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Strange heart rhythm while lying on right side???

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Posted 9/7/2005 2:18 PM (GMT 0)
I have the strangest occurences of an odd heart rhythym if I lay on my right side, most of the time my neck needs to be at an angle to get this.

My heart suddently takes off in hard, strong, fast beats. I tried to discuss this with pcp and he muttered something about vagal nerve response and tense neck muscles. Which wasn't very informative at all. Apparently, he didn't feel that it was dangerous, I don't guess... getting info out of this doctor is like fishing without bait... darn hard.

So, I'm wondering if anyone here has ever had/heard of this???

-Sarah

Posted 9/7/2005 7:31 PM (GMT 0)
Hi Sarah!  Unfortunately arrythmias are a mystery to a lot of PCP's and even some cardiologists.  There are quite a few different types of arrythmias.  To determine which type you have usually an EKG needs to be done during an episode, so most cardiologists will have a person wear a heart monitor at least for 24 hours so they can hopefully catch an episode on tape.  How fast does your heart rate get and does it slow down on its own?  Until I had an ablation procedure, my heart rate was getting up to around 215 beats per minute and would not convert to regular rhythm without a trip to ER.  The last couple of years before my ablation I was going to ER about once a month!  Very frustrating!  My arrythmia was called Supra Ventricular Tachycardia.  Don't you just hate it when a doc "dismisses" a concern that you have!  Maybe a new PCP is needed and a referral to a cardiologist to find out what kind or arrythmia you have then a treatment can be determined.  Best wishes to you, Pat
Posted 9/7/2005 9:31 PM (GMT 0)
Hi Pat and thanks for your thoughts. I've been the cardiologist route and worn the holter, but they say normal sinus rhythym, all tests on my heart are great. It's just lying on that side with my neck bent. It doesn't get all that fast, just a sudden run of hard beats and it stops immediately upon me changing positions. I am seeing a neurologist tommorrow, so will bring this up since it could possible be an aggravated nerve somewhere.
-Sarah
Posted 9/7/2005 11:17 PM (GMT 0)
Hi Sarah! tongue

 

Pat gave you some good advice and it seems that by referring you to a neurologist your Dr. gave you some good direction as well.  It's funny how the vagus nerve can cause odd things like this, but it has been known to happen.  I included a link below that is not a quick read, tongue but if you were interested I wanted to make sure I made it available for you.

 

Good luck tomorrow at your appt!!  Please let me/us know how that goes.

 

Hugs, Teri tongue

http://circ.ahajournals.org/cgi/content/full/96/4/1209

Posted 9/8/2005 2:19 AM (GMT 0)
Teri, thanks for the link but I couldn't understand a word of it..lol. I just had another "episode" of the strange beats. I was sort of hunched over my computer when it happened. Eased off when I straightened myself up. This is getting on my nerves so badly. I go for a week or so and start doing really well anxiety wise.. then get an episode of this and just backslide into a panic attack.
Afterwards, it still feels to me like an odd beat... but someone else can take my pulse and feel it being steady and even. So that must just be anxiety.
Definately going to lay this out for neurologist tommorrow. Maybe I'll get lucky and he totally understands what I am talking about!!!
-Sarah
Posted 9/8/2005 2:47 AM (GMT 0)
Sarah, I'm sorry, but it was the closest thing I could find for the vagus nerve and any type of arrhythmia. :( Please let me know what the neuro Dr. tells you!!

Hugs, Teri :)
Posted 9/8/2005 5:57 AM (GMT 0)
Hi Sarah! I just got done posting to you on the PVC topic. What you're describing here is something that fascinated me and drove me nuts for about a year. (I know, I've had every arrnythmia known to man. Well, it would be close. My least favorite was V-fib following heart surgery, but bless Ben Franklin and that kite of his! LOL!). ANYway....this used to happen to me - still does, once in a while - and, being tuned in to all this stuff I would notice it and it would feel like PVCs or SOMETHING - and yet my rate and rhythm would be normal. I couldn't stand it, because I already have enough stuff I know really IS going on in there! So finally, at work one night it started up on and off, and things were pretty quiet, and I hooked myself up to an idle monitor and the ER doc just said to holler at him when it happened. First time he was in the bathroom (of course) and the nurse who did see it freaked because she didn't know what it was. FINALLY the doctor was handy and saw it. I already had my theory in place, but of course couldn't prove it, and couldn't see the monitor screen. Now then - I'm not saying this is what you're feeling, but it works the same way, is totally benign (don't you somehow come to hate that word eventually? My daughter has the same thing going on now). It's called Accelerated IdioVentricular Rhythm (AIVR) and what happens is the normal signal starts to conduct through that Right Bundle Branch Block, so the beat starts "downstairs" instead of up in the sinus node like it's supposed to. Since it starts in the ventricles the beat is more forceful and you notice it (unlike when things are working according to Hoyle). It generally means nothing, is often seen in conjunction with RBBB (I understand your RBBB is "incomplete" which means it's more or less intermittent). Anyway, this is one possible explanation for the phenomenon you describe, and it's an OK one. That thing where you get your neck in a certain position very well could be the vagus effect. Again, no biggie clinically, but tell that to the anxious patient. Right. Hopefully this helps: the vagus nerve starts out in the brain, travels down the neck alongside your carotid artery (don't be rubbing on that tendon there, either, unless a doctor tells you to), down your esophagus and all throughought your GI system. It helps slow the heart rate. It's part of what's called the sympathetic nervous system. The parasympathetic nerves help speed up the heart. OK, when you're lying down you're trying to relax (I guess) and the heart rate tries to slow down, via impulses from the vagus nerve - which is also busy helping you to digest your food or telling you you're hungry! So the obvious conclusion: having eaten or being hungry or having an upset stomach can all be associated with PVCs, or pressure on parts of the neck, etc. The body is a marvel - but I'd really like to speak to the designer. Know what I mean? :)
Posted 9/8/2005 12:34 PM (GMT 0)
Okay.. which side of the neck does this nerve run down? I have extremely tense neck muscles, feels like bone sometimes.. and have spasms in there that make me have vertigo issues. Had one spasm while driving once that had me thinking I'd had a stroke I was so suddenly dizzy. Had one walking once and for two minutes I swear I was walking sideways. Can tense neck muscles interfere with this vagus nerve? Can it become compressed? I go see a neurologist today to look at the left side of my body, due to possible nerve compression somewhere... my left side extremities like to go to sleep on my at odd moments, and I can't raise my left arm about shoulder without it happening.
The whole heart thing just flips me out. It's my major anxiety point. Took me a long time to figure out that the chest pain I have is reflux problems. Would send me into instant panic (I can't have "normal" heart burn pain... no burning sensation in throat.. just pain and acid taste). My dad was ill my entire life with heart problems.. he had congestive heart failure, which the docs are telling me is not an inheritable condition. So, I guess I transfer some of that, and each "heart related" blip I feel in my chest throws me back into memories of being in hospitals and calling ambulances for my father and of course, the anxiety there makes it harder and harder to deal with.
I've had these strange beats come a LOT with a movement. Like sitting forward to type, or leaning back, or reaching for something, or squatting down to pick something up. It seems like Im aggravating something (vagus nerve, maybe) that connects to the heart and lets me know it's aggravated through it???
I do not have any dizziness associated with these strange beats. Used to, but that was the instant panic over it and once I learned to control that, the dizziness stopped. No shortness of breath. No any other strange stuff going on, but the quick hard beats.
I go to the ER, they put me on a monitor and looks perfect. I've worn an holter, they saw nothing but normal sinus rhythym. They have picked up a normal sinus arrythmia on an ekg there, but doc says it is my size.. they see it a lot in kids and thin people and I'm very petite. Something about a longer pause between beats while lying flat cuz the heart is filling with more blood or something. The ER doc said absolutely normal.
Well, that's enough rambling.. must go to neuro.
Thanks for the input!!!
-Sarah
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