posted
From time to time, just walking around, or going about a normal day, I notice that I can feel my pulse. Everywhere. I can feel it in my fingers resting on a table, in the slight motion of my body as my heart beats just sitting here, in the roof of my mouth, my head, in my chest... my shirt is wiggling right now because it is beating. It doesn't feel unhealthy, it's just unusual and a strange sensation to be constantly reminded that your heart is always working hard. I was curious if anyone could relate to this, or if anyone had a hint of explanation why it would be so noticeable at times, and not at others, aside from paying attention which might have something to do with it.
Posts: 655 | Registered: May 2005
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posted
The technical term for an abnormal awareness of your heartbeat is "palpitations." There is usually no associated pathology found, and it is often inexplicable why it happens. More rarely it can be associated with high blood pressure, an extra fast heart beat (secondary to caffeine, nervousness, or what have you), an arrythmia, or a "skipped beat" (aka a premature ventricular contraction, or PVC), etc.
Since you are thinking about it enough to look for more information, it is probably worth getting checked out. Any general physician could give you a once-over in the office that would rule out anything of serious concern.
eMedicine has a good, accessible article on palpitations. It's a useful read. From the list of causes, e.g.:
quote:Normal heartbeat
-Occasional awareness of your normally beating heart, the simplest explanation of palpitations
-Increased awareness when everything else is quiet, such as when you try to fall asleep in a quiet room
-After physical exertion or emotional upset, when you sense that the speed of your normally beating heart has increased
-When your heart rate becomes greater than 100 beats per minute, termed sinus tachycardia
-Certain substances, including prescription, over-the-counter, and herbal medicines, that stimulate the heart to beat faster and harder --Caffeine --Tobacco --Alcohol --Bronchodilators/inhalers containing albuterol used in asthma and other lung diseases --Theophylline (Bronchial, Hydrophed, Marax, Tedral) --Thyroid medicine --Pseudoephedrine (Actifed, Afrin, PediaCare) in cold and allergy formulations --Ephedrine (Kondon's Nasal, Pretz-D) or Ma huang (often found in diet pills)
The article also lists other (less likely) causes, if you are interested. Some of them sound scarier than others, but the scarier ones are relatively quite rare. Still, though, as I said above, it's worth getting checked out, if you are at the point of looking for more information.
Posts: 14017 | Registered: May 2000
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posted
I asked for explanations more out of curiosity than out of medical concern. I am in good shape and I didn't have an excessively fast heart rate or anything, just abnormally strong/abnormally noticed by me. Thanks for the concern though, but it now feels normal and... i just don't think it's a real issue. I felt really emotionally like... high-strung? excited sort of throughout the day, so maybe that had something to do with it. Hm.
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You may or may not know that I am a physician, so I generally recommend people get assessed in person by a medical professional, even if I think it's likely nothing to worry about. A) I've been burned before, as rare things do occur, B) it is a matter of professional liability for me, and C) otherwise I stay up late worrying about having given bad care (even if over an anonymousish internet forum).
However, I recognize and respect your autonomy, and I am sure you are perfectly competent to make your own decisions about yourself and your body. I just don't want to have unduly influenced you in an untoward direction, you see.
For it's worth, I very carefully did not characterize you as "concerned" in my initial post, but rather as "thinking about it enough to look for more information" and/or "at the point of seeking more information." I understood that you were not really worried about it (just curious in an intellectual way), and I didn't want to appear to characterize you as a worrywart. On the other hand, I did want to give your question due consideration.
It's a fine line.
---
Edited to add: Let us know if it continues or progresses, okay?
Posts: 14017 | Registered: May 2000
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posted
CT, what form would such an assessment take? I mean, say that me, er...no, say a friend has intermittent bouts of sinus tachycardia. She doesn't want to fuss with a full workup with heart monitors and the like, figuring it's probably no big deal. After all, she's relatively healthy now, and exercises regularly, has lost a lot of weight, and is doing well.
The tachy episodes are NOT related to caffeine because she tracked them and found no link to caffeine consumption. Sometimes they would occur within an hour of drinking caffeine, sometimes when no caffeine had been consumed at all that day.
Would it be significant to a medical professional that the episodes began during chemotherapy? And have continued off and on ever since but have perhaps increased in frequency in the last few months? I mean, if we're speaking hypothetically of course. About my friend. Not about me, because see I know better than to keep a potentially worrisome condition from my doctor. Ahem.
Posts: 14428 | Registered: Aug 2001
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posted
Some chemotherapy agents can cause heart damage. Doxorubicin (aka Adriamycin) is notorious for this, including arrhythmias specifically (as well as heart failure), although the arrythmias are usually not life-threatening. Those arrhythmias can progress over time, though, and may occassionally (see linked study) require pacemaker implantation.
I don't know enough about oncology to answer about other specific chemotherapy agents, but I know there are others known to have cardiac effects, as well.
Were I to know your friend, I'd sit down with her and have a frank talk about her kids and her spouse (if she has kids and a spouse, of course), and how they likely depend on her for so much. I'd also talk to her about how the people in her life probably are trusting her to take care of herself, and that a betrayal of that trust would be crushing to a small child.
I'd then mention that a general physical exam is very useful for ruling out heart failure (presence or lack of edema, heart sounds through the stethescope in various positions, feel of the pulse and point of maximal impact at various places, etc.). Additionally, a simple office EKG that takes about 5 minutes to do gives a lot of information, but there's also the possibility of being sent home on a 24-hr Holter monitor (easy, portable, rather like a clingy crop top to wear under regular clothes) to further reassure, even if the office visit turns out normal.
Depending on what the physical exam shows and her physician's level of suspicion, she may or may not be referred to have an ECHO done, which is just like a sonogram of the heart. It's an easy, simple, outpatient test, and the main problem people have with it is that the tech has to smear some gel on the patient's test. It wipes off, though.
I'd be happy to talk more with your friend if she is interested, though I would continue to (strongly) recommend that she let her GP and/or oncologist know about these symptoms.
posted
There's a difference between your heart beating in such as way as to be noticed, and you actively being aware of your heartbeat.
Sharpshooters can slow their heartbeat to minimize the motion of their gun. I used to freak my wife out by slowing my heartrate intentionally when she was lying with her head on my chest. I'm certainly able to feel my heartbeat anytime I stop and take time to be aware of it.
Posts: 3735 | Registered: Mar 2002
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quote:Originally posted by Glenn Arnold: There's a difference between your heart beating in such as way as to be noticed, and you actively being aware of your heartbeat.
I'm not sure there is a clear clinical difference, though. That is to say, there seem to be many cases when these occur simultaneously and/or can't be distinguished from one another (see eMedicine article on Palpitaions above for details).
Doubtlessly there are cases where this can be distinguished, but in many instances, there is no clear line between the two. It's a bit of a mystery.
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posted
If I rest my hand on a surface I can often feel my pulse. I can feel it in my chest if I "listen". I don't think it's unusual to be able to do this. After all, it's a lot of blood pounding through your veins.
Posts: 8473 | Registered: Apr 2003
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posted
I don't mind when I can feel my heartbeat unless it's because I'm trying a sinus medicine that does it. A couple beats is one thing, dealing for hours is annoying.
The one that bugs me is after I climb up some stairs, my hands can swell a little and feel heavy. I hate that. It makes me feel so out of shape. I mean, I am, but I don't like to feel it.
Posts: 2283 | Registered: Dec 2003
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posted
Glen, how do you do that? I am wondering, because when I was in the Army I was a medic, and when it was slow we used to sit around and measure each others heartbeats for practice. We also used to see if we could affect them at all by trying different techniques.
Posts: 15082 | Registered: Jul 2001
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posted
The same way you breathe slower, I guess. Except that I can still choose to breathe slower, and I've lost the ability to control my heart rate. Maybe age has to do with it.
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posted
Oh, but I can still tell the nurse what my blood pressure is before she announces it. You can feel the heartbeat under the cuff in the same way that they hear it, although diastolic is harder to tell.
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posted
Regarding changing your heart beat: I've found that whenever I'm taking my own pulse I change my breathing pattern and can't trust the reading I get. It seems like when I breathe out my heart beats slower, and then when i have to, or simply breathe again, it beats faster for a bit. Do other people notice these same sort of things?
Posts: 655 | Registered: May 2005
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quote:Originally posted by Starsnuffer: Regarding changing your heart beat: I've found that whenever I'm taking my own pulse I change my breathing pattern and can't trust the reading I get. It seems like when I breathe out my heart beats slower, and then when i have to, or simply breathe again, it beats faster for a bit. Do other people notice these same sort of things?
It's a normal occurrence. One of the heart sounds you hear in the stethescope also changes ("splits") when you breathe.
posted
One of my relatively frequent insomnia issues is that I can't fall asleep because my heart is beating too loudly.
I can feel it in various body parts whenever I pay attention, and I can conciously slow it down or speed it up to and extent. The freakiest thing is that if I turn my head so my face is parallel to the floor looking down and pay attention, I can see my vision going momentarily out of focus with each heartbeat. My eye doctor told me that happens all the time, and your brain just normally compensates for it. Putting your head face down pools the blood a little more than normal in your eyes and increases the effect a bit, so if you're very aware of your eyes you can see it. It's kinda cool.
Posts: 7954 | Registered: Mar 2004
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posted
When I was hooked up to a monitor (and still somewhat drugged) I played with how low I could get my heart rate. As I recall, (and, again, drugged) it got down to 50 ish.
I was very relaxed.
Oh, I can tell with the blood pressure cuff, too.
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