OH's 'illness'

Could it be more psychological than physical?

Am no doctor and he should go back and speak to them but if all those tests have come back clear and he does suffer from panic attacks I'd be more inclined to think the PA's are enhancing the palpitations. It's a vicious circle as far as I can see with one causing the other. ie - he'll have a PA if his heart flutters but that also, the PA's convince him he's got a serious illness.

Maybe the doctor could send him for CBT (cognitive behavioural therapy) to help him cope with the PA's?

? for you and him though. It sounds scary for him.

I agree it sounds more psychological, anxiety related which are causing the panic attacks. It does seem like some sort of therapy would be helpful if the medical tests have come back clear.

I'm not medical but it does sound a lot like a panic attack and I've had a fair few of those, mostly back at uni. The palpitations begin before the full on panic hits. I got myself through them by distraction and don't get them anymore, when I feel myself getting palpitations either from some kind of worry or out of the blue I just breathe deeply through them now.

I think it could be to do with anxiety. I suffered with anxiety and my heart at times felt like it was about to jump out my chest, the more paranoid you get over it the worse it is. Maybe tackle the fact that it could be this, if he is in a relaxed frame of mind and not worrying then see how he feels.

Sounds like anxiety, culminating in panic attacks. I dont know if antidepressant are used but well worth going to the docs

I think this - just need to get him back in that Dr's surgery..

I had a similar problem in August 2010. It started with a night out, there was a fight in the pub so I left early and went home, when I was sat in bed I started getting a 'fluttery' sensation in my chest and then my heart felt like it was trying to beat its way out of my ribcage and just would not slow down, no matter much I tried to relax myself. This then happened on a few occasions over the next couple of weeks and the second that my heart first did that little 'skipped beat' feeling, I would start panicking and just work myself up into a ridiculous state, convinced that I was having a heart attack.

One day I was at work, and the fast beating started again and ended with an ambulance being called to take me to hospital. 6 hours, blood tests, x-rays and ECG's later I was sent home being told that there was nothing wrong. 2 days after that, back in hospital again with the same symptoms except this time I had gotten myself so worked up that I was convinced I had shooting pains down my left arm and all sorts and I genuinely thought that I was going to die. All pretty scary at 22 years old. The same tests were repeated, again all came back clear and I was sent home with a GP's appointment the next day.

At the GP I was given an asthma test and subsequently an inhaler. The GP believed that the initial problems started with a small asthma attack, (which I wouldn't necessarily have recognised as I didn't know that I had it), made worse by my constant panicking that there was something wrong with my heart. The fear built up so much over time that it caused the physical symptoms to follow. I was also referred for 6 sessions of counselling to teach me how to deal with any stress, and how to calm myself down if I felt like things were starting to build up again.

18 months later and I still get the occasional fluttery feeling in my chest, but I now know how to combat this and calm myself down before it gets any worse.

Like your OH, I hated going to the doctors/hospital with this as I was convinced that every time I went into the hospital, I wouldn't come back out. It's that fear that makes the symptoms worse and needs to be dealt with. If all of the tests are coming back clear then there IS nothing wrong, it is just going to be a case of tackling the psychological issues to prevent the physical symptoms from appearing again.

Sorry for rambling, I just thought that by writing it all down (maybe you could show him?) it may help to reassure him that things are going to be ok?

It could be a panic attack but I'll put a different slant on it. I had 7 years of palpitations and debilitating exhaustion. 7 years of being told it was anxiety and that I thought about it too much. Until 7 weeks ago when I contracted an infection and collapsed in the GP surgery and lost consciousness. I was blue lighted in an ambulance to hospital and they did a normal ECG which was normal. My OH then said to the consultant do it when she stands up...this showed my heart rate dramatically increased and blood pressure plummeted. I have since been diagnosed with condition called POTS syndrome and am finally receiving treatment.

I would definitely get him back to the doctors and keep going back until a solution is reached.

I have a heart condition that causes palptiations that are nothing to do with panic attacks. (called an SVT). The electrical system of my heart "short circuits". I have had lots of investigations and monitoring and a period on beta blockers, but once I was certain that it was not life-threatening I felt ok about it. it's just one of those things and I don't want the surgery thank you very much!.

Does your OH need more reassurance as to the causee and effect of this palps? Anything to do with hearts can be extremely scary.

He hates the fact that it cant be explained and that the 'fluttering' (perfect description) happens when he is seemingly chilled out and watching TV. Last night it woke him up and because he'd been laying on his arm he had pins and needles and was convinced he was having a heart attack.

I do need to get him back to the doctors.

It could just be panic attacks, or it could be some kind of arrhythmia - SVT has already been mentioned, or could be something like paroxysmal atrial fibrillation/flutter. These things can be very hard to diagnose though, as if they only happen at random and don't last very long, they don't get caught by standard ECG/blood tests unless you're actually having an ECG when it happens.

If he can, get him to keep a note of when he gets these feelings and how long it lasts. If he can measure his own pulse at that time, and whether it is irregular or regular (can be hard to tell if it's fast!) then even better! If he hasn't already had a 24 hour ECG, then this would probably be the next step for him.

Lots of people are convinced they're going to die/are having heart attacks during panic attacks, actually. Though it is less common for a panic attack to wake you from sleep.

As a nurse and someone who has panic attacks, it does sound like it could be panic/anxiety related. They can happen even at times of rest (mine happened when i went to bed, and made me feel like i need to run away from something). Panic attacks are very much a physical condition with syspmtoms that can make you feel really lousy and like you are going to die - I would advise that your OH does some proper reasearch into them and if he can gain an understanding on what is happening physically it might help him learn how to control and even overcome them. I used a great CD call mindworks panic prevention program and it really did help as it explains what is happening and how to thinki yourself out of it.

It could be worth him looking into this but if in doubt ALWAYS go bakc to the GP, especially if the symptoms progress/ worsen.

Similar to others, all my EGCs etc have come back normal - in fact my heart - valves and blood vessels etc - are all in jolly good nick.

I did have a heart monitor on for 8 days so they could record lots of activity. It was a bit of a pain, but like Enterflora my heart rate leaps up from 60 to 200bpm in seconds. I've also passed out from it which is why iIhad to get it investigated.

Is most definitely not "all in my mind" (not that there is anythig wrong with that) so don't let your OH get fobbed off.

Might sounds weird does he get indigestion alot.? My OH was getting palpitations and was panicking about it, turns out (after 1 zillion tests) its linked to the indigestion, now he has tablet for the indigestion the palpations the sleep apnoea have both vanished!

I sometimes have heart palpatations (though not often) and doctor said it could be down to my anaemia as apparently this is a side effect as such. He might have got them from something small but now perhaps could be more psychological?

Enterflora - I will definitely show him this. I have told him that I will nag our Dr too if he doesnt because it's not fair for him to be so on edge.

It was me who said that they are a 'physical condition' - what i meant by this is exactly what you have pointed out - it is the flight or fight response kicking in that causes a very physical response (palpataions, becoming clammy, feeling a need to vomit/defecate, run, hide). I understand that the triggers are emotional/ anxiety related but they they don't always happen at times of stress for everyone. I have had them for the past 5 years on and off sometimes they can happen as im trying to get to sleep, sometimes waking me up if ive had a stressful dream, whilst having a relaxing bath, driving to work, sitting on a train ... the panic is not always directly linked to anything that can be identified as a 'danger' to produce such a response.

Basically the underlying cause is psychological but the symptoms are very physically real (I've heard some people say that panic attacks are 'all in your head'.... when your heart is racing and you've just puked and you do feel like your going to die, it doesn't matter where it is, you just know that your body shouldn't feel like that)

As I also said though at the end of my post, he should keep going back to the GP if he is concerned or gets worse.I just wanted to say that don't rule panic attack out completely..... For his sake I hope that they can give him a more thorough check and better advice and support for what ever the cause may be.

Has he had his thyroid checked? Some women in my clinic have problems with palpitations and we check thyroid function as a rule as hypothyroidism can cause palpitations.

Might be worth gettiing a TFT (thyroid function test) at his GP.

This is not strictly true. Anxiety (and therefore the physiological response) is caused by an interpretation of a trigger. The trigger could be anything including internal triggers, external triggers, triggers that you aren't even conscious of- literally anything at anytime including when snoozing or asleep. That is one of the worst things about panic- that it is so unpredictable. So a flutter of the heart (that could be normal or abnormal) if interpretted as a sign that "I am dying" is then understandably going to cause anxiety and the associated physiological responses. The physiological response could then be interpretted as further confirmation of the initial thought "I am dying" and it is this confirmation that then causes the panic attack (because it becames a vicious cycle and a rapid escalation of the anxiety). This is the difference between "anxiety" and "panic". The feelings that cause alsorts of responses in people in cluding, becoming hypervigalent to what is happening internally because they are worried that it is going to happen again- this hypervigalence then picks up on small changes on things in our bodies that are normal but often go by unnoticed- therefore the cycle becomes worse.

So, it could be that there is something physically wrong and there may not be- who knows unless further tests are done.

The fact that these incidents pass and he is still is alive suggests that there is a psychological aspect to this i.e. his interpretation of the trigger isn't entirely accurate. It doesn't make it any easier to deal with though and I wish him all the best. Psychological problems are still real problems and very difficult to manage.

I'd suggest going back to the GP for further phyiscal tests and also asking for a referral for CBT (evidence based for treating anxiety and panic) but not counselling (there is no evidence base). I hope he gets it sorted x x

CG - Thyroid is a good shout he's always struggled with his weight. He only has to look at a biscuit to put on a stone. He cycles 16miles a day and plays football 4times a week and after changing his diet he's only lost a stone in about 12months.

Thats okay EF, I did understand what you were saying and total agree that the treatment for a panic attack is based around psychological therapies and interventions rather than physical treatments that would be used for SVT. In terms of the OP some sort of 24 hour tape could be useful as this would be able to show what his heart is doing when he is 'relaxed' and trying to settle down. Any condition that effects the heart is blooming scary if you don't know what is causing it (Spent years as a kid rushing to get my mums angina spray when she went through a phase of having frequent attacks and it was scary).

PP - I hope you OH manages to get the answers he needs and if he wants to borrow that CD that I mentioned I'm happy to post it to you?