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Heart & Cardiology/Palpitations/annoying feelings round diaphragm


Am 62, otherwise healthy man, Live in Denmark.

All too many nights this happen: After sleeping 2-3-4 hours I wake up and have palpitations/heart"thumps" and a very uncomfortable feeling above or a little below the diaphragm.
It keeps me awake for hours, sets me in a bad mood and this partly insomnia-like conditions is bad for my life quality  and for my love relation.
It CAN also happen at daytime, but I don't notice it so much then.

It feels in many ways positional. If I get out of bed and sit or walk a little while, the worst symptoms usually disappear, but they often return minutes after I lie down again to sleep. When I lie down, it can feel as if my heart - and maybe also other organs - sort of "settle in place" and thereby "the thing" starts again with pounding heart, pulsating feeling and quite often increasing urine production as well, so I have to get up again after half an hour.
Can it be pressure between organs? Can my nervous system/the vagus nerve be unusually sensitive?

It happens often - but not only - after "a good dinner with friends", which mean plenty of food, later in the evening than in my normal schedule, and maybe 4-5 glasses of wine. No coffee. But it can happen without any alcohol as well.

I grow mad looking for reasons!

I do breathing excercises and take valerian (which in these days seem helpful) and I take a proton pump inhibitor (Pantoprazol), cause my doc thought it COULD have something to do with acid. This seemed to help a bit in the beginning, but it doesn't keep the "bastards" away these days.

My heart has been checked with ecg several times, echo one time and with monitors a couple of times. They have not found anything.

What can this be? Is it possible to find out? Or do I have to live with it, just doing my own stupid experiments with not eating this and not drinking that?

Kind regards

Hello Martin,

It's probably skipped heart beats you're feeling as palpitations and the uncomfortable feeling below the diaphragm.   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.   With normal ECG and echo, you need not worry about the palpitations.  Of course, worry about coronary artery narrowing, common at your age.  Exercise a lot, eat a heart-healthy diet, don't smoke, and keep watch on your blood pressure and blood cholesterol.  The palpitations have nothing to do with coronary disease.

Please write back if this note 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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