:
- What to do?
- What is the difference in symptoms between SVT and VT?
- Can VT took longer than 20 minutes?
- Can my extrasystoles have anything to do with this?
- Do you have any tricks to maybe stop such an episode (already try with breathing).
I had one episode today.
I came out of a restaurant, full stomach, and went into the car.
When I was sitting down I felt that it started, my heart started pumping really fast, I had to get out of the car and ofc I was full of adrealine.
I didn't pannick, although not really, so I just waited till it was over.
It took 20 minutes to calm down (after doing a few breathing exercises and just sitting down and talking a bit).
I didn't have any side-complaints such as dizzy, chest pain, or shortness of breath. Only a bit of musscle pain in my arms but that is because I made so many movements with them. I only sometimes had a extrasystole (which I have every day an average of around 500).
This problem I already have for quite some time. I also have it when doing sports sometimes. It normally has something to do with a sudden movement, breathing, or full stomach. Also when I am stressed it happens faster.
I have been to the hospital a few times, but as far as I know they didn't record an episode or find anything wrong, they know that I have a lot of extrasystoles but state this is not dangerous.
The tachycardia episode today took 20 minutes. Normally it goes away within the minute. So I am quite worried.
Ofc I started looking online and saw that SVT has many of the symptoms. But I am afraid that it can also be VT. I have had holters, ECG tests, and photo's have been made of my heart in the past. I don't know what to do next or to be sure that it is ok.
My questions:
- What to do?
- What is the difference in symptoms between SVT and VT?
- Can VT took longer than 20 minutes?
- Can my extrasystoles have anything to do with this?
- Do you have any tricks to maybe stop such an episode (already try with breathing).
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms seem to be related to pure anxiety or a panic attack.
You should know that anxiety can lead to activation of sympathetic nervous system, which causes a load of adrenaline and noradrenaline in the blood, leading to ectopic heart beats and tachycardia.
From the other hand some ectopic heart beats (which are quite normal, especially after eating), can trigger a panic attack or anxiety.
Considering your cardiac performed tests that have shown a normal heart structure, all these episodes and ectopic heart beats do not seem to be harmful.
SVT and VT are different types of tachycardia, which differ from the region where they originate. The differentiation is confirmed by ECG, where they can easily be differentiated. From the other hand, you should know that VT usually occur in an abnormal heart structure (dilated, ischemic or hypertrophic cardiomyopathy), while SVT may frequently occur in a normal heart.
Regarding your other question, I would explain that VT may be sustained persisting even much longer than 20 minutes.
But, facing your medical history and the absence of any structural heart disease, it is much more likely that your palpitation be a supraventricular tachycardia (SVT or atrial fibrillation), if not a normal sinus tachycardia be the cause.
The only way to confirm a possible arrhythmic event, especially if it not frequent, would be wearing a loop o event recorder (which records the cardiac rhythm for a prolonged period of time; weeks or months).
Also, some predisposing factors may be responsible for triggering a supraventricular arrhythmia, such as thyroid dysfunction, anxiety, a gastrointestinal disorder (such as hiatal hernia or GERD), blood electrolytes disorders, etc.
If SVT is confirmed, depending on its re-entry circuit, it may be susceptible to some maneuvers that heighten the vagal tone (such as massage of carotid sinus, firm pressure over ocular globes, or swallowing solid food, washin the face with cold water, or a Valsalva maneuver, etc.)
Nevertheless, I would recommend asking immediate medical assistance to the nearest ER service in case of another similar episode, as it would be possible to isolate the possible arrhythmia by ECG.
You need to discuss with your attending doctor on the above mentioned issues.
In case of any available medical tests (Holter, etc,), you can upload them here for a second professional opinion.
Hope you will find this answer of some help!
Feel free to ask me again, if you have any other uncertainties.
Kind regards,
Dr, Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms seem to be related to pure anxiety or a panic attack.
You should know that anxiety can lead to activation of sympathetic nervous system, which causes a load of adrenaline and noradrenaline in the blood, leading to ectopic heart beats and tachycardia.
From the other hand some ectopic heart beats (which are quite normal, especially after eating), can trigger a panic attack or anxiety.
Considering your cardiac performed tests that have shown a normal heart structure, all these episodes and ectopic heart beats do not seem to be harmful.
SVT and VT are different types of tachycardia, which differ from the region where they originate. The differentiation is confirmed by ECG, where they can easily be differentiated. From the other hand, you should know that VT usually occur in an abnormal heart structure (dilated, ischemic or hypertrophic cardiomyopathy), while SVT may frequently occur in a normal heart.
Regarding your other question, I would explain that VT may be sustained persisting even much longer than 20 minutes.
But, facing your medical history and the absence of any structural heart disease, it is much more likely that your palpitation be a supraventricular tachycardia (SVT or atrial fibrillation), if not a normal sinus tachycardia be the cause.
The only way to confirm a possible arrhythmic event, especially if it not frequent, would be wearing a loop o event recorder (which records the cardiac rhythm for a prolonged period of time; weeks or months).
Also, some predisposing factors may be responsible for triggering a supraventricular arrhythmia, such as thyroid dysfunction, anxiety, a gastrointestinal disorder (such as hiatal hernia or GERD), blood electrolytes disorders, etc.
If SVT is confirmed, depending on its re-entry circuit, it may be susceptible to some maneuvers that heighten the vagal tone (such as massage of carotid sinus, firm pressure over ocular globes, or swallowing solid food, washin the face with cold water, or a Valsalva maneuver, etc.)
Nevertheless, I would recommend asking immediate medical assistance to the nearest ER service in case of another similar episode, as it would be possible to isolate the possible arrhythmia by ECG.
You need to discuss with your attending doctor on the above mentioned issues.
In case of any available medical tests (Holter, etc,), you can upload them here for a second professional opinion.
Hope you will find this answer of some help!
Feel free to ask me again, if you have any other uncertainties.
Kind regards,
Dr, Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for your answer.
I really appreciate it.
All the tests in the past did indeed state that my heart is structurally fine. The many extra beats I have don't make me scared and the reason that I have been tested so much, and experience similar episodes already for years, don't make me pannick. I feel completely fine for the rest and the episodes don't hold me back.
Nonetheless they are very annoying and when they happen I have to start running (as if someone shoots adrenaline through my veins). So I will def consider walking around with a holter for a longer period if necessary (although I am now working abroad so it take a while before being back at my doctor).
Regarding your answer if it is anxiety I def considered that but I personally think it is not the case. The reason why is because the onset of an episode is clearly distinguishable with a premature beat and is triggered by a certain event such as a movement. Regardless I do consider the fact that the continuation of the episode can be anxiety or stress. The 20 minutes today maybe were not really 20 minutes but just 1 minute maybe and the rest other minutes were just me stressing out without being fully aware of it which could be quite interesting.
I have one additional question. Most of my episodes are triggered by sudden movements. For example today when I sat down in the car with a full stomach. A different time during running when I saw someone walking and I turned around. Another time when jumping on a bed face down. Full stomachs and sudden movement (where my stomach pushes against my heart area) are a common trigger for these episodes. I would also want to add that an episode normally is preceded by a premature beat (which I have many of).
Does this description make a difference when distinguishing between VT and SVT for example? Or is it really almost only related to what the ECG says?
Thank you again for your answer and I will certainly keep you up to date when more information comes.
Best,
Me
Thank you for your answer.
I really appreciate it.
All the tests in the past did indeed state that my heart is structurally fine. The many extra beats I have don't make me scared and the reason that I have been tested so much, and experience similar episodes already for years, don't make me pannick. I feel completely fine for the rest and the episodes don't hold me back.
Nonetheless they are very annoying and when they happen I have to start running (as if someone shoots adrenaline through my veins). So I will def consider walking around with a holter for a longer period if necessary (although I am now working abroad so it take a while before being back at my doctor).
Regarding your answer if it is anxiety I def considered that but I personally think it is not the case. The reason why is because the onset of an episode is clearly distinguishable with a premature beat and is triggered by a certain event such as a movement. Regardless I do consider the fact that the continuation of the episode can be anxiety or stress. The 20 minutes today maybe were not really 20 minutes but just 1 minute maybe and the rest other minutes were just me stressing out without being fully aware of it which could be quite interesting.
I have one additional question. Most of my episodes are triggered by sudden movements. For example today when I sat down in the car with a full stomach. A different time during running when I saw someone walking and I turned around. Another time when jumping on a bed face down. Full stomachs and sudden movement (where my stomach pushes against my heart area) are a common trigger for these episodes. I would also want to add that an episode normally is preceded by a premature beat (which I have many of).
Does this description make a difference when distinguishing between VT and SVT for example? Or is it really almost only related to what the ECG says?
Thank you again for your answer and I will certainly keep you up to date when more information comes.
Best,
Me
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again,
On my personal opinion, your persistent palpitations (if they really occurred), whether an arrhythmia has to be chosen, should be more likely suspected to be runs of SVT.
But, I can’t exclude a sinus tachycardia triggered by anxiety after some frequent ectopic beats.
So, what we prefer in these situations is to make a more precise evaluation by continuing ambulatory ECG monitoring (and if those events are rare to prolong the monitoring period, as I explained you before).
Based on your clinical symptomatology, your already performed cardiac tests, your triggering factors, I do believe that VT is unlikely to be the cause of your complaints.
So, relax! No serious cardiac implications seem to be on the horizon.
And my answer to your question is YES!
ECG is the gold standard when considering cardiac arrhythmia investigation.
I also insist in advising you to discuss with your doctor on the possibility to explore those possible triggering factors (especially digestive issues, like hiatal hernia, GERD, etc. thyroid function status, etc.)
A fibrogastroscopy, and additional lab tests are necessary to explore the most likely triggering factors of your palpitations.
Meanwhile, I remain at your disposal for any further discussions regarding the ongoing available tests and complaints.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again,
On my personal opinion, your persistent palpitations (if they really occurred), whether an arrhythmia has to be chosen, should be more likely suspected to be runs of SVT.
But, I can’t exclude a sinus tachycardia triggered by anxiety after some frequent ectopic beats.
So, what we prefer in these situations is to make a more precise evaluation by continuing ambulatory ECG monitoring (and if those events are rare to prolong the monitoring period, as I explained you before).
Based on your clinical symptomatology, your already performed cardiac tests, your triggering factors, I do believe that VT is unlikely to be the cause of your complaints.
So, relax! No serious cardiac implications seem to be on the horizon.
And my answer to your question is YES!
ECG is the gold standard when considering cardiac arrhythmia investigation.
I also insist in advising you to discuss with your doctor on the possibility to explore those possible triggering factors (especially digestive issues, like hiatal hernia, GERD, etc. thyroid function status, etc.)
A fibrogastroscopy, and additional lab tests are necessary to explore the most likely triggering factors of your palpitations.
Meanwhile, I remain at your disposal for any further discussions regarding the ongoing available tests and complaints.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again for your answer.
I will go to a doctor this week and request a Holter again.
I just want to catch it, although I am in a different country I will ask for the print-out and post it here for a second opinion, thank you so much for that.
I forgot to mention by the way that my Mother has WPW although she was told that she has this 35 years ago or something.
During all the checks I did they never mentioned to me and I did ask for it directly once, so I guess that rules WPW out maybe, but I will mention it.
The relation to stomach or other problems seems as a logical explanation. Although I don't have chest pains the day before the episode I did have quite heavy acid reflux during the night. It could also have something to do with Vagal Nerve Irritation. I often have a lot of gas in my stomach. Often when I have an episode it starts with a fluttering sense in the stomach area (just above it). It feels as a subsequence of skipped beats, what it may be, but I often thought there was some relation with gas (or food maybe) in the stomach triggering a certain reaction. The tachycardia could be anxiety as a result of the fluttering sensation or triggered in the same way.
Regardless, I will keep you up to date, and thank you so much.
I really appreciate this, my life is not affected by this (although the detailed description above may suggest otherwise haha) and I refuse to let it do so, but I want to know what it is because it is just plainly annoying.
I will go to a doctor this week and request a Holter again.
I just want to catch it, although I am in a different country I will ask for the print-out and post it here for a second opinion, thank you so much for that.
I forgot to mention by the way that my Mother has WPW although she was told that she has this 35 years ago or something.
During all the checks I did they never mentioned to me and I did ask for it directly once, so I guess that rules WPW out maybe, but I will mention it.
The relation to stomach or other problems seems as a logical explanation. Although I don't have chest pains the day before the episode I did have quite heavy acid reflux during the night. It could also have something to do with Vagal Nerve Irritation. I often have a lot of gas in my stomach. Often when I have an episode it starts with a fluttering sense in the stomach area (just above it). It feels as a subsequence of skipped beats, what it may be, but I often thought there was some relation with gas (or food maybe) in the stomach triggering a certain reaction. The tachycardia could be anxiety as a result of the fluttering sensation or triggered in the same way.
Regardless, I will keep you up to date, and thank you so much.
I really appreciate this, my life is not affected by this (although the detailed description above may suggest otherwise haha) and I refuse to let it do so, but I want to know what it is because it is just plainly annoying.
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Regarding WPW, your previous performed cardiac tests have excluded such disorder. So, I do not think that you suffer from this disorder.
Nevertheless, I would recommend performing a new ambulatory prolonged ECG monitoring to examine your heart rhythm trends during a prolonged time.
I would also recommend performing a fibrogastroscopy for the above mentioned reasons.
Hope to have clarified some of your uncertainties!
Regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Regarding WPW, your previous performed cardiac tests have excluded such disorder. So, I do not think that you suffer from this disorder.
Nevertheless, I would recommend performing a new ambulatory prolonged ECG monitoring to examine your heart rhythm trends during a prolonged time.
I would also recommend performing a fibrogastroscopy for the above mentioned reasons.
Hope to have clarified some of your uncertainties!
Regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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