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What Does My Holter Monitor Report Indicate?

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Posted on Tue, 7 Apr 2015
Question: I had several cardiac tests done twice over the past 6 months. The most recent tests were done last month. I did a stress test, echo, ECG, 2 holter monitors etc... The results of the stress test and echo came back normal showing a structurally normal heart. My holter showed 200 PACS and 15 single unifocal PVCS. I have a resting heart rate which goes around 54 which worries me but my cardiologist says it is normal and my heart is healthy. Also during sleep my heart rate went down to 41. I get worried because when I wake up in the morning I get a lot of what I think are PACS. for example this morning I could feel a lot of them and my heart starts racing. I have also noticed another thing.  

I have a lot of acid reflux and when I feel this my heartbeat is also irregular. I will feel some faster beats and some slower beats but still in sinus rythm. Is this normal? Can heart rate be affected by acid reflux. I will feel my heart rate alternate a little fast and a little slow sometimes I will have 10 faster beats and then 1 or 2 slower beats and then faster again. I don't understand this. Is this normal function of the heart?  My cardiologist says this is all anxiety related. Is this possible? I feel like my heart will start racing at certain times when I'm aggitated


5 days 
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
Heart normal; probably anxiety related symptoms.

Detailed Answer:
Hello
Welcome to HealthcareMagic.

I have gone through your details thoroughly and understand your concerns.

You cardiac investigation results suggest that there is no serious cardiac disease.

Normal ECG, stress test and ECHO suggest that there is no possibility of ischemic heart disease or a heart failure.
The findings of holter are also clinically insignificant. This rules are possibility of serious arrhythmia.

Since your heart is healthy, resting heart rate 54 and sleeping heart rate 41 is fairly normal.

Increased morning heart rate can be a result of adrenaline surge. This is also quite normal.

Till there is sinus rhythm, the variability in heart rate is not a matter of worry.

Acid reflux can cause palpitations due to anxiety about pain due to reflux.

I think, almost all of the symptoms which you have mentioned, can be attributed to anxiety. There can be autonomic instability in anxiety which can lead to such symptoms.

Also, as all of your cardiac investigations are normal, I do not think you should worry. The more you will think about these symptoms, the more anxious you will be. This will make your symptoms worse.

Anxiety can cause a hell lot of symptoms which can mimic a heart condition. Here are my some suggestions for you to control anxiety:
1. Practice slow and deep breathing and meditation.
2. Avoid excessive coffee and tea intake.
3. Eat green leafy vegetables and fruits.
4. Drink plenty of water.
5. Take adequate sleep.

This will make you feel better.

Hope this helps.

Feel free to ask further.

Thanks.

Dr. Shubham Mehta, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (1 hour later)
Doctor Thank you for your response. It has put my mind more at ease. I wasn't sure if it was anxiety because sometimes my heart rate will race to 150-160 bpm. I wasn't sure if anxiety could do this. Also sometimes my heart will race like that for a minute or 2 but I do deep breathing and it slows down. I have heard that if it is heart related these episodes would last longer. Is that true?
doctor
Answered by Dr. Shubham Mehta (6 hours later)
Brief Answer:
heart-related palpitations last longer.

Detailed Answer:
Happy that your found my suggestions helpful.

Yes. Mostly, the heart-related palpitations last longer. Or rather, they are present constantly in most cases.

But this time duration is just a vague criteria to decide whether its anxiety or heart disease.

The strongest evidence in your case for healthy heart is the normal cardiac investigations.

So, do not worry.

Control over anxiety will relieve your symptoms. I would advice you to follow the tips which I listed earlier to control anxiety.

You will be fine :)

Wish you good health.

Kindly close the discussion if you are satisfied with the response and give your valuable feedback.

If you have more queries in future, you can approach me directly anytime. I will be happy to help you.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2144 Questions

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What Does My Holter Monitor Report Indicate?

Brief Answer: Heart normal; probably anxiety related symptoms. Detailed Answer: Hello Welcome to HealthcareMagic. I have gone through your details thoroughly and understand your concerns. You cardiac investigation results suggest that there is no serious cardiac disease. Normal ECG, stress test and ECHO suggest that there is no possibility of ischemic heart disease or a heart failure. The findings of holter are also clinically insignificant. This rules are possibility of serious arrhythmia. Since your heart is healthy, resting heart rate 54 and sleeping heart rate 41 is fairly normal. Increased morning heart rate can be a result of adrenaline surge. This is also quite normal. Till there is sinus rhythm, the variability in heart rate is not a matter of worry. Acid reflux can cause palpitations due to anxiety about pain due to reflux. I think, almost all of the symptoms which you have mentioned, can be attributed to anxiety. There can be autonomic instability in anxiety which can lead to such symptoms. Also, as all of your cardiac investigations are normal, I do not think you should worry. The more you will think about these symptoms, the more anxious you will be. This will make your symptoms worse. Anxiety can cause a hell lot of symptoms which can mimic a heart condition. Here are my some suggestions for you to control anxiety: 1. Practice slow and deep breathing and meditation. 2. Avoid excessive coffee and tea intake. 3. Eat green leafy vegetables and fruits. 4. Drink plenty of water. 5. Take adequate sleep. This will make you feel better. Hope this helps. Feel free to ask further. Thanks. Dr. Shubham Mehta, MD.