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Elliot Ruff
Elliot Ruff,
Category: Cardiology
Satisfied Customers: 519
Experience:  GP at Whitstable Medical Practice
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I am having heart palpitations which are more of an

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Hello
JA: Hi. How can I help?
Customer: i am having heart palpitations which are more of an irregular heart beats. my heart rate is normal but every few beats i get that hiccup or flutter in my heart. i have had ecg and xray at a&e but it didnt show anything. i was told I'd have to be referred back to gp of which i have already gone that way before and had 24hr monitor . nothing was found because on that day i didnt have palpitations. they normally come on for a day in a month and usually around period or ovulation. this time its different . I've been having them for over a week and they dont go away for longer than 10mins sometimes . they are also stronger this time... i have ibs and reflux. i also take prescriptions iron tablets from time to time when my iron level is low.
JA: Do you know if your family has a history of heart disease? In general, how would you describe your health lately?
Customer: my dad suffers of similar symptoms but was never diagnosed with any condition as he doesnt like going to doctors. his mother my grandma had 4 heart attacts and a stroke within last 20 years of her life . she was 83 when she died
JA: Anything else in your medical history you think the Doctor should know?
Customer: my own health is ok .

Good afternoon, I am Dr Elliot and hope I can help

Can I ask how old you are?

Customer: replied 9 days ago.
36yo

Thank you, ***** ***** you for the useful answers at the beginning, a lot of people write a very small amount but this is helpful.

So a normal ECG and 24hr tape is very useful. However there are a few more things that should be done. Given they are sporadic I would ask for a 7 day tape/ECG, I would also ask to have an echocardiogram and blood tests to exclude any thyroid problems.

The symptoms you describe are likely to be secondary to ectopic beats which are completely benign and can be aggravated by things such as caffeine, stress, dehydration.

If it is considered ectopics and you continually feel them, there is the option to take beta blockers to control them. However you do not need to do anything about them assuming all the investigations are normal.

What you describe is quite common, but certainly a very unsettling feeling.

Does my explanation and suggestions help?

Customer: replied 9 days ago.
i have had an ultrasound of my heart and recent bloods done too.. all seemed to be normal . Could there be anything else that could cause arrhythmia because i lead healthy lifestyle i am not dehydrated and not stressing ( at least not that i know of) i also dont drink caffeine

I think any underlying cause is unlikely given the investigations being normal

Customer: replied 9 days ago.
ok ... thank you ...you have been very reassuring .

Could it be an anxiety/stress cause? The most common cause of ectopics can also be anxiety/stress as this causes a surge of adrenaline which will cause the heart to beat faster or harder which will give an unpleasant feeling of palpitations

Please could I also ask you to rate me response, this is the only way that I can be credited for providing answers

Customer: replied 9 days ago.
i am not sure about anxiety as i have them for just over a week and they are there throughout the day. my heart doesnt seem to be beating faster or harder ... just have those strong hiccups that sometimes make me feel like i want to clear my chest and cough. i also have a constant headache ( low grade)

Sorry, but on seconds thoughts, with hiccups, this can be due to indigestion/reflux/silent reflux, so not necessarily having heart burn, but this stimulus can cause vagus nerve stimulation which indirectly triggers palpitations.

It may also be worth trialling a PPI such as Omeprazole or Lansoprazole and see if it settles down after a few weeks

You can get a low dose Omeprazole over the counter from a pharmacist

Customer: replied 9 days ago.
i do have reflux and i take omeprazole for months now

Could you try an increased dose? What dose are you taking? and are you still getting reflux despite omeprazole?

Customer: replied 9 days ago.
is it safe to use omeprazole and propranolol if i had to take it for ectopics?
Customer: replied 9 days ago.
my dose is 20mg a day
Customer: replied 9 days ago.
i dont get reflux

Okay, so you could increase it to 40mg daily for a week to see if it makes a difference, but I would return back to 20mg if there is no difference

Customer: replied 9 days ago.
ok that sound good

I would hold of using Propranolol which increasing the dose to see if you notice a difference

If that doesn't achieve anything then I would use the propranolol to control it, I have some patients who take propranolol for 3-6 months and then find that the palpitations settle without the medication

Customer: replied 9 days ago.
you are right with indirect connection to reflux as i normally burp a lot for the past few days
Customer: replied 9 days ago.
that sounds promissing

Good, well I hope that helps

If you come back, then reply back to this thread and let me know how you get on, I would be interested to know

Elliot Ruff and other Cardiology Specialists are ready to help you
Customer: replied 9 days ago.
i will definately do .thank you x

Please could I ask that you kindly rate my response. This is the only way I am credited for answering questions, thank you and good luck

Customer: replied 9 days ago.
i have done so