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 i am a 50 year old post menopausal female who has been experiencing a funky 'extra hard' type of beat. I feel it as a thudding sensation that sometimes is accompanied by a full feeling in my neck and head. Mostly it is only one thudding beat- however once it continued for a few beats and almost caused me to pass out. I immediately went to a cardiologist- had a stress echo, and also had a 24 hour holter monitor. Neither showed anything except 'normal activity' for my age.... This has become frustrating as it is starting to happen more and more frequently and feel now if i continue to complain i will be perceived as a hysterical female. I do not take any medication except a baby aspirin daily [when i remember] for Factor V Leiden and an occasional xanax [half a.25mg] before bedtime to help me stay asleep.. [menopause is causing insomnia and estrogen and FVLeiden don't mix]- I am starting to become concerned that i am going to drop dead from one of these episodes even though they are telling me all is okay. They are happening more frequently- and happen at any time, sometimes just sitting in bed, sometimes when i am hungry and others after i have eaten. I have started to run again [i used to run about 5-15 miles/day and it does NOT happen during that time. It also is not accompanied by any actual pain. Not sure where to go from here and it is starting to make me nervous.
Some more hx- I had a PE while delivering my daughter 23 years ago- none since. I have normal PT/PTT's and INR's- I have had US's to r/o DVT's and CT's to positively r/o PE's -all negative. What do you suggest my next step be?
Thanks for any direction you can offer....
Answer Dear Beth,
You're probably having extra heart beats called premature contractions. If they occur soon after the preceding heart beat they are not felt as extra beats because the heart is still empty and pumps little blood. The longer-than-usual pause after the extra beat lets the heart fill with extra blood, so the beat after this pause is an extra hard beat. Premature beats are normal heart activity, no threat to life or health for someone with normal echo and EKG. About half of us have them. They do not mean you have heart disease or will in the future develop heart disease or any catastrophe. If you want to be sure, ask for an event monitor, a little box you carry with you that records your EKG for a few minutes before and after it detects an irregular beat. Extra beats are most likely to occur when we're resting, especially after eating, and not to occur when we're exercising.
Please write back if this note doesn't answer all your questions.
