Initial Upper Left Abdominal pain and Random Forceful Heartbeat

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wrafiq
New Member


Date Joined Aug 2014
Total Posts : 5
   Posted 8/12/2014 2:50 AM (GMT -6)   
Hi Everyone,

I am newly registered here. Been reading up things on this forums for the last month or so.

Thought I share my problem and see if anyone shares the same issue as it's not identical to anything i've read so far. And if by any slim chance could figure out what the problem is.

I am 28 Male and overweight 5'8 95Kgs. Married. Recently quit cigarettes in April. Never had any heart related issues before. Play football and Basketball every other week. Not under any real stress. I've got a recent salary bump and a new company car to look forward too. Though in May i learnt i was going to be a Father sometime early next year =)

So the issue started in late June this year. I was playing indoor soccer/football and midway through the game, my upper left abdominal area (end of the bottom of the left rib-where it curves). It felt bloated and like a muscle pull.
The pain wasn't going away for 2-3 days and it would hurt if I'd cough or stretched stretched that region.

I then decided to go to a GP and he said it was indigestion (which I wasn't very convinced of since the pain felt more muscle then stomach related) gave me meds for gas and indigestion. After 2 days on the meds i got very bad diarrhoea and went straight to GI specialist.(by this time, the pain had subsided abit) Did a series test - blood works, xray and ultrasound of the abdominal region and they couldn't find anything besides abit of a fatty liver. So the GI specialist concluded it was some sort of infection. Not wanting to treat it using harsh antibiotics, he gave me some probiotics and told me to monitor if the pain and diarrhoea.

2-3 days later I was feeling much better. Pain had gone down nearly 80% and no more diarrhoea. However maybe on the 5th/6th day while lazing on my sofa watching one of the world cup games, i got a very sudden hard/forceful heartbeat. I got a bit startled but soon forgot about it (being distracted by the football).

Then the next day I had a lamb pie for lunch and about half an hour after lunch, I had maybe 5 forceful heartbeats all within 3 minutes and I started panicking - i started feeling slightly dizzy and nauseated, not sure if it was a panic attack (never had one before also) or the heart that was in trouble but I really thought it was a heart attack. I quickly drove myself to a nearby medical centre and had ECG done. The ECG was all normal expect my BP had gone up to 155, the doctor said it was probably stress (meh). All tired out, I went home and took a nap while still not convinced things were fine.

That night I borrowed my parent's home BP monitor and my BP was fine 80-90s and I started looking up hard heartbeats on google and 70% of the things i read were life threatening which lead to me really stressing out about my heart.

I decided to wait and ask my GI specialist about it because I had a follow up appointment with him the next day. He brushed it off saying it was anxiety and stress so he gave me Xanax. Starting to believe it could be stress after all since 2 medical professionals concluded so, I started on the Xanax while also taking a time out from work for 3 days and spend the time chilling out at home with the wife.

During the next couple of days, I still noted an occasional hard heart beat. Maybe 2-5 a day but I decided to ignore it. But maybe about a week later, I woke up at 6 am to use the bathroom and while trying to get back to sleep my heart had a forceful beat then another and then another and the adrenalin kicked in. I was wide awake and very aware of my heartbeats. Started to do relaxing breathing techniques but after 10 mins my heart was still racing and I had a atleast 15 forceful heart beats within those 20 minutes. Thinking to myself, maybe the doctors was wrong and not wanting to worry my pregnant wife, I called my mum who lived down the road to pick me up and drive me to the ER.

At the ER, again the ECG didn't pick up anything, (by that time I had self diagnosed myself and thought it had to be a PVC or PAC after reading up on it) and was quite shocked to see a normal ECG reading. Told the on call doctor about what was going on and she referred me to one of the hospital's cardiologist. So I did more blood work, a stress ECG test, urine test, lung capacity test(not sure what it's called. the one where you inhale and blow as hard and as long into a tube) and an echogram. It was all normal according to the cardiologist, sensing my frustration, the cardiologist ordered me to wear an event monitor for 5 days(King of Hearts for those familiar). BTW the abdominal pain & slight bloating was slowly coming back but not as bad as it was when I first got it.

After 5 days and extremely confident I recorded about 30 forceful heart beats and was really happy that we could finally figure out what was wrong. I went back to the cardiologist and he reviewed the recording and the recording only showed 5 Missed beats and everything else was normal! He concluded that it's nothing serious. Told me to try to forget about it and relax.

I am getting so annoyed at being told to relax because that's what I've been doing for the last month or so. Work is not stressful at all, it's an accounting agency and it's only stressful at the start and end of the year Oct-March, it's quite a bore-fest during the middle of the year. It's exciting being at home cause we've started nesting/planning for the little one. I've started take heart friendly Supplements like COQ10 and magnesium. Cutting down spicy food.

Now, I've not got a major attack since mid July but the number of hard heartbeats have increase to maybe 15-20 a day from 2-5 a day. I've learnt to be at ease with it now but it does only really bothers me now if I get them in quick succession like 3 forceful beats in 5 minutes as i'll start to feel abit nauseated and there's this urge to burp. I still can't think of a trigger or if whatever i am taking is helping. Reading up on things, I think it might be a hiatus hernia but i don't feel like I have GERD, havent had the time to see a GI about it.

However, what really pushed me to seek answers again is I've just been scheduled to travel to tokyo and london alone for work in september for 2 weeks each and I am worried about what happens if I suffer something there.

Sorry it's quite long and for the grammatical mistakes (English isn't my first language) but i wanted to make sure i didnt leave anything out.


Hope to hear what you all have to say about this.

JungRulz
Regular Member


Date Joined Jan 2014
Total Posts : 394
   Posted 8/12/2014 7:16 PM (GMT -6)   
My first Holter this year showed 6000 PVCs/24 hr and some PACs. The second Holter this year showed 3900 PVCs/24 hr and some PACs. I've been living with them, in one form or another, for 40 years. Because of them, I drink no alcohol, no caffeine, and have never smoked. I avoid many cold medications and high potency supplements, I avoid energy drinks. Stress is a big factor, confrontational meetings at work would provoke tons of them, I'd take Klonopin before the meetings to reduce the effect. I've taken a Beta Blocker most of my adult life, it slows your heart and reduces the contractile force of the heart beating, either eliminating them entirely, reducing the numbers of them, or making them less noticeable.

There are Premature Ventricular Contractions with a Compensatory Pause after them, and Interpolated PVCs without the pause. The ones with the pause tend to feel like a hard thump since the heart filled with a little more blood than usual during the pause and when the normal beat occurs, the additional blood being forced out is more noticeable.

www.equimedcorp.com/rhythms/topic/40/

The following web page is by an Electrophysiologist which is a heart rhythm specialist. He addresses it from the perspective of a cyclist that is experiencing PVCs and wants to understand more.

www.drjohnm.org/2013/06/benign-pvcs-a-heart-rhythm-doctors-approach/

Another link that seems to cover the topic well is here, though I normally don't rely on Wiki for medical items, I think the article covers it well.

/en.m.wikipedia.org/wiki/Palpitation

It's important to see your doctor if you've never had them before and you notice them for the first time, or if you regularly get them and they get worse (6000/Day is not my normal level, hundreds per day was, when they increased, I went to the doctors again, I make no assumptions). Incredibly, most of the people that get them don't feel them and only discover them during routine physicals or while at the doctor for other things). 6000 a day is 4 per minute 24 hours a day. I didn't get them while sleeping, so over 18 hours of being awake, I got 5 per minute. To add insult to unjury, I'd get long streams of bigeminy, every other beat a PVC, and I'd feel odd, with the Compensatory Pauses, it cuts the heart rate in half, and at rest it's normally in the 60's, so during the bigeminy, the heart rate was in the 30's.

Anyone developing such symptoms should always consult their doctor or visit the E.R., but having been examined by your doctor and tested, you should rest assured that these types of rhythm disturbances (the doctors don't call them arrhythmias, they now refer to them as an "unusual awareness of your heart") are quite common and at this point you're lucky to have so few (but everyone I have still causes me anxiety).

Hope this helps.

wrafiq
New Member


Date Joined Aug 2014
Total Posts : 5
   Posted 8/12/2014 8:45 PM (GMT -6)   
Appreciate you took the time to respond to my issue.

The article by the Electrophysiologist is quite assuring.

I do have a few points i want to highlight:

1. My strong beats - they didn't show up on my event monitor. I thought recorded about 30+ but only 5 showed up. I also don't really feel any skips in the beats, i've been trying my best to quickly check my pulse after a strong beat but it seems fine. Also used my basic heart app on my phone. It's really feels like "thum tud, thum tud, THUMMM tud" Is it really my heart then? Oesophagus spasms?

2. That weird tender/bloated/sore feeling right at the bottom curve of the left rib. Just about an inch from the sternum. It comes and goes. Exercise seems to aggravate it. What could it be??

3. The number of hard beats are rising slowly. Started with 2-5 a day. Hitting 30s now.

Those points are my primary concern. Been to a GI and Cardiologist. Should i still persist going back to them or get another opinion or ride it out?

JungRulz
Regular Member


Date Joined Jan 2014
Total Posts : 394
   Posted 8/13/2014 7:17 AM (GMT -6)   
Our heart rate is constantly tweaked to meet changing conditions.

Respiratory Sinus Arrhythmia is where our heart rate (HR) increases as we breathe in and decreases as we breathe out. This natural effect diminishes as we get older.

Two neurological systems are tied to the heart, the Sympathetic (increases HR) Parasympathetic (decreases HR). When we eat, the parasympathetic nervous system, via the Vagus Nerve, becomes more active and it is connected to the heart as well. Alterations in HR will occur as a result.

We also have Baro Receptors in the Aortic Arch and Carotid Arteries in the neck. When we stand, blood pressure drops, they sense this and increase HR. If blood pressure increases, they sense this and slow the HR.

These changes in HR do not represent premature beats, rather they would be reflected as subtle changes in the timing of your HR. I suppose that given sufficient slowing of your HR as described above, the heart would fill with slightly more blood, possibly causing the feeling of a harder beat.

By the time you feel isolated skipped or premature beats, taking your pulse won't show anything. The premature beat is not felt, or felt very mildly. The thump felt is usually the normal beat. The only residue that may exist is Heart Rate Variability, the next few beats after a premature beat supposedly are slightly faster than the HR before the premature beat, I'm sure more so in young and conditioned people.

My premature beats have presented in various ways over the years, I no longer look for uniformity.

Oesophagus spasms? Do you ever have problems swallowing food or water? My stomach roils, sometimes when it's quiet it can be heard across the room, it feels like premature beats, occasionally it causes a few. This might be what you're feeling.

Not sure about the bloating near the sternum. May be more GI.

It doesn't hurt to return to your cardiologist with worsening symptoms or every few months until it stops being an issue or until they determine the cause.

There's a device on the market that attaches to your cell phone and you download an app, you can see your actual rhythm and save it. The company that sells it offers EKG interpretation for a nominal fee, or you can just show your doctor. It's FDA approved and shows one lead of results by holding in your hands, I think two other leads are available by pressing it against your chest or holding it in a different way.

pvct
Regular Member


Date Joined May 2014
Total Posts : 128
   Posted 8/13/2014 9:16 AM (GMT -6)   
JungRulz gives a wonderful and informative reply. I have these PVCs and PACs, as well as GI problems, as do countless others here. I have Ectopic beats and currently am going through some more of them. You can take comfort in what your GI and Cardiologist have worked up and there are a lot of people here that will give you their wisdom and support.
Hope things get better for you.

wrafiq
New Member


Date Joined Aug 2014
Total Posts : 5
   Posted 8/13/2014 8:09 PM (GMT -6)   
Thanks JungRulz!

Oesophagus spasms is just a thought since the THUMMMs don't show up on HR monitors. I have to say when i do get a few hard heart beats in a row (if thats what they are). My throat feels tight and constricted but I still can drink water and eat without pain. I've also noticed that when a THUMP happens when I am exhaling, there is a mini pause in my breath like as if the air being exhaled is cut off.

I was just asking about if I should revisit my cardiologist and GI since the Cardiologist said don't worry and the GI gave me xanax. Nothing to really target the issue.
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