New member looking for advice on heart issues (vagal nerve?)

[AstroJ]

Hello,

I have often consulted the forum in the past as a lurker when looking for guidance but I now have a specific enquiry so I have decided to sign up to this wonderful community. I'm hoping somebody can offer some advice.

For the past two years I have been suffering from debilitating anxiety that is all focused around the function of my heart. It began with panic attacks and thudding heart with dizziness and tunnel vision, as well as aches and pains in the chest, shoulders and arms over a period of weeks before eventually I went to A&E. As you would expect, everything checked out fine but there was some concern over my heart rate (around 140 even after calming down and laying in the hospital). I returned to A&E a month or so later and this time, whilst in the ambulance, my HR was varying wildly from 80 to 140 within a few beats and I was getting incredibly nauseous. The ECGs all were fine though apparently so I was referred to the care of my GP.

From the GP I was referred to a cardiologist and had full work up done (3 day monitor, stress test, bloods, echo, etc.) and found that I have sinus tachycardia but was once again told that "the problem" was anxiety. At this point I should mention that I have a long history with anxiety and panic, particularly health anxiety and OCD.

To cut a long story slightly less long (sorry for rambling), over the ensuing 18 months, I have tried to combat my stress and anxiety and have succeeded in reducing the panic attacks and my overall resting HR has dropped from around 100 to 70-80.

However in the last year, my symptoms have become much more specific and provoked more by physical things than by anxiety or stress. I have been struggling with standing up from a sitting or lying position, bending or squatting down, climbing the stairs, stretching and yawning, passing a bowel movement , singing, and on a particularly bad day, even things like drinking too fast or swallowing hard.

What happens is, I get a feeling of faintness and a wave of pressure and nausea which I can only compare to the feeling of G-force when you take off in a plane. This lasts for a few seconds and what follows is a feeling of weakness particularly upper body weakness and a thudding heart with late, skipped beats as I exhale.

The late heart thuds feel as though my heart wants to beat earlier but is delayed and becomes overly full with blood and then has to pump extra hard. It's an incredibly unpleasant squeezing sensation. When this occurs after climbing the stairs it can also be painful. Not the same kind of anxiety related muscular chest pain that I have previously experienced, but a pulsing tenderness that I feel in my chest and throat with each thud.

I'm quite content with the results of my cardiology tests and feel that my heart is healthy, so this is no longer a fear. However, it didn't take me too much Googling to find out about the vagus nerve and its function and as my symptoms are often associated with problems with acid reflux, bloating and a sense of relief after burping, I'm pretty sure that this is where my problem lies.

The problem is that knowing what is causing these issues isn't making it any easier. I have been out of work for the last year because I can barely function. I can't climb the stairs, I can't lift anything, I can't even bend down to tie my shoes. Getting up in the morning is the hardest part of the day because showering and getting dressed leaves me feeling totally weak and nauseous.

I have been going back and pestering my GP again recently after 6 months of being almost totally housebound. I went through 6 sessions with a PWP, then I was put on Sertraline but this gave me an incredibly upset stomach. I also decided that I don't want to be on mood medication as I have no problems whatsoever with depression or low moods. More recently, I have been going to CBT, then I was put on Propranolol. The beta blockers were great at stopping the thudding but the late beats, pressure in chest and weakness remained. After a few days they started to give me horrendous migraines and I became concerned that beta blockers would not be good if I'm having problems with the vagal nerve as reducing my overall blood pressure could lead to vasovagal syncope. My GP agreed and has prescribed me another SSRI, Citalopram. This brings us to today.

I haven't started on the Citalopram yet because I have read that it shouldn't be taken if you are experiencing palps, irregular HR or tachycardia (all of which I am). I have requested another appointment with my GP to discuss this. I have brought up my vagal theory with a few doctors and none of them want to entertain the idea. They want to treat the anxiety and while I recognise that there is a relationship between the two, I think I can handle the anxiety myself as I always have done. CBT doesn't seem to be effective for me because it pertains to challenging my beliefs but all of my symptoms are physical and I have zero emotional or stress triggers any more. I acknowledge and find comfort in the fact that this started as anxiety and panic attacks but I feel that my nervous system is now feeling the after effects of sustained heightened anxiety and need to manage and treat that, instead.

Wow, I have really rambled on here. I apologise but I think this is the first time I've tried to articulate any of this stuff in writing.





I'm just going to summarise with a quick TL;DR:

My heart thuds painfully and uncomfortably with skipped beats and faintness, nausea, chest pressure upon standing up, bending down or climbing the stairs. I am unable to work and running out of money/goodwill from loved ones. I believe this is due to an overstimulated vagus nerve but doctors don't want to explore this. Meds don't agree with me. What can I do? Has anybody else experienced this?


Oh, also... Should have put this at the top. I'm male, 24, 6'2" and weigh between 11-12 stone. My blood pressure is on the higher end of normal but I believe this is because I am tall and slim. I have very poor circulation and this has got worse because I haven't been able to be active. I used to be fit but now I am incredibly unfit because of all this but I eat healthily, don't drink, no caffeine, no bad sugars, no junk food, no smoking, nothing fun like that.

Sorry about this ridiculously long post and thanks for reading if you got to the end.

[Aaahhfreakout]

Yes! I also have the pressure problems on standing, bending, etc. It started long before my palpitations but now they can be triggered by these movements. It usually calms down after a few seconds but it's no fun feeling like my head, heart and neck are going to explode. My vision can drain away a bit too or go sparkly.

Also, I know for a fact that the vagus nerve can trigger skipped heartbeats. I've done it on ECG with yawning, burping, straining, etc. 100% correlation, no doubt at all.

I have brought up my vagal theory with a few doctors and none of them want to entertain the idea.

I brought it up with a doctor and he was quite the opposite, he was very interested in how I've managed to trigger skipped heartbeats from even burping and yawning. He was telling me about the vagus nerve stimulation tests they did with ice cold water in medical school, slowing the heartrate to the extent they'd pass out.

It's not the same guy but there's a cardiologist who's very open-minded who makes YouTube videos, I'd highly recommend his channel as he talks about palpitations, the vagus nerve, and all sorts of stuff:

https://www.youtube.com/user/YorkCardiology/videos

My own personal suspicion is we have to imagine the heart and nerves has become irritable and we have to calm them and let them return to normal over time, by reducing stimulation from adrenaline, acids in food, chronic hyperventilation, etc.

[AstroJ]

Wow, thanks for your response. It is very reassuring to know that others have felt these weird sensations. I know it's a bit of a cliché but anxiety (and especially heart anxiety) can feel very lonely sometimes when the doctors are telling you everything's fine but you don't feel right.

Thank you so much for the YouTube links, I have watched quite a few of his videos this evening and I feel I have a much better understanding of these delayed beats as ectopic beats.

One video in particular could explain the G-force like feeling that I get. I can't post the link because I'm a new member but it is titled "Palps and that sinking feeling in my stomach"

I have requested a callback from my GP tomorrow so will discuss ectopics and more of what I have learned with her tomorrow.

[Aaahhfreakout]

When you say to a GP that you learned from a cardiologist's videos, they've got to take you more seriously or they might end up looking silly as the cardiologist obviously knows a lot more about hearts than they do. I hope it goes well.

By the way, I forgot to say I've had the pressure problem when standing up, bending over, etc. for a much longer time than you, going back a couple of decades I guess. If it's the same thing, it can't be too bad a symptom.

I'm not sure if it's got a name but it might be this (or something like this):

https://en.wikipedia.org/wiki/Orthostatic_hypotension

I've not investigated it too much so far, though. The blood pressure test for it sounds simple, though. A competent doctor should do that.

[Buggs]

"The late heart thuds feel as though my heart wants to beat earlier but is delayed and becomes overly full with blood and then has to pump extra hard. It's an incredibly unpleasant squeezing sensation. When this occurs after climbing the stairs it can also be painful. Not the same kind of anxiety related muscular chest pain that I have previously experienced, but a pulsing tenderness that I feel in my chest and throat with each thud."

This right here happens with me all the time. Most of the time it happens while resting and AFTER climbing stairs or walking up hills. I went to a cardiologist a few years ago who explained to me that as long as you're not experiencing it DURING strenuous activity, you're likely fine.

But yeah, I read that and I'm like dude that's totally me!

[nietweer]

Hi AstroJ,

Very unsetteling to read your story. First, because I feel bad for you that you have to go through life like this. But also, because I have very similar symptoms and similar way of thinking.

I think you and me both are very 'aware' of our hearts. To what it does in every situation. Getting up from a chair, I probably feel the same as what you do. Heck, most of the activities you mention are the same for me. When I'm feeling good and not anxious, I can climb stairs and do most things just fine. But when I'm already nervous or anxious, the symptoms get 10 times worse and just climbing a stairs will make my heart beat heavy and rapid.

And, like you, I have fear and anxiety about my heart for around 5 years now. I measure my heart rate also very often during the day. As long as my heart beats correctly and regulary I am fine. But as soon as I start exercising, stressing, feeling something weird in my chest or belly, then I start measuring my heart rate obsessively again.

Doing this for years might indeed have an effect on our bodies. Since 5 weeks now I have many arrythmia's at the moment I almost fall asleep. Never had those before.
Next week I'll get a event monitor for a week, so hopefully the doc will be able to see what's happening.

But, as the doc says, it's most likely just anxiety. If you're anxious for so long about something, it must have an effect. We think we can handle our anxiety just fine, but maybe we can't.

We're making our bodies tensed, stressed and work in a different matter. Maybe we're creating our own symptoms. Exercise for instance is very important for our bodies, but if we don't do it we make our hearts and bodies worse.

Anyway, I don't really have an advice or anything. Just wanted to let you know that you are not alone in this. The only way out is probably getting cleared by the docs and then just try to pick up life again where we left. And that includes work, exercise and climbing stairs.

Keep your head up mate. Our minds play tricks on our bodies.

[AstroJ]

Thank you for your kind words, nietweer.

I can't overstate the positive impact that the YouTube videos linked earlier in this thread have had on me. Having a professional cardiologist explain things in such a thorough way, particularly as it pertains to the heart and anxiety, has been a massive reassurance.

I would definitely check out his videos on ectopics, sleep and posture, if you haven't already.

The sleep thing you mention is interesting because in the last couple of months, I have been getting my worst ectopics first thing in the morning. Particularly if I set an alarm or am woken by somebody at the door. Every morning, I wake up with these skipped beats and feeling faint and almost like I have flu, until I sit up and get out bed.

I've since had more GP appointments and I'm feeling better about my future. I have two more CBT sessions and I've started doing some light exercise and applying for jobs.

It's still a daily struggle but hopefully we'll get there.

Good luck with your heart anxieties!

[Charlie1108]

This topic really interests me. I'm 31 weeks pregnant and been suffering terribly with palpitations and skipped beats. I can have the beats all day on a bad day. I've had ECGs, an echo and only today an appointment with a cardiologist who said my heart was completely normal (relief). Anyhow, the palpitations are terrible after food. I've also noticed when I eat and am calmer; such as today, I get the exact same symptoms as you. Personally, I go hot, spacey, feel faint and then I panic so heart palps start. These attacks are way more apparent when I'm not in a state of anxiety. I'm wondering if it's the body's response to a calming of the nerves? The vagus nerve really interests me. Although I absolutely hate the feeling!

[Catherine S]

Charlie, you've had this explained to you in your threads recently. I personally have referred to your stomach and diaphram being compromised during the later stages of pregnancy, which can result in the Vagus nerve being irritated, and because it runs through your heart it can result in a fast beating heart and skipped beats and flutters etc. So you think this might be the reason for your heart problems?

ISB x

[Charlie1108]

I understand the palpitations etc when stressed out but find it strange to experience such weird sensations when not in a state of anxiety. I've had good news today which has calmed my nerves so I get this weird, dizzy head pressure thing. I suppose it makes sense when you've been living on your neves for so long that the reactions would be so extreme. I've been reading a lot about the nerve and how it responds and it does seem to correlate. Just need to calm the nerves down I guess? It's almost like anxiety is saying "don't forget about me"!