Monday, January 13, 2014

Benign Heart Palpitations



My Story

Updated 06-20-2018

Seven year ago I had a single palpitation. It hit my heart like a lightning bolt. It was a powerful heart palpitation. Thirty seconds later I had another, and another. They just wouldn’t stop. I went to the hospital thinking I was gonna die. 

The doctors hooked me up to a machine and one hour later the doctors sent me home. The machine registered a bunch of PVCs, or something like that. But they said it wasn’t uncommon. Later that day, the heart palpitations got worse, so I went back to the hospital. 

When I got to the hospital, they hooked me up to an EKG/ECG. Next they did a CT scan with calcium scoring. The score was 0, which is perfect. The hospital referred me to a cardiologist and sent me home. 

The next day I went to the cardiologist and they gave me a holter-monitor. The device is portable and records the rhythm of the heart continuously for 24 to 48 hours. Twenty-four hours later I went back to the cardiologist and he analyzed the data. 

Next he did a echocardiogram, which is a test of the action of the heart using ultrasound waves to produce a visual display. It’s often used for the diagnosis or monitoring of heart disease. 

So basically, I had all the gold-standard heart tests. And the cardiologist conclusion was that my heart palpitations were benign, which means the palpitations were not harmful in effect. He also said I had no abnormalities of the heart. 

He went on to say that my palpitations would likely last forever and that I shouldn’t worry about them. And to go on living my life as normal. And that’s what I did. And for the next 7 years I continued to have palpitations. 

During the first year the severity of each palpitation lessened. But they never went away. In fact, there wasn’t one day that passed that I didn’t have at least one palpitation. Weeks would go by were I only had a few palpitations each day whereas other days I might get several hundred. 

Certain movements, activities or foods seemed to trigger a palpitation. For example, bending over could trigger a palp or when turning over in bed. Sometimes my heart would skip a beat when lifting heavy weights at the gym or when attempting to jog. Jogging became off limits to me. Sometimes a Starbucks Frappuccino would set off a flurry of palpitations. But sleeping would seem to make them go away…for a little while. 

Despite spending the last 25 years working out religiously. I began taking my health more seriously by always seeing my doctor on a regular basis and getting blood work performed every 6 months. 

One thing I noticed about my blood work is that my testosterone was ALWAYS low. My total testosterone was usually between 157 and 204. That’s extremely low considering I am currently 43 and especially since I got some decent muscle size. 

But then something interesting happened. I asked my doctor if he could give me a prescription for testosterone gel. Basically I wanted to see if it would make me feel a little younger again and why not since I qualify for testosterone replacement therapy.

Here’s where it gets interesting. My palpitations completely stopped within a week or two of taking the testosterone gel. Wtf? For the last 7 years I never went one day without at least one palpitation per day. And all the sudden I start taking testosterone and my palpations disappear! I can even jog again.

I’m not really sure why this happened or if the palpitations are directly related to my low testosterone. But I’ve been palpitation free for 4 months and that’s a great feeling! I’m planning to go back to my cardiologist next month and then to an endocrinologist soon after. I feel like I’ve found a piece of the puzzle and hope to find a cure for my palpitations. Maybe the doctors might have the missing link? 

I am sure there can be a million possible causes for these skipped beats. And it seems no one really knows what causes “benign” palpitations. I think those were my cardiologist exact words seven year ago, “we're not completely sure what causes benign palpitations”.

My personal opinion is that I might be insulin-resistant (pre-diabetic), which can be made worse for people with low testosterone, or can result because of low testosterone. Testing for insulin-resistance requires a special test called a 2-hour insulin glucose challenge test.

UPDATE 6/20/2018: With so many bills, I still have not yet went to my cardiologist, but I will soon. Also, I recently stopped taking the testosterone jell and my palpitations returned with a vengeance. So I used Defy Medical (telemedicine) to get my hands on some testosterone injections. Basically, Defy Medical is a place you can get testosterone injects online. Anyhow, my palpitations stopped again almost immediately after restarting the testosterone injections. No question about it, testosterone stops my benign heart palpitations!

Anyway, maybe my story might help someone. Stay tuned as I will update you with more information when I see my doctors. And if you have a question just leave a message in the comment box at the bottom of the page. Heck, maybe together we can solve this. 



What are Benign Heart Palpitations?


Benign heart palpitations are an abnormality of heartbeat which range from accelerated heart rate, skipped beats or noticeable heart arrhythmias. In some rare cases, the irregular heart rhythm can cause difficulty breathing or dizziness. Benign heart palpitations are the most common heart problems and occur in people with healthy hearts. Therefore, benign heart palpitations are defined as, “palpitations without any underlying heat disease or abnormalities.” However, heart palpitations can be associated with serious illness such as emphysema, coronary heart disease or asthma. It’s critical to determine the cause to rule out serious underlying medical problems. 


Symptoms of Benign Heart Palpitations


Benign heart palpitation [or heart palps] attacks can last for a few hours or seconds, and occur daily or infrequently. Benign premature beats occur suddenly and often noticed when relaxing. Most people who suffer from benign palpitations describe an onset as a one-two punch, fluttering, flip-flopping, taking long pauses or pounding feeling. Individuals commonly experience benign heart palpitations when:

  • Bending over, then standing up suddenly
  • Laying down flat [horizontal], then turning to the left or right side
  • Lifting very heavy weights
  • Sleeping or resting
  • Experiencing stress or anxiety
  • Excessively smoking [benign palpitations are more likely to occur 15 minutes after smoking a cigarette]
  • Drinking coffee [people who drink coffee are more likely to experience a benign palpitation soon after or during a cup of coffee]. 
  • Consuming alcohol. 

Causes of Benign Heart Palpitations


To date there’s no definitive cause for benign heart palpitations. It’s widely speculated that benign palpitations arise due to the stimulation of the vagus nerve, but no conclusive evidence has proven this. 

Normal to excessive stress or anxiety is another widely speculated cause for benign heart palpitations. Again, no scientific study has proven that benign palpitations are associated with stress or anxiety. However, some cardiologist believe stress and anxiety can exacerbate a patients condition. 

If you’re experiencing heart palpitations, it’s highly recommended you seek professional medical advice to rule out any serious medical conditions. 

Do Benign Heart Palpitations Last Forever?


Benign heart palpitation can occur in people at any age or sex, but when palpations start occurring, the palpitations typically last forever. Many patients who experience benign palpitations for the first time, generally experience a skipped beat feeling every now-and-then, sometimes just once or twice a month. However, regular palpitation episode usually start to occur soon after, with greater frequency and intensity. Commonly these palpitation attacks can last less then a second, several hours or a few days, but generally only happen a few times daily or weekly. During extreme episodes, a person can feel a palpitation every one or two minutes, and sometimes several seconds long. However, these extreme episodes tend to subside or stop completely for a few days, weeks or even years. 


Are Benign Heart Palpitations Dangerous?


So the real concern is, are you going to die from benign heart palpitations? The answer is no. Benign heart palpitations are not deadly or dangerous. In fact, if you were planning to ride the biggest roller coaster at Disney World or climb Mount Everest, you shouldn’t alter your life because of your condition. However, it doesn’t mean you won’t experience a skipped beat or a prolonged episode during an adventure. 

Moreover, someone who has been diagnosed with benign heart palpitations by a certified cardiologist can continue to exercise [such as cardio exercise or lifting weights]. In fact, several patients who suffer from benign heart palpitations are bodybuilders, and participate in powerlifting. 

It should be noted, lifting very heavy weights, or participating in intense workouts can sometimes cause a skipped beat or two during peak intensity. This has been widely reported among workout enthusiast who were diagnosed with benign heart palpitations. 

In most cases, patients experience palpitations or PVCs after or before exercise, not during. Some patients have reported to experience a higher frequency and rate of palpitations shortly after exercising.

Okay, while benign heart palpitations aren't dangerous, if considerable plaque buildup exist in the coronary artery, there is a chance that a strong heartbeat can cause plaque to break off, which can possibly lead to a stroke or heart attack


Can benign heart palpitations kill you or are they dangerous?

Avoid Sugar and Chocolate


Many healthy people have skipped heart beats, we call them PACs or PVCs, but we have skipped heart beats and it’s a natural phenomena. Most of the time it’s caused by stress, it’s caused by adrenaline or cortisol or stress bio-chemicals. However, sugar and chocolate can bring it out because of the relationships between insulin and adrenaline in the body. Certainly caffeine can do it and alcohol can lower the arrhythmia threshold. So it’s important to consider these things. If you want to stop PVCs avoid eating refined foods, sugar and chocolate. 


Can Food or Beverages Cause Palpitations?


The most common substance associated with benign palpitations is caffeine. Most people are sensitive to any stimulant, but individuals who have a benign heart palpitations tend to experience a greater number of palpitations while caffeine is in their system. Eliminating or reducing beverages that contain caffeine such as espresso-based drinks like lattes, cappuccinos or soda can drastically improve palpitations. 

Some people complain that chocolate, alcohol or over-the-counter medications containing [pseudoephedrine] also increase palpitations.


Can Pregnancy Cause a Greater Frequency of Heart Palpitations?


Regardless if you suffer from benign heart palpitations or not, pregnancy can increase palpitations. Pregnancy causes a significant shift in blood volume and adds new stress on the heart, and mental stress. This has a tendency to cause rapid heart action not present prior to pregnancy. After pregnancy, the person may not experience palpitations as regular or might experience more palpitations due to stress circumstances associated with parenthood. 

Women with a history of benign heart palpitations often claim their condition lessened during pregnancy as their blood volume increases and cardiac output increases. 


Viagra Use and Benign Heart Palpitations?


Viagra [Sildenafil Citrate] use should be limited or completely discontinued if you’re experiencing heart palpitations during use. Not until you’ve been cleared by a certified cardiologist should you resume the erectile dysfunction treatment. Palpitations due to Viagra use could be associated with a more serious illness.

However, patients who suffer from benign heart palpitations are generally permitted by there cardiologist to use Viagra on a regular basis. Most patients never experience any palpitations during Viagra use, however, some patients claim to experience increased palpitations during use. 

Does Creatine Monohydrate Cure Heart Palpitations?



Creatine supplements (i.e. Monohydrate, Ethyl Ester, Tri-Creatine Malate, Buffered Creatine, Micronized Creatine, Liquid Creatine and Conjugated) can affect heart function and may cause high blood pressure. Although some clinical studies show ability to increase muscle mass and help fight muscle weakness associated with illnesses, such as muscular dystrophy and heart failure.




Preliminary studies also suggest creatine monohydrate may help lower levels of triglycerides (fats in the blood) and high concentrations of triglycerides. Its also been reported to help lower levels of homocysteine. Homocysteine is associated with heart disease, including stroke and heart attack. There have been a few participants in those studies who claimed to begin getting palpitations during creatine supplementation. Some bodybuilders have reported increased palpitations with creatine after supplementation.  


How does the Physician Diagnose Benign Heart Palpitations?


Diagnosing benign heart palpitations usually starts of like any other patient complaint, with a focus on things like over-the-counter medications, types of foods or beverages consumed. Followed by patient history, a physical examination of the lungs and heart are performed, including laboratory studies. Since most palpitations have a benign origin, a doctor may only require an ECG or basic blood work. If the patients symptoms appear more severe, such as loss of consciousness or lightheadedness due to palpitations, the doctor may require a comprehensive evaluation. This type of evaluation might involve CT scan with calcium scoring [a gold standard test], heart ultrasound, Holter monitor, EKG, treadmill test, or advanced blood test, including thyroid test. 

What Medications are Prescribed to Prevent Benign Palpitations?


There isn’t a medication that cures benign heart palpitations, but there are drugs to lessen the severity. Medications to treat benign palpitations are only prescribed by a heart specialist as they can cause serious side effects, even death if not used correctly. When used as prescribed, medications can significantly reduce episodes. Due to side affects and cost, most patients with benign palpitations prefer not to use prescription drugs to treat their disorder. 

The use of Beta-blockers or Bisoprolol, in attempt to prevent benign palpitations, is regarded as an off-label use of the drug. Beta-blockers are intended to treat true heart arrhythmias caused by underlying heart abnormalities. Other heart anti-arrhythmic drugs might include:
  • Amiodarone
  • Disopyramide
  • Sotalol
  • Propranolol
  • Ibutillide
  • Dofetillide
  • Flecainide
  • Propafenone
  • Quinidine
  • Stye Medicine
In terms of herbal remedies, there’s no definitive supplement proven to reduce the severity of benign palpitations. However, low levels of magnesium or potassium in the body could be associated with benign palpitations, and in some instances, be responsible for more severe heart rhythm disorders. Therefore, supplementation of foods high in magnesium or potassium can be helpful. 


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