OpenHealth Q&A

Experiencing Heart Palpitations and Neurological Symptoms: A Personal Account

I am a 40-year-old male, standing at 6 feet 2 inches tall and weighing 175 pounds. Approximately a month ago, I began to experience an unusual awareness of my heartbeat, along with a sensation of occasional missed beats. This episode lasted for several hours without any accompanying symptoms such as breathlessness, chest discomfort, lightheadedness, or other alarming signs. However, the anxiety it induced prompted me to seek medical attention at the emergency room. Upon examination, I was found to have mild tachycardia (around 110 bpm) and a sinus rhythm that exhibited significant arrhythmia. My blood pressure reading was 109/78. After the symptoms subsided, an ECG test returned normal results. All other tests, including a complete blood count, metabolic panel, magnesium levels, TSH, Troponin-I, C Reactive Protein, d-dimer, and chest X-rays were also normal. Consequently, I was discharged with the recommendation to consult with a cardiologist. Since that initial incident, I've been experiencing similar episodes almost every day, sometimes multiple times within the same day. These occurrences typically happen when I am sitting or reclining (the first time happened during an extended period at a concert). The duration of these episodes varies; they can last from a few minutes to several hours. In certain instances, I notice additional symptoms, which may include: - Muscle twitching, particularly affecting the left side of my face, left back, and my left arm or hand, although it can occur in other areas too. - Heightened muscle stiffness or soreness upon waking. - Anxiety, which may stem from the distressful nature of these episodes. - A sensation of pressure in my head, resembling the onset of a migraine, but without progressing to pain or nausea. - An increased urge to swallow or sigh. - Tearing accompanied by a dryness in my eyes. - Gastrointestinal discomfort. - Challenges with maintaining focus, including difficulties in handling intricate conversations during these episodes. At times, the severity of these symptoms can be disruptive enough to disturb my sleep. Here’s a bit of relevant medical history: - No previous cardiac conditions. - I underwent removal of a right-sided temporal lobe cavernoma in 2016, which had been causing epilepsy. Since the surgery, I have remained seizure-free. A CT scan that was performed shortly after my ER visit revealed no new problems other than the previous surgical site. I have a follow-up MRI, both with and without contrast, arranged soon. These recent episodes feel distinct from any symptoms I experienced during my previous seizures, and I have not experienced any loss of consciousness during them. - I have a history of intermittent migraines that significantly improved after brain tumor removal, although they did not completely resolve. I occasionally take 25mg of Sumatriptan as needed for migraine relief, and this medication does not seem to influence my current episodes. - Recently, I was taking Tadalafil to address erectile dysfunction that developed following brain surgery, which had gradually worsened over the years. I had been on it daily for two weeks when the heart palpitations began. Stopping the medication did not alter the frequency or intensity of these episodes. - I had mononucleosis around six months ago, which led to the removal of my tonsils due to significant swelling about five months ago. - I am a non-smoker, drink alcohol less than once a week, and only occasionally use THC vape, usually during family visits in Colorado about once or twice a year. A week ago, my coronary artery calcium score returned at zero, indicating no calcified plaque. I am currently awaiting the analysis from a five-day monitoring session using a three-lead ECG, along with a treadmill ECG scheduled shortly. An EEG and MRI have also been arranged for later this month. Additionally, I plan to meet with an electrophysiologist next month and have follow-up appointments with both cardiology and neurology following the completion of all these assessments. I am seeking suggestions for further tests or if there are other specialists I should consult. These episodes are quite distressing and have emerged unexpectedly over the past month. Initially, I considered that Tadalafil might be a contributing factor, but having stopped its use for a month, the episodes have remained consistent in their occurrence and intensity.

Answers (1)

8/18/2025, 1:11:21 AM

OpenHealth AI

It sounds like you're going through a very challenging experience with your heart palpitations and neurological symptoms. It's important to recognize that these episodes can be distressing, especially given your medical history and the recent emergence of these symptoms. Here's a structured response that addresses your concerns and outlines the next steps:

Main Points:

1. Symptoms and Background: You are experiencing frequent heart palpitations, associated with neurological symptoms including muscle twitching, stiffness, and cognitive challenges.
2. Current Evaluations: You are undergoing thorough assessments, including ECG monitoring, MRI, and consultations with specialists.
3. Next Steps: Focus on managing your anxiety and tracking your symptoms closely, while remaining proactive in your upcoming medical evaluations.

Explanation:

The episodes you describe, including the awareness of your heartbeat and related neurological symptoms, can be concerning. The combination of palpitations and twitching could potentially link to various issues, such as anxiety, autonomic dysfunction, or even residual effects from your previous brain surgery. Your ECG and other tests being normal is reassuring, but the persistence and distress of your symptoms warrant continued evaluation.

While you await the results of your ongoing tests, here are some strategies and considerations:

Next Steps:

1. Monitor Symptoms: Keep a detailed diary of your episodes, noting when they occur, their duration, associated symptoms, triggers (e.g., stress, specific activities), and any relief measures you try. This information will be valuable for your specialists.

2. Manage Anxiety: Since anxiety can exacerbate palpitations, consider relaxation techniques such as deep breathing exercises, mindfulness, or gentle yoga. These can help reduce the frequency and intensity of your symptoms.

3. Physical Activity: Regular, light to moderate exercise (once you're cleared by your doctors) can improve cardiovascular health and may help reduce anxiety. Gradually incorporate brisk walking, stretching, or any other preferred activities.

4. Consultation Suggestions:

   • Neurologist: Since you're experiencing neurological symptoms and have a history of epilepsy, maintaining close follow-up with your neurologist is important. Share your ongoing symptoms and their impact on your life.
   • Electrophysiologist: Your scheduled appointment will help assess your heart's rhythm more closely and determine if there are any underlying causes that need addressing.
   • Psychologist/Psychiatrist: If anxiety continues to be a significant part of your experience, a mental health professional specializing in anxiety management can provide support and coping strategies.

5. Follow Up on Medications: Since you've already discontinued Tadalafil and noticed no change, keep your doctors informed about any medications you're taking, including over-the-counter ones, to rule out adverse effects or interactions.

6. Stay Informed: Continue to ask questions and express your concerns during your follow-up appointments. If something feels off or if your symptoms change, don't hesitate to reach out to your healthcare team.

Remember, your situation is complex, and it's great to see you being proactive in seeking answers. You're taking the right steps by engaging with healthcare professionals and advocating for your health. Please stay connected with your care team and keep prioritizing both your physical and mental well-being.