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Heart & Cardiology/Heart palpitation questions


I've read several of your posts re: heart palpitations and I have a few questions.  To give you a brief background, earlier in the year I began suffering from panic attacks, though I didn't realize what they were because of the cardio symptoms.. dizziness, palpitations, etc.  I've had an extensive cardio work up... stress echo, regular echo, holter, ekgs, and have been diagnosed w/rare pvcs/pacs, but all else was clear.  I'm a 39 y-o, otherwise highly active, healthy female with no family history or heart disease risk factors.  I was put on lexapro for anxiety.  

Recently, I've begun tapering the lexapro and I've noticed the return/increase of the palpitations.  I'm trying to track them to see if there are any other environmental factors that might be causing them (dehydration, hunger, lexapro withdrawl) that might help me to ease my symptoms.

Do all palps speed up/slow down the heart rate?  Because often when I feel something, my heart rate stays exactly the same.  If this is the case, I'm wondering if it is psychosomatic and perhaps more related to the lexapro tapering than anything else.  Do you know if tapering off a med like lexapro can cause this reaction?

I also tend to notice them at roughly the same time every day, early evening when my resting heart rate is a bit lower... about mid 60s.  Are palpitations more common at a low resting heart rate?  

I try to attribute the palpitations to anxiety, but I often don't feel 'actively anxious' when I have them.  Does this seem like a common finding, that anxiety palps occur even when more relaxed?

Your input is appreciated.

Hello Kristen,

Premature beats are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any catastrophe.
They are more likely to occur when the heart is beating slowly.  They don't make your heart beat faster, thought of course anxiety does.  Anxiety may increase premature beats, but they occur normally even when you're not anxious.

Please write back if this doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


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.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

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.

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