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31 Jul 2006

Heart Pulpitations and tight chest
Hi there

Please help me with this query. Last week Monday, I awoke feeling very anxious with constant heart pulpitations. My chest felt very very tight. I tried to calm down, relax, and carry on work but it persisted and just got worse. My heart felt like it was going to breakthrough my chest. I phoned my doctor who said it sounded like I was going through an anxiety attack. All fine and well I did what he told me and it got better but the heart pulpitations persisted through the night.

By the next afternoon I was pretty much back to normal. Now it's Monday again and my heart is just pulpitating again but in stages. It goes from normal beats to 1 major hard beat and then normal again. I feel a bit dilarious and the pulpitations are soft but there none the less.

Please advise. I am 26 years old.

Answer 1,802 views

01 Jan 0001

Dear Mitch,

You clearly have an intermittently irregular pulse. Whilst your description does suggest a particular type of irregularity, a firm diagnosis cannot be made without ECG confirmation. The problem often is that the irregularity does not conveniently appear when you are the doctors rooms having an ECG, so a random, resting ECG may appear totally normal, but the irregularity reappears the next day or night again.

The solution to this is to go not to a GP, but to a specialist cardiologist. Here, more specialised tests can be done, in particular, a Holter monitor can be used. This is a small mobile ECG which you wear for 24-48 hours: this constantly monitors your ECG, and the readings can then be analysed by the cardiologist afterwards. Any irregularities re thus captured on record for analysis, and the appropriate treatment can be given.

This does not sound like a life-threatening condition, but it does need to be diagnosed and monitored, as some forms of pulse irregularities are know to degenerate over time into conditions which may need pacemakers or other forms of treatment.

Please arrange for a referral to a cardiologist as soon as possible. In the meantime, yes, do try to “be calm” to minimise the effects of anxiety, and, if you are a smoker, STOP IMMEDIATELY, because smoking worsens this condition.

Good luck.

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