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Prominent heartbeat after partying with ASD CLOSURE.

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Hello Doctor,
Hope you remember me. I am 24 years old patientmale, got operated for ASD closure 4 months ago. Sir, till last week everything was going good. I had no problems regarding the recovery, only sometimes bit stretching pain on the sutures. Till now, I have been drinking alcohol once a week( 5-6 times after the surgery) and smoking very occasionally ( 7-8 cigarettes) from time i got operated. on 21st September, I been to party where i drank around 300 ml whisky and danced too for half an hour. It was okay till 23rd evening, when i started feeling my heartbeat prominent. I could sleep properly that night due to pounding heartbeat. Next morning I went to hospital and got the Chest X-ray, ECG and Echocardiography done. I couldn't get an appointment of my Cardiologist still managed to see a Cardiac surgeon which assured me everything is okay and don't worry it happens sometimes. But its been two days, i still feel heartbeat when sitting alone and calm. I can also feel it when i raise my arms for doing arm stretching exercise and that makes me feel abnormal. I am Wealth Manager and developing my business, So had to see and deal with many people and staff. Sometimes lose my temper too. Then I feel my heart is weak and feel a stretch along the left side of chest, which i never felt after the surgery till 23rd September. I have really started feeling depressed and less enthusiastic through the day. I do walk daily for 30-45 min ( Brisk walking).Its very depressing when to can't feel peace as palpitations are heard when sitting idle. I have been not resting except sleeping due to the annoying heartbeat feeling and the reports being normal. i am attaching the latest tests as on 22nd September

Category: Cardiologist

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Category: Cardiologist
 31 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com

The investigations that you have attached indicate that the asd is successfully closed. The ecg shows normal sinus rhythm. When you are having these pounding sensation does the heart rate increase. I mean does the heart race faster or is it only the force of beating that you feel. You could check this out by feeling your pulse rate at the wrist. Having alcohol of 300 ml on a single day is quite risky not only from the heart point of view but from other organs point of view as well. An arrhythmia could well have been precipitated by thus high alcohol intake if the heart rate is increased. However if you just feel that the force of beating is increased it could be psychological and antidepressants and beta blockers should be of help.
Feel free to discuss further,

Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

Hello again Sir,
Thanks for the revert. Here, I want to add that in the question i mistyped 2 days. Its been 2 weeks I am feeling the heart beating loud and yes, it is faster sometimes. It feels normal only when i wake up in morning, else heart rate is 80 bpm or higher. Sometimes 90-100 too. I want to add few more points sir:

  • When i stand bare-chested, I can see the heart beating as the left side of chest goes up-down. Is it normal? I didn't notice that earlier before 23rd September. And its not that I see it sometimes. Its always there, morning, evening, resting.
  • when i lie down and watch T.V, if I put remote on my stomach, it gives visible movement up and down.

These symptoms, I can feel and see actually, How can be it psychological? I am countering it as this same diagnosis was given by my family doctor too with a grin.
Secondly,
  • From past two weeks, I am experiencing fullness burps, even after a small meal. It was severe for 4-5 days, but decreasing with time now as I been prescribed RABESEC DSR and PRE-PRO BIOTIC CAPs, which I am taking daily from 10 days.
  • Sometimes, little pain in the stomach too, So was diagnosed as GAS by the family doctor.

Thirdly, I hesistated to share it in first question, as dint wanted to rule out to be Psychological symptoms:
  • I did felt pain in the left arm, for 4-5 initial days. It was not a sharp main, but intermittent waekness sort of discomfort.
  • shortness of breath also where i had to take a medium to deep breath after 10-15 minutes, but its also lightened and I do feel to have breath only when exerting a bit.

Lastly, Sir
  • Till now, It must be clear I do take the stress, and its my work these days which requires hustle n bustle and lot of planning and scheduling.
  • If i think, I should take a break and rest or lighten the routine, then this problem occupies the mind and i feel like keeping me busy again.

Please suggest me:
  • If its Arrythmia, how can be it taken care off?
  • If Gas?
  • If stress, will yoga do something here? or depressants and beta blockers?

I had always limited my alochol intake for long, but one ocassion shud not be a bolt-srike for me.
Regards.


Hello,

I agree with your doctor. Most of the complaints here appear to be arising out of anxiety and psychological stress. The visible pulsations in chest or stomach are a normal phenomenon. Possibly you never noticed them in the past and because of anxiety you are now paying more attention to it. The heart rate of 80 to 100 doesn't signify any serious arrhythmia that may be ongoing. you could feel your pulse at the wrist and if it appears to come regularly during the heart pounding episodes then it is not an arrhytmia most probably. You could be having gas problems going by the history of burping etc and antacids could help. As far as yoga is concerned it would help definitely to calm you. Whether you need antidepressants or antianxiety is the call of a psychiatrist. Beta blockers could be of help to reduce the pounding sensation in your chest. Just watch out for the pulse going below 60 per minute after beta blockers. You need to relax and de stress yourself.
Feel free to discuss further,

Regards


Patient replied :

Hello Dr.Vivek, I agree to the concepts here, but being a lay man, I am not able to agree fully. Its being a month now, I still have that complaint " I feel the heart area tender or stretched, it feels like its weak. I have no issues if its still curing. But if the curing has been done, then will this feeling go along with me lifetime? Actually, your answer will make me decisive abt future. Please give the verdict if this is a little injury due to drinking large amount of alcohol once and dancing for first time after surgery or something else which will be a little less than normal condition. Please clarify me sir. I have never felt weak. I went for the surgery in 3 days when the symptoms came. I am an optimist and want to aware of my condition to deal with it in a better way.
Thanks


I would say it is none of the above. - not drinking, dancing or anything else. Most likely this is anxiety realted. Just give it some time - 4-6 weeks, and take the medications. It should be alright. Anti anxiety medications might be needed if the symptoms are persistant. I understand that you feel this is not just anxiety. But from my view point your symptoms mostly poiny towards anxiey only.
Hope this helps
Feel free to ask followups
Thank you


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
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
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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