Strong heart beat

Is anyone else often consciously aware of their own heart beat? My RHR varies between 52 and low 60s (I’m 53 years old) depending on time of day etc but I’m often very aware of how strong the thump is. If I’m sitting with my left arm up against my side it’s very pronounced.
I’ve had odd bouts of ‘extra beat’ syndrome but not recently. Is this just a side effect of a strong left ventricle?

I’ve always been able to hear mine, or maybe not hear it, but feel it in one of my ears. You can also see it in my stomach if I’m laid down on my back. Can also definitely feel it with my left arm against my side. I always just assumed it was normal?

Palpitations are often an electrolyte or hydration issue (more potassium probably), and are totally normal to experience sometimes. With the covid lockdowns a lot of daily food habits and behaviors have been tossed and you may not be getting what you normally do. However it sounds like you have a history of arrhythmia and it may be worth getting that checked out if it persists.

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It’s not a palpitation I’m feeling, I know what ectopic beats feel like. This is just regular ordinary rhythm but it feels so strong.

per webmd:

Palpitations make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

That’s what you’re describing :man_shrugging: Palpitation != ectopic heart beat.

OK I have never really looked into the true medical definition of palpitation but what I’m experiencing is definitely not an e topic beat. As I’ve said, when I’ve been stressed or anxious I’ve had that and know what it feels like. My BP is always normal or low normal so that’s not a concern. Maybe I’m just imagining it :grinning:.

At times my resting heart rate gets quite low, and then I can really feel each beat. When it started happening I got a bit worried and went to get it checked, was sent to the hospital for some ECG checkups but they didn’t find any anomalies and said it was fine and that my RHR was probably low due to training.

I still think it gets a bit too low, given that I’m not that serious with cycling and running, but try to not worry too much.

My average resting heart rate according to Garmin watch is 46 bpm as low as 38 at night. Which I get when I take it manually. I know optical wrist monitors get a lot of slack for their accuracy but it Matches my Tickr near perfect. I don’t feel my heart beat though.

I am slightly over weight and only work out 6 hours a week mix of cycling and running but I am far from athlete level.

I started noticing this in early September after a particularly hard week of training. The diagnosis was ectopic beats (premature ventricular contractions) from an ECG at the GP surgery and I was referred to a cardiologist as the onset was sudden and they are frequent.

I had a cardiac echo which confirmed the ectopics and mildly dilated left and right ventricles but otherwise normal function. Atria were right at the limit of normal size. This was suggested to be unsurprising in someone with my training history, nothing concerning.

They fitted a heart monitor for two weeks, which showed that 12% of all beats were ectopics, with HR ranging from 42 to 165. This is very frequent. The data showed the ectopics stop when I elevate my HR. This is also a good sign. I was following a TB plan as have been advised to avoid max effort for the time being.

I also had a CT scan (contrast angiogram). That was interesting. My HR was a bit high on the slab for a clear image. So they gave me beta blockers to slow it down and also try to calm the ectopics. It didn’t stop them that I could feel. I could see the ecg trace live. What they noted was the ectopic beats all looked identical on the trace. This apparently signals a single point focus cause.

It took over a month to get the CT result. They were looking for coronary artery disease. It came back that I have very slight furring of one coronary artery. Nothing that would explain the ectopics and again this was considered a good result.

However I was told to get my cholesterol checked and I should go on statins if it was high. I was thinking well there’s no way I can train more than TB HV to control it through exercise. I eat a lot of eggs as we have chickens. It was slightly high in 2013 at my last check. And I’ve put on about 10% weight since then.

I got those results last week. My total was 4.2, HDL 1.2, ratio 3.6. These are mmol/L so not the units used in the US. They’re good numbers though, and better than before (5.2, 1.1, 4.5) and I can keep eating the eggs!

Small note: a lot of the weight may be muscle mass. I took up rowing in 2015, my thighs are bigger, and there is a study from Denmark saying small thighs are bad news for heart health.

I think that probably means I’m going to make it. I don’t think very slight furring is abnormal at my age (48). Can’t have an annual CT scan to check on it. But I can monitor my cholesterol regularly to check it’s still good.

They still don’t have a root cause. I’ve been offered an MRI to check for subtle changes in the heart that could be the cause. There could be scar tissue. Ultra endurance has been associated with this, and I’ve done Paris Brest Paris 4 times now. They want to do an exercise stress test to confirm the finding it settles down under load. No sign of a date for those yet. I think the covid situation is slowing things down.

Meanwhile as everything so far suggests nothing dangerous, I’m going to do a ramp test on Tuesday and see what my TB gains are.

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I’ve had ectopic beats for years. Lots of people have them. They’ve never caused me any problems.

With mine the onset was very sudden. Here is my heart rate variability chart from the Apple Watch around the time my ectopics started.

The heart rate variability spiked on the afternoon of 5th September. Then that evening I did Mary Austin -1. It was lying in bed late that night I when I then noticed the palpitations, and they were very strong. The recorded HRV went from around 40ms to 360ms. It’s stayed elevated ever since though it’s not that extreme. It isn’t a true HRV number any more, it’s being thrown off by the ectopics. It’s clear some thing changed then.

This is going to sound odd, but hear me out…

Did you change shampoo around that time?

The reason I ask is EXACTLY this happened to a friend of mine. He went through all the tests, they found nothing, until he happened to mention to a different GP that ‘at least he wasn’t going to go bald’ - he’d switched to some sort of caffeinated/chemical shampoo to try to stop hairloss. Apparently, palpitations and ectopic beats are a rare but known side effect of this.

Probably not the case for you, but I thought I’d throw it out there. Obviously any medication/medication change around the same time period would also be relevant.

My heart used to beat strongly enough that my girlfriend would complain about it shaking the bed.

It’s actually possible to estimate SV and CO from such vibrations.

Are you sure your having ectopics and not something else such as svt? Ectopics are simply feeling the heart miss a beat or feel like an extra beat. Examples are PVCs and PACs.

The diagnosis was PVCs. I don’t think that alone would have led to these investigations but the sudden onset and very high frequency (1 beat in 8 over two weeks) were flagged as concerns. As the cardiologist said on day 1, the vast majority of people who have my training history will find that it’s just an over sensitivity due to enlargement of the ventricles, when heart rate drops at rest, and will turn out to be nothing to worry about, but there are several things she needed to rule out before saying it’s good. Her speciality is arrhythmias so I’m in the right place.

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Interesting one. I haven’t changed anything around that time. The only thing that I can trace to around that time specifically was I was reaching the end of SSB MV II, but had done a double session on the water at the rowing club, and got carried away racing. Rather than ditch the day’s TR session, I moved the next two days back by 1 day, so had 4 hard days in a row, missing a recovery day. It was the following weekend from those 4 hard days when the palpitations started.

My other half is a veterinary surgeon. She says based on the results so far, if I was one of her patients, at this point she’d have discharged me. “They’re only doing the MRI because they can”. Though it’s been several weeks since they offered the MRI and no-one has been in touch about a date.

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This is very normal especially with your left arm by your side and you will probably notice it when you sleep on your left side. Just like how you feel your pulse it different places around the body e.g. neck, wrist, you can feel your heartbeat at the chest in different places. What you’re feeling is your apical pulse point, which is the most bottom point of the heart, where it forms a point like shape. It is the point of your heart that is closest to the chest and even moves closer to the chest whilst it contracts. Also, as you mention it is where the big strong left ventricle is close to, so easy to feel the force, especially in thinner and fitter people. I am a cardiac scientist who specialises in performing cardiac ultrasound (echocardiograms) and often in thin and fit patients when you put the ultrasound probe at this point you can feel the heart beating through the probe.

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Had a girlfriend who basically wouldn’t snuggle with me in bed b/c my heartbeat was so loud. had to settle for spooning (vs her head anywhere near my chest). Went for a medical procedure a couple weeks ago, nurse puts stethescope to my chest and says “Good Lord your heart is loud!!”. Be proud of it, be happy it’s working.

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I got comments last time I was in for a physical. I don’t really think that much of it these days but even when I’m in subpar shape my heart is presumably fitter than average.