AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Question late 30s, no meds, normal
8 weeks ago, I started feeling a strong heartbeat, like heart was banging/knocking into chest wall or lung - because it was followed by urge to cough (and would usually need to cough). For 10 days it was very uncomfortable and annoying. I'd feel it sitting up or lying down to sleep, especially on left side.
Dr ordered holter monitor, which I wore 6 weeks ago, but results came back with 'occasional ectopic beat' and no correlation between when I felt symptom and what was recorded. The recording was of poor quality, the technician wrote. The sensor pads were placed around my bra (to accommodate nursing baby). Could this have contributed to the poor quality recording, and could something have been missed because of the pad placement/recording quality?
Since then I still have bouts of the 'knocking' with and without the urge to cough. But in last 2 days, it feels more like fluttering now and more coughing. Still annoying and uncomfortable. I'm not ill and don't have dry throat causing cough. I think the heart/cough are related. But Dr said since the holter came back 'normal' there's nothing else to do, and that the cough could be due to any number of reasons. I'm worried. Does this sound like anything serious? What kind of follow-up should I pursue, if not with this Dr, then another for a second opinion #I'm in Canada#.
Answer Dear Ann,
The poor quality could well have been caused by your bra preventing good contact between sensor pads and skin. I suppose some information could have been missed.
If you feel a single bangs, then you're feeling ectopic beats, which are premature beats occurring when the heart is nearly empty because of the preceding normal beat. Then there's a long pause waiting for the next normal beat during which pause the heart fills extra full of blood so the next (normal) beat pumps out an extra large amount of blood, the heart moves more than usual and may thump on chest wall or lung and cause the cough. If you have two premature beats in a row, one right after another, you would feel an especially big bang. All this is normal heart activity, no threat to life or health for someone with normal heart structure and function. Your heart structure and function are almost certainly normal since you've recently had normal labor and delivery. It's not at all serious, in fact it's normal heart activity. You need not worry. Wait until you're through nursing. If you still have the big bangs every single day, get another Holter monitor. If not every day but still annoying, get an event monitor, a little box you carry with you for days that records your EKG a few minutes before and after it detects a premature beat.
Please write back if this note doesn't answer all your questions.
