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Heart & Cardiology/Irregular heart patterns


QUESTION: I am 29, 205 pounds, 6'4" and my blood pressure iss 116/80.

I have been experiencing palpitation which I have learned are normal and have learned to cope with them in the past years as they are infrequent. As of September last year I started training a bit harder for a few running races with the goal of a marathon at the end of this year. I have always been a runner but my frequency and intensity of workouts has always varied.

In November while running I experienced mild chest pain accompanied by an irregular pulse. The pulse seemed to go through cycles. A few strong pulses then it would get weak for a few pulses and then increase in strength again and repeat. I stopped running upon noticing it and it subsided only to return after trying to run again. This happened on two separate runs about a week apart. During this period palpitations and skipped beats seemed to be more frequent.

I saw a Doctor and did an EKG soon after. She noticed a few small palpitations but nothing completely abnormal. I also had blood work done (for a life insurance policy) and everything was within the normal level. After the visit I continued to run (6-11 miles at a time) without any symptoms until last week when I experienced the same symptoms again.

I'm not sure what is going on and causes me to worry a bit. I should probably also note that sometimes when falling asleep I experience sudden but small gasps for air. I don't know if that is related or not but heard it could be related to valve problems. I am planning to visit the Doctor again soon, is there anything else I can do for myself or to maybe to help the Doctor better diagnose me? Can I continue to run with the goal of a marathon? Please advise.

Thanks for your time!

ANSWER: Hello Bryan,

Skipped 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 cardiac catastrophe.

Ask for an echocardiogram to be sure your heart's structure and function are normal.

Please write back if this note doesnít answer all your questions.

David Richardson

---------- FOLLOW-UP ----------

QUESTION: Thanks for your quick response! I really appreciate what you do.

I have one follow up question - What about the varying pulse strength and chest pain while running? Is that something to be worried about?

The varying pulse strength is probably normal, and at your age the pain is probably chest wall.  Chest pain in a young person is usually cramping of muscles in the chest wall.  If pushing on the painful area modifies the pain (makes it better or worse), or if the pain is relieved by bending the body away from the painful area, that proves the pain is from chest  wall.  Even if these maneuvers donít affect the pain, itís still probably chest wall.  Pain caused by narrowing of the coronary arteries that supply blood to the heart is extremely rare below age 40. Chest wall pain is no threat to life or health, just a big nuisance.  

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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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