Sorry, another question about missed beats

[Onthepulse]

Hi,

Still got them:weep:.

Does anyone get them when they go for a walk? I always found a walk would get rid of them but they were still skipping away. When i have eaten they are skippy and last night in bed i couldn't lie on my back because it made them worse. My belly is really popping wind at the moment and all i can hear is "pop,pop,pop". I really am thinking this is contributing to the sudden onset of these horrible skipped beats again...i have been really gassy.

Thanks in advance for any help


Pulsey

[hannybun]

Hello

Just thought I would let you know, wind, gas around the heart causes this, its harmless xx

[Onthepulse]

Hi Hannybun,

I know about the wind & gas thing causing this and mentioned it to my doc, but was told being anxious is causing the wind!
I have never had it so prolonged due to wind before. Last year, i came back from holiday and my stomach was so bloated, i was getting the irregular beats so decided to see doc and she said i had ibs... i did have loose stools for a while, but i just have wind now, really bad.
I could pump for England...:blush:

Pulsey

[Panickypants]

I have noticed that when mine are worse i have a very noisy bottom lol..i never realised this could cause them x

[RLR]

Well, you're precisely correct that GI disturbances can induce benign palpitations to occur and with very good reason; the GI tract is innervated by the pneumogastric nerve, which ascends to become the vagus nerve. The vagus nerve innervates the heart, lungs, spleen and even the larnyx among other terminal points.

When gas is trapped in the lumen of the intestines, it can cause pressure against the walls of the smooth muscle. This movement and pressure can cause the pneumogastric nerve to produce an evoked potential, or impulse of the neurotransmitter acetylcholine which travels along the nerve and ultimately to the synapse or terminal end of the vagus nerve. The vagus nerve is part of the parasympathetic nervous system and wherein the sympathetic nervous system represents the gas pedal, the parasympathetic system constitutes the brakes. In other words, sympathetic tone speeds things up, parasympathetic tone slows things down. In the case of the heart, the evoked potential arrives and depending upon precisely when it enters the cardiac cycle, you can sense it as a flutter if during atrial depolarization, a hard thump if during ventricular depolarization and even a perceived absence of a beat if it occurs during ventricular repolarization, or the stage of the cycle where the heart is briefly motionless before initiating the cycle once again.

Vagus-induced palpitations have often been experienced by all people but they fail to make the association. If you've ever been suddenly frightened or startled, you've likely experienced rather dramatic action by the vagus nerve on the heart. Surely you've heard people in such instances exclaim "That made my heart skip a beat!" or "That made my heart stop for an instant!" or "My heart nearly leaped out of my chest!" These are all classic examples of people experiencing vagus-induced palpitations. People who have had this experience in the context of something like watching a horror movie do not associate the sensation with any type of pathology because there is a direct temporal relationship between the precipitating event and the subsequent physical sensations. Do you see my point here? In other words, people who have all had their heart skip a beat when suddenly frightened do not subsequently develop the notion that something is wrong with their heart. It's a normal physiological response to fear, so the brain rationalizes it as normal and inconsequential. Most importantly, once the fear passes, the events do not continue to occur. This is the focal point which you must come to realize.

This is precisely what is happening in your case, except you are unable to make a direct association in the temporal context because stress and anxiety can produce mildly elevated neurologic responses associated with something known as fight-or-flight, wherein the body responds to any fearful or startling stimulus by either preparing the body to fend off danger or the ability to run from it. People who experience this innate response in the context of chronic anxiety or stress come to believe the changes in physiology to be associated with some type of underlying physical disease. Most often, they worry about their heart and this begins to establish health anxiety that only serves to increase apprehension and worry, ultimately increasing symptoms in a cyclic manner. Because the anxiety or stress is constant, so are the palpitation events and this is the juncture which so wrongly sends patients down the path of believing something which was originally normal, now constitutes something different altogether. Do you see the connection here?

Understand that the body's physiological response to fear is normally brief, but in the presence of anxiety and or significant stress, there is a constant imposition upon the mind and body which causes a continual response at a low level. Patients so afflicted might exclaim that they just feel generally ill, fatigued and as though something has changed in their health status. In fact, it is a gross misperception of mere physiological changes that alters the affected person's rationale and they consequently make a direct association between their physical symptoms and some type of underlying physical disease.

Patients in this predicament often develop extensive medical files that depict constant and repeated medical tests in search of an underlying pathology which doesn't actually exist, but because the symptoms persist, they are unable to believe in tests which constantly prove negative. They oftentimes rather believe that something is being overlooked or missed by these tests and the physician rather than any possibility that their entire perspective is at the root of the cause. In other words, they go in search of a physical cause because they become unswervingly convinced that if symptoms are present, there is a disease responsible. Nothing could be further from the truth.

When tests are negative, they're negative. The algorithms of these various diagnostic protocols are based on actual disease. If the disease is not present, then the test is incapable of revealing its presence. It doesn't overlook it.

In sum, vagus-induced palpitations have no origin in disease and they are an entirely normal physiological response occurring in a manner which the patient is unable to rationalize like they would if it occurred in the context of an immediate fearful stimulus. This type of palpitation is not an arrhythmia of any classification and although they can technically appear as premature or paroxsymal ectopic contractions, they are entirely dissociated from pathological arrhythmias characteristic of underlying disease. Subsequently then, vagus-induced palpitations are entirely incapable of inducing any type of cardiac event. They are benign in every sense.

The short answer here is if you relieve the GI problem, the palpitation frequency will correspondingly decrease as well. There is nothing wrong with your heart, either structurely or electrically.

You'll be fine.

Best regards,

Rutheford Rane, MD (ret.) aka RLR

[Going home]

Ive been aware of the influence of the vagus nerve on the heart for quite a while now and so glad that we have a doctor on board to tell us exactly how it works. When the connection was made for me I didn't believe it, until I started taking ant-acids and the skipped beats almost entirely stopped. All the years that i'd had various heart tests, and a small chewable stomach tablet was all it took to stop them for me :blush:

GH xx

[xfilme]

RLR... I sugger ectopic beats and wonder whether it might be related to digestive probs. Ive been really stressed and worrying about it for a year. Your response totally put my mind at rest. Thank you so much. x