A couple of weeks ago, I was sitting on the couch, reading, and I started to feel weird. I noticed that my heart was beating irregularly. I've had heart flutters before, and usually they just pass. It's a weird, kind of uncomfortable sensation. Have you ever felt this? This time, I did some yoga breathing to relax but the feeling didn't pass. I put my fingers on my wrist to feel my pulse, and yes, I was having irregular heart beats. I got up to get my stethoscope and put it on my chest. Very irregular.
I considered what to do. I'd been down this road before. About 10 years ago, I had something like this happen. I had chest pain and palpitations while working at the hospital. I was sent to the ER and put on a heart monitor. Of course, the act of putting me on the monitor was curative, and my heart rhythm was back to normal. I followed up with a cardiologist, was put on a 72 hour heart monitor, which was essentially normal, except for the tachycardia (fast heart rate) that occurred when I was running. Ha! I wonder what the technicians thought when they saw that!
So in light of that, I decided to ride out this episode. I felt ok, and I knew, as a medical person, that if I went to the ER, in February, which is the thick of cold and flu season, that the triage nurse would take one look at me, see a thin, athletic looking woman, and think low cardiac risk. She probably would start to judge me and think anxiety. I know how these ER nurses think, since I used to be one of them. She'd put me at the bottom of the priority list, and I'd probably sit in that waiting room for hours while they took people who were much sicker than me. That's how the ER works. Knowing all this, I figured that if I felt worse, I could always go to the ER, or I could see my personal physician the next day.
******Disclaimer: I'm not recommending anyone do what I did. If you are feeling chest pains or rapid/irregular heart beats, you need to get it checked out! I possess enough medical knowledge to be dangerous to myself. You know what they say, medical professionals make the worst patients. Do as I say, not as I do.******
The symptoms finally passed and I haven't had another episode since. Curious to find out what could have happened, I did some research. Conventional wisdom tells us that exercise is good for our heart, and puts us at low risk for cardiac issues. But some controversial studies have come out that say maybe TOO MUCH running is not good for our hearts. What happens when we run?
There's no question that endurance activities put a strain on our hearts. Your heart is a muscle, and when you train, that muscle works hard. Moderate exercise helps strengthen that muscle, and is considered "cardioprotective", or good for your heart. But what about more intense endurance activities, like marathon running or triathlons?
Over time, the heart adapts to endurance activities by increasing the effectiveness of the heart to pump blood to the body. In other words, this leads to increased muscle size of the heart and a lower pulse rate. But running an endurance event, like a marathon can lead to temporary changes in the heart muscle that indicate damage. The good news is that for most of us, everything returns to normal after 24-48 hours. And even though you do hear of people dropping dead at the finish line, those events are really, really rare.
What could be causing my palpitations? Studies show that these irregular heart beats are more common in older athletes. Actually, irregular heart beats are more common in older people in general. There can be several different types of palpitations. But for the purpose of this blog post, I'm going to focus on the 2 most common types of palpitations that occur in athletes.
Premature ventricular contractions (PVCs) are fairly common in athletes of all ages. There are several different theories behind this, but commonly these beats are thought to be an "escape" rhythm felt between normal beats of the slower heart rate in the well trained athlete. Random PVCs are not usually a problem. I've had these many times, and I think that's most likely what was going on with me that afternoon.
There are other causes for heart palpitations that have nothing to do with running. Fatigue, caffeine, stress, thyroid problems, and hormonal changes (pregnancy, menstruation, and menopause) can also cause palpitations.
When is an irregular heartbeat a problem? Palpitations during a run are usually considered to be more serious than those that occur during rest. Those need to be checked out. But other palpitations? Like mine?
I haven't had any further episodes. There was no associated chest pain. Oddly, once I had a glass of wine, things settled down. I'm not sure what caused my heart to flutter. God knows I've had a lot of stress lately. The good thing for me is that I've had this worked up in the past, and everything was 100% normal. For now, I'm ok to wait.
And you know, it's still better to run than to sit on the couch and think about running.
But when in doubt, get it checked out.
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