Palpitations & Standing Up

[SeattleRain]

How many palpitations do you have per day, and what do they feel like?

For those that have the strong, forceful, "throbbing" contractions after standing up - do you know why this happens (specifically)?

After a month have having maybe 1 palp, I'm starting to have them regularly each day (5 - 10) again. I don't buy the "it's normal" bologna my doctor tells me. It's hard to imagine that never having a palpitation my entire life, to having 20 - 30 per day is "normal".

[imapumpkin]

It's not "normal"...but it's also not dangerous. some days i have no palpitations, some days i get them all day long, some days i get the during my bouts of tachycardia. People get palpitations for any number of reasons...hormones, anxiety, arrhythmias it can be dehydration...palpitations suck and they feel really scary--- i get the throbbing contractions too and often they make me very nauseous, but palpitations shouldn't be a cause or concern. like a lot of POTS symptoms (chest pain for instance) it seems like it should be really concerning but unfortunately it just goes along with the territory. If you think your doctor is blowing you off you can always get a second opinion...but from what I understand palpitations themselves are not dangerous and not nec indicative of a dangerous condition.

blinkofani explained it well in the post "Tachycardia Palpitations." You can search it to see her explanation.

[SeattleRain]

Thanks for the response. I did see blink's response in your thread and that did make a lot of sense. When I went to the cardiologist I put (not a concern) next to my notes about palpitations so he didn't focus on them as the problem. But they definitely seem like they're related to another problem I'm having...

Are the throbbing contractions when you stand up? Or just at any times?

[Canadiangirl73]

I have had a lot of documented palpitations (PACs,PVCs, NSVT, SVT) via Holters and event recorders are they mostly correlated to postural changes (lying to sitting, standing to lying, etc.). I really believe it is tied to cardiac filling, more specifically filling of the left ventricle which is the heart's main pumping chamber. In a non-POTS person, it takes only two heart beats to bring back up the blood that is pulled down by gravity. In us however, the complex mechanism is faulty so blood pools making our heart work harder to adapt to the shift in volume. I have had bigeminy (normal sinus beat, PVC, normal sinus beat, PVC, etc.) after a vasalva-type maneuver which modifies venous return. So IMHO and in my case, I have definitely put the two together. If I do something that affects the venous return to my heart or if I don't wear my compression gear to help with pooling or if I'm dehydrated and didn't have enough salt, I will definitely get more of those.

Also, I had several ECGs lying down and standing and the standing ones show my T-waves (to simplify the "electricity" in the ventricles) are flat or inverted. After founding that out, I dug a bit deeper and found that studies came across this phenomenon in POTS patients. Dr. Raj at Vanderbilt even discusses this briefly.

http://www.ncbi.nlm.nih.gov/pubmed/17617070

http://www.ipej.org/0602/raj.htm

I was told these are benign. They are uncomfortable at times and yes they can be weird or scary but I've learned to keep them at bay as best I could by eating salt, being hydrated and wearing all of my compression garments. I never had them before the onset of POTS; they started two months afterwards. I've had POTS for 18 months and palps for 16 and I'm still here! Hope this helps!

P.S.: The palps do wax and wane like the rest of the symptoms and I have more of them when I'm more potsie.

[MomtoGiuliana]

I can have 100's of PVCs/PACs in a day some days. For me, digestion seems to set it off, or sometimes positional changes. I know it is very uncomfortable, and it is normal to feel alarmed. It's good to get reassurance from your dr that it is benign. It is a very common POTS symptom.

[Tuesday]

I had pretty much constant palpitations for 3-4 months. It's not dangerous (assuming there are no other underlying structural issues with the heart).

Like others, I would have hundreds in a day. It became so normal for me that I almost didn't notice it.

The palpitations themselves are not something to be afraid of. They are a symptom, and you need to figure out what is causing them (low bp? low blood volume?) and work with your doctor to understand where to go from there.

For me, the palpitations were the symptom that finally lead to my diagnoses, so I'm pretty thankful for them They have gone away as I've gotten other things under control with medication.

[imapumpkin]

I get the throbbing the most intensely when I go to get out of bed, but all of them are the throbbing kind and happen sporadically throughout the day for no apparent reason. I also have been having them for half of my life and not just since I have had POTS so I'm sure POTS makes them worse.

[Guest Alex]

Before being diagnosed with POTS I only had episodes of tachycardia.

Shortly after I started taking a bunch of meds that keep my hr within manageable limits, I have started experiencing all sorts of weird palpitations. A Holter monitor helped my dr identify those as pvc's. I can have none or a whole bunch of them during a 24 h period, but I haven't seen any pattern in their frequency or distribution. My assumption is that they are meds side effects. My cardiologist reassured me that while they may be bothersome and scary, they are benign in a structurally sound heart.

Alex

[joyagh]

my last holter showed 2500 PVC's per day, and my TTT was inconclusive b/c I had constant palps. it was b/c I was lying down. For me, I get more lying down - constantly. When I increase my HR (simply by standing or moving around - it goes up to 110-120 and I get breathless) my palps stop.

I've been on 50 MG of BB's for a couple months now, and it helps the palps. I still get them but far fewer. I personally think my heart is used to working harder when I'm upright, so when I lie down, it's pumping too hard for the demand and I get PVC's. also I think I have an adrenalyn problem. I can feel the rushing of it to my heart.

maybe for you the palps start when your heart starts pumping harder when you stand?

BB's do help.

[SeattleRain]

Wow - 2500 is a lot! Are they painful for you? Mine feel like being shot in the chest with a cross bow - extremely painful and startling.

My palps come like clockwork in the morning right after waking up and laying bed. If I have them standing up (not very often) - they feel different. Not as painful but more uncomfortable, like there's a difference in blood flow/volume. I also notice that if I'm walking around and then lie in bed on my right side in a certain position - they're completely predictable - and start happening almost immediately.