Palpitations after a drink

Hello,

Thank you for your query at doctorspring.com.

Although it is true that binge drinking has been associated with arrhythmias and can lead to palpitations it is highly unlikely yhat one or 2 drinks or beer can cause these symptoms. The symptoms that you describe are very suggestive of anxiety. Simce you can perform brisk walking for 5 km it is unlikely that you are having any coronary artery disease.

As for the palpitations get a 2 D Echo and a 24 hours holter examination done. If that is normal you need psychiatrist help for anxiety. Also please avoid alcohol in excess of a drink or 2.

Hope this helps, please feel free to discuss further.
Regards
Dr Vivek Mahajan
DM Cardiology

Many thanks Dr Vivek Mahajan. I've also noticed that palpitations come after I eat and lean over, or generally misalign my body, lean upward too much (picking something off the floor), or press something (accidentally) over my stomach (or flexing stomach muscles).

I certainly don't have a good posture, but it seems like this period, my body is so sensitive (as well as my awareness) that anything can trigger them. Last nite I couldn't sleep because of it, and I took one propranolol which created havoc (mad adrenaline rush and heart beat) until it kicked in. Although I didn't sleep, I didn't have any palpitations up until few moments ago, actually.

I will contact my GP on Monday and see if he can refer me to the psychiatrist.
I also have CT arranged for 20 December because my cardiologist wants to be sure that everything is ok. However, at the time I visit her, I didn't have any palpitations so I didn't report them at all. Now I have them every day, it seems. And although I am under a lot of stress (job and family), palpitations sometimes come with an adrenaline surge and that creates more stress. Not sure how to proceed taking all that into account.

Do you think I should contact my cardiologist and report the palpitations?

Hello,

Thanks for your reply.

Change of position should not cause palpitations. I don't think you need a ct angio because you can walk upto 5 km without problems and so it is not warranted.

To clarify if the palpitations are heart related 24 hours holter can document any arrhythmia that occurs concurrently. 2D echo can give an idea of any structural heart disease.

I recommend you see a psychiatrist if the above tests are normal.

Regards

Hi,

I am so sorry not to be able to reply sooner. I have severe problems with internet and was cut off for almost two weeks now. It's back on now.

I just wish to say that I do understand what are you telling me. However, I haven't had any palpitations for the last week or so, but I have also felt more calm in general. So, I guess they were probably stress induced.

As for the CT test which I have on 20th, that is ordered because I have noticed some chest tightening during some running sessions which worry me. Although those can also be anxiety induced (muscles being tight etc), my cardiologist thought it would be useful to see whether there is anything wrong, hence CT.
The only thing that I didn't understand from your email is about you mentioning 2D echo. Are you saying that any structural heart disease cannot be seen with CT?
Many thanks and I do apologise once more for not being able to reply sooner.

Have a nice weekend

Hello,
In your first mail you had mentioned that you could walk briskly up to 5 miles without much of a problem. The only problem that you mention was about having palpitations.

If you indeed have chest heaviness on exercising and you are confused that the cause maybe anxiety vs cardiac cause then ct angio is not the best test for you.
You should undergo a tmt test and if it is normal you should forget about the chest pain.

Ct coronary angio deals with the coronary artery anatomy. I am not sure if they shall be focusing on other aspects of cardiac anatomy to rule out any structural heart disease.

Regards
Dr Vivek Mahajan

Hi, many thanks for your prompt reply. I think they asked me whether I have any breathing problems, and I said no. I don't have any breathing problems when I run either. Yes, I can walk 5miles pretty quickly without getting overly tired, or tired at all. At the time I visited my cardiologist (which was two months ago now) I didn't have any problems with palpitations. They occurred few days before I emailed you, and I had a lot of them, but then they also disappeared after a few days. In other words, in the last 10+ days I didn't have them at all. I guess, I'll need to wait and see what happens after this CT that I about to have next Friday. I am going to be doing CT in the other hospital, so I won't be able to speak with the cardiologist right away. I think the procedure is the following one: if there is anything wrong, they will contact me, but if there isn't, they won't. That is how they do it in UK.

Hello
Every system has its own way of functioning and protocols
Lets wait for ct angio and decide what is to be done next aftet the results
All the best

Regards
Dr Vivek Mahajan
DM Cardiology