palpitations continue

[MKR]

I am a new poster having just discovered your site last night. I had an AVR last June (mechanical valve inserted) and in December had an aortic root replacement that was required after they found an aortic aneurysm in a routine followup in October. Aside from some fatigue, I had thought my recovery from the first surgery was going well until they found the aneurysm, which obviously was a shock since I had to go under the knife again. My question is this: Since the 2nd surgery, I have been experiencing ongoing heart palpitations that seem to be worse when I lay down at night, sit on the john, etc. While the beat seems regular, my chest and often my head pulsates so strongly it feels like it is going to jump out of my body. My cardiologist did a halter monitor a few months ago which showed no irregularities, which was confirmed by a recent echo that thankfully showed everything is OK structurally. What is confusing is the fact that I did not have palpitations following the first surgery, which makes me wonder whether it has anything to do with the root replacement and new dacron tube. Has anyone else experienced this and if so, are there any suggestions on how to stop it, does it eventually go away, etc. I went back to work 8 weeks after the second surgery, and while I'm having to live with the palpitations, they are very disturbing, especially at night. I am currently on coumadin and toprol for HBP that was detected after and probably brought about after the 1st surgery. Any thoughts or suggestions?

 

[Ross]

Hi and welcome to the forum

December till now and your having them, I'm not so sure they will go away. I could see it a month or two after surgery, but this far out.....not likely, but then again, everyone is different. In other words, I'm just taking a pot shot guess.

If they didn't see anything on the monitor, I'm not sure what to say.

 

[Karlynn]

I'm with Ross, sounds like you may need to see some medication for this if it is disturbing you. Have you had a Holter Monitor done (which monitors your heart for 24 hours?) I would recommend that this be your next step.

And welcome!

 

[MikeHeim]

I had palpitations before my surgery and then for about two months after surgery. Like yours, mine were always worse when I was sitting or laying. I still have the sensation (I wouldn't call it palpitations) of my heart beating when I lay down on my left side, so I try to avoid that as much as possible for the sake of comfort. From what my cardiologist told me, palpitations aren't an issue in their own right, but can point to more serious issues. If you've been seen by the cardio and told you don't have any other issues, I'm not sure there's much you can do.

 

[Karlynn]

If you've been seen by the cardio and told you don't have any other issues, I'm not sure there's much you can do.

Medications can be tried. I would caution against going with any of the serious antiarrhythmics if the palpitations are benign. They can have some unwanted side-effects. However, sometimes something as simple as a beta blocker could help. I take Toprol to keep my heart rate down and to diminish my palpitations. It's worth exploring. I had horrendous arrhythmia prior to my surgery. Even though none were deemed life-threatening, they were life-style threatening. Fortunately my VR solved most of that, with just a little residual that Toprol works on.

 

[TomS]

The dacron aortic root replacement echo's the sound of the heart beating. I've learned from others on this site that it is normal. Mine (with a mechanical valve as well) beats very loud and hard, and I feel each beat...and it is fine. Are you sure that you are not just experiencing this versus palpitations?
Tom

 

[jax3172]

Palpatations

Palpatations

I often have palpatations. Sometimes they are worse than other times. I can feel my heart beating strongly in my collar bones, neck, and back. I also have funky heart beats (atrial runs, PVCs, etc). They do seem worse in the evening when I lay on the couch after dinner. I also have a dacron ascending aorta and AVR but my plumbing job was done all at once. My point is this: maybe the common denominator is the ascending aorta replacement. Maybe there's something about it that causes (at the very least) strong heart beats. Many on this site have had this procedure so I'm anxious to see if this is a common problem with ascending aorta replacements. If so, wouldn't it be nice to have the doctors tell us that!

 

[MKR]

Thanks for the feedback

Thanks for the feedback

Thank you all for your input. I have wondered whether the palpitations are a byproduct of the dacron covered aortic root, which if so, I guess I will learn to live with. Given my surprise in October when I learned of the aneurysm, I guess it is normal to feel a little paranoid.

 

[Kathleen]

If the holter shows nothing perhaps a low dose anti anxiety med may help. You could be having a late emotional response to what your have gone through. If it helps to make your head not feel like it is going to blow off you would know where you stand and then could take the proper course of action for some additional help.
Kathleen

 

[ladyofthelake]

thoughts or suggestions

thoughts or suggestions

MKR,

Maybe it is possible that when they cut through tissue one of the larger heart nerves was maimed? The nerves can and do heal. I once had a severe arrhythmia that showed me some days of Non Sustained VTach. Oh, that was soooo not fun and it took me quite long time of 4 months before my heart rhythm smoothed out again. That one required the use of an anti arrhythmic drug, long term. I recently, also had a very incorrect attempt to wean off the anti arrhythmic drug that netted me a 7 PVC a minute arrhythmia that lasted for several months (that’s an anxiety producer just to type it!!!! lol). That entire arrhythmic experience did finally simmer down to a 2,000 ectopic beat a day arrhythmia after 8 months of it - so that is when I knew the Vagus/Heart Nerves were actually healing from that upset they encountered. When one of the larger Vagus nerves is knocked out of wack it can take it quite awhile before it stops bouncing (metaphorically). My doc always says "the nerves are one of the slowest healers in the body" The fact that your skipped beats are occurring when you are still or at rest is more of a sign that they are not caused by you, mentally. However, I think that many people that have to experience arrhythmia do feel anxiety when it happens and the anxiety with the worry about it will produce more anxiety adrenaline to help your palps feel even stronger. It is good that your holter test showed a non-eventful reading a few months ago. It may be that when you are active you don't feel your missed beats as well as you do when you are silent and relaxed.

I agree that anti arrhythmic drugs can be a disaster (as I am such living proof of that) but I do believe the most helpful of meds is the beta-blockers - your Toprol. Psychiatric anti depressant meds/SSRIs/Paxil - not good either because most of them inhibit HERG making you more arrhythmia prone with much greater risks, they can not be ethically/competently used with any blood thinner meds because they increase the risk of gastrointestinal bleeding 10 fold and they interact with beta blockers as the both inhibit CYP enzymes which makes them potentially toxic together. So I think the one med that may be helpful that doesn't have these types of severe concerns may be a light dose of a tranquilizer if it is that difficult to manage.

My tips that I have picked up to help me cope when I am showing a 10,000 abnormal beat a day, nasty heart tango holter reading is - gentle coughing may help reset your H Rhythm, I always sip on cool water which helps to wet down the nerves - hydrate them, splash cold water on your face, neck and use a damp cold cloth on wrists - which serves as the dive effect, sometimes if they are very frequent missed beats/PVCs and it is a good time for a shower I will bend my head under the facet and let cool water run from the back of my neck to wet my hair and that actually has stopped some arrhythmias. Also, when my Cardiologist reads one of my messy holters she will call me and say - Hey are you taking your Omegas and Magnesium?? If not, please do so now. One of the safest and natural anti arrhythmics is magnesium supplements (a 200 mg of magnesium glycinate pill does the trick for me and it does not interact with many meds) Also, using a combined 500+ mg EPA an DHA dose of Omega 3 may be helpful to keep a better rhythm if Coumadin is not a big issue but that one is not as safe for people on blood thinners and it needs to be checked out first. Last but not least, both my Cardio and her assistant recently jarred my memory to do gentle walking when my heart decides to tango on it's own and it does help, it burns up the extra adrenaline/catacholamines that are feeding the abnormal heart rhythm. Two hours of extra sleep a day when I can get it when my heart nerves have been, long term nasty has also been helpful. (There are some cases reported of even severed nerves growing new fiber and healing) So I hope something in my “unruly heart nerve toolbox” is of help to you and hope the nerves heal up for you soon.

(For reassurance sake, on all the benign abnormal heart rhythm statements you hear, my heart chamber sizes and ejection fraction and all other measurments are all very normal - up to this point, despite the amount of arrhythmia - and leaky valves I have had to manage and I have been arrhythmia free or just minimal tolerable normal misses for the past year that I have healed from bagging the anti arrhythmic drug

 

[azpam]

I agree with Lisa. I also take magnesium glycinate for arrythmias,omega 3's, and also hawthorne to keep my pulse low.I like the alternatives before the drugs and have worked very well for me. I also take Juice Plus-17 fruit and vegetables in a capsule form.( The only one by the way out there analyzed by the FDA twice and studied ALOT by many universities with independent double blind,placebo controlled studies.)I loved it so much with all that research that i became a dealer! Alternatives are the way to go for me. I have "stalled" my surgery for 10 yrs now by taking alternatives. My cardiologist in February asked me:"How long ago has it been since i told you that you needed surgery NOW-your valve is bad!? I said "10 years ago".He finally admitted he was wrong that day and said "whatever i was doing, to keep doing it!"

 

[Nan]

Hi and welcome.

I also agree with the use of magnesium, perhaps along with calcium too. And if you can take it without a problem with coumadin, omega 3's. (doesn't seem to impact my INR, but clear it with your doc, maybe check sooner if you decide to take it). And a mild anti-anxiety agent to help you throught it. I was once speaking with someone who got frequent palps and he said he either had a martini or a tranquilizer to get him through!

Even though they can be benign, they are sure upsetting to the person having them.

Lots of luck.

 

[aussigal]

I have these also and have had the same OP as you...
My Cardio always remarks on how loud my valve is and I feel it is even louder because of the Dacron tube attatched.
I feel the heartbeat very clearly and as well feel any odd beats just as clearly. Being 10 weeks post-op I am still new to this and panic just a bit everytime something new is noticed and race off to see my Cardio. This time I was told its pretty normal and not to worry unless my heart starts to race at 150 beats per min. as well.
One of the problems with irregular beats is clots but the treatment for them is warfarin so we are already covered for that. Beta Blockers like Toprol which I notice you take as do I are also another quick-fix for these palps. You may just need an adjustment to you dose or to settle your mind that these are not as bad as you think, cos you did have the suggested tests and have seen your Doc. about it.
I would think it is likely an anxiety issue. I was in denial about that but as soon as my Cardio gave me the all-clear most of my palps pretty much went away. I too was having them at night for hours on end.

I hope they settle for you like mine have, they can be very worrying. I like the suggestions of cold water, a shower, coughing etc...I got out of bed and moved around a bit some nights and that helped.