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Heart palpitations at beginning of exercise. Should I worry?

Resolved Question:

This question is to Dr. Mahajan, as a follow on to our May/June correspondences:

How are you doing Dr. Mahajan.

I really appreciate all your genuine care and advice.

Just wanted to update you that I have lost 25 lbs (~ 11 kg) (was 200 lbs, and now 175 lbs) and have been exercising on the threadmill for 30 minutes a day, while keeping my heart rate at 125 bmp or less all throughout.

Per your recommendation, the threadmill is set at level (not incline for safety of my knees).

I am also regularly taking 40 mg of lipitor, fish oil, and CoQ10 supplements.

One thing I have never mentioned in the past that I may also have sleep apnea, where few times a year I may just feel gasping for air at nights.

The concern I have is, sometimes when I do abrupt motion or just start walking briskly, at the beginning of this I feel pulpitations of the heart as if skipping beats or heart just jumping.

Is this something I need to be concerned about?

Attached, is also my lipids and blood levels measured on July 02.

Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Thank you for your query at DoctorSpring.com
I understand your concern.
I am glad to talk to you again and see that you have made so much improvement since we spoke last time.
Yes, the reports are normal, and that is very encouraging.
I won't pay much importance to the palpitations feeling, since it lasts a few seconds only, considering all your other parameters are normal.
Do not worry about it.
Feel free to discuss further,

Patient replied :

Thanks so much Dr. Mahajan for the prompt reply.
Today, I went to family doctor and he took EKG.
He said the results were normal and the computer
said normal sinus rythm, but abnormal EKG.
the family doctor said not to worry about it.
what do you think this means?

Expert:  Dr. Vivek Mahajan replied 3 Days.

Can you upload the EKG?
Well, if it is sinus rhythm, it means it is normal.

Patient replied :

Dr. Mahajan, Here are the results of EKG from last Wednesday (09/02/2015). It was sent to cardiologist office, and these are his interpretation.

Component Results

Component Standard Range Your Value
Ventricular Rate 65
Atrial Rate 65
P-R Interval 196
QRS Duration 80
Q-T Interval 390
QTC Calculation (Bezet) 405
P Axis 58
R Axis 4
T Axis 58
Diagnosis Normal sinus rhythm
Diagnosis Cannot exclude Inferior infarct , age undetermined
Diagnosis Abnormal electrocardiogram
Diagnosis Confirmed by HONDA MD, HENRY M (39) on 9/4/2015 11:25:46 PM

General Information

Collected: 09/02/2015 3:31 PM Resulted: 09/04/2015 11:25 PM Unfortunately, the graph is not available from my online records. Today (09/10/2015), I went to another urgent care, and they did another EKG. Attached, are today's results as well.

Expert:  Dr. Vivek Mahajan replied 2 Days.

Going through EKG report without graph will be difficult to say whether it is normal or abnormal as sometimes inferior changes in EKG may be normal and has to be confirmed by repeating a EKG with deep inspiration and when these changes disappear we say its a normal EKG and if persists then it may be abnormal , which has to be confirmed by ECHOCARDIOGRAM..
I reviewed the ECG, it is normal.
Dr Satish

Patient replied :

So today's (09/10/2015) ECG is normal but last week's is abnormal?

Expert:  Dr. Vivek Mahajan replied 1 Day.

Last week's could just be minor electrical changes.
Your ECG is normal. Do not worry.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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