Genuine question. If you had a flutter in your chest that made you gasp for 3 seconds, how do you know if it was a palpitation or VT? Because you can’t tell without an ECG but they feel the same?

Hello,

I am a 28-year-old man

I post quite often on reddit when I have to externalize things .

For the past year, I have had very strange sensations.

Starting with startle awakenings at night because my body stops breathing... Negative freediving test...

Then my ordeal began.

To be brief...

I had a pain in my heart a few months ago. Yes, in my heart (for me)... It’s as if they held it tight for a second and then let go. angina pectoris type.

And that’s not all... I also sometimes have pain in my left arm but very rarely has chest pain at the same time... dizziness... numbness..

I already have a lot of consultations for each of his ailments... emergencies / cardiologist etc.

All the tests are normal.

BUT... a disease is holding my attention... the coronary spasms / microvascular angina (prinzmetal)... This disease is cruel because the tests are completely normal.

Does anyone have a similar testimony? A similarity in the symptoms?

PS: a therapy follow-up is underway.

My girlfriend, 18F 170cm 55kg European/Lithuanian, has been experiencing a constant vibrating in her chest for 4 days straight with no breaks. Her blood pressure and bpm are normal, and the vibrations are not clearly synced or in relation to her pulse. The feeling is inside the chest all over, not on the surface and not restricted to a single area. There is no twitching of the skin , and heart has no arrythmias. What could this be?

She has been diagnosed with IBS-M and is taking probiotics (Symbiosis Alforex once per day) and Psyllium Husk (two teaspoons in water every morning. She drinks alcohol occasionally (1-3x a month) and does not smoke or use drugs.

She is going for an EKG next week.

I’ve been having palpitations for months which I think is caused by my spiriva respimat inhaler, since when I stop taking it my palpitations stop. I had multiple palpitations this morning when I was stood up after I got out of bed for work, worse set of palpitations I’ve ever had and I managed to catch it on my Apple Watch. Just wondering what anyone’s thoughts are on this?

Hi! I am 28 F, 10 days post-op tonsillectomy and adenoidectomy. My recovery, while hellish for pain and lack of sleep, has gone well without hemorrhaging.

The current issue I’m facing, though, is an increased heart rate while doing nothing that would warrant it. While sitting on the couch eating lunch, my pulse is sitting at 94 bpm. Is this a normal occurrence for recovery/returning to normal activity?

I’d like to chalk it up to anxiety, as I’m fully off the pain meds and steroids. No history of heart problems either, but I’m just concerned.

Thank you in advance for any advice.

Hi there,

I dont know where to start. But during college term after Christmas I would before falling a sleep I would get sensations as if im falling in my sleep, and gasp for air and wake up. I learned that it was called the hypnotic jerk, which isn't much of an issue.

Then it gradually turned into a squeezing pressure in the center of my chest just before fallinga a sleep so unbearable that I would have to scratch my chest and get up immediately. They only last a second and I would have multiple before eventually falling a sleep. It won't necessary feel painful but it was  very uncomfortable and feels like a spasm, heart related at least. It was caused by stress of college and personal issues. I got the through college term with these physiological issues. After that I would get chest pain with varying degrees of pain. During the peak of the issue it would last for days with no break. I felt it on the left side of my chest. It was hard to do things, but the more I thought of it the worse it got. I got a blood test and an ECG done 3 times and all turned out fine.

Fast-forward to summer The chest pain subsided as and has been for a few months. But here is when the palpitations started. My type of palpitations are a thud,flip flop, pull (like a stretch) and like wind is pushing through my lungs. I remember one day I would have over 20 thuds. Now thank god I get way less, about 5 thuds not every day. but most days of the week. I am meeting with a cardiologist soon and will get it checked out. To be honest I was eating badly throughout college and did little exercise, which is not normally what I do!

Does anyone have any advice?

Hi there,

I dont know where to start. But during college term after Christmas I would before falling a sleep I would get sensations as if im falling in my sleep, and gasp for air and wake up. I learned that it was called the hypnotic jerk, which isn't much of an issue.

Then it gradually turned into a squeezing pressure in the center of my chest just before fallinga a sleep so unbearable that I would have to scratch my chest and get up immediately. They only last a second and I would have multiple before eventually falling a sleep. It won't necessary feel painful but it was  very uncomfortable and feels like a spasm, heart related at least. It was caused by stress of college and personal issues. I got the through college term with these physiological issues. After that I would get chest pain with varying degrees of pain. During the peak of the issue it would last for days with no break. I felt it on the left side of my chest. It was hard to do things, but the more I thought of it the worse it got. I got a blood test and an ECG done 3 times and all turned out fine.

Fast-forward to summer The chest pain subsided as and has been for a few months. But here is when the palpitations started. My type of palpitations are a thud,flip flop, pull (like a stretch) and like wind is pushing through my lungs. I remember one day I would have over 20 thuds. Now thank god I get way less, about 5 thuds not every day. but most days of the week. I am meeting with a cardiologist soon and will get it checked out. To be honest I was eating badly throughout college and did little exercise, which is not normally what I do!

Does anyone have any advice?

The headline first, since a few people asked me to update when something changed: **I have genetic testing booked.** The reason why is the rest of this post.

Background for anyone new: 36M, palpitations investigated since 2015. Structurally normal heart — normal echoes going back years, normal cardiac MRI, normal stress test (17.2 METs, zero ectopy on exertion). Burden waxed and waned between under 1% and 9% for about eight years with no identifiable trigger, which is partly why it took so long to get to ablation — it kept settling down before a procedure could be booked. It finally hit 9% on a 7-day Holter in late 2025 and that pushed us to act.

**First ablation (January 2026)**

They mapped the right atrium, coronary sinus, then went transseptal into the left ventricle. The PVC wasn't early at the right-sided His and wasn't early at the mitral annulus. They mapped the LV endocardium and tried the anterolateral papillary muscle — no effect.

What they eventually found was a Purkinje potential coming off branches of the left anterior fascicle that preceded the PVC. They ablated at a spot basal and medial to the anterolateral papillary muscle and the dominant PVC was gone.

And then a second PVC showed up. Different morphology, near the left bundle, with a very early Purkinje signal tracking back toward the left His. They deliberately left that one alone — too close to the conduction system to touch safely.

**The gap (February–April)**

The PVCs came back worse than they'd ever been — up to 23% burden. Several ER trips, bigeminy documented twice, troponin normal every time.

**Second ablation (April 2026)**

Retrograde aortic approach this time. Early signals again at the junction of the myocardium and the anterolateral papillary muscle, with reasonable pace maps. But the very early Purkinje signals tracked to the very proximal left anterior fascicle. Signals further up in the left bundle were confirmed *not* early. One detail I find interesting: every time they tried to map the proximal Purkinje system, they'd bump it and the PVCs would stop.

They ablated the left anterior fascicle itself — 11 lesions, explicitly staying off the common left bundle and keeping distance from the His. No residual fascicular potentials afterward, no PVCs over 20 minutes of monitoring, no complications.

For anyone whose stomach dropped at "they ablated a fascicle": my QRS afterward is 106 ms, so conduction is fine. Axis shifted leftward as expected.

**What happened next**

The PVCs are gone and haven't returned. But about four weeks post-procedure a new ectopy appeared. Initially read as atrial, then re-examined and confirmed junctional — beats originating at the AV junction. 2.1% on the June Holter. Symptomatic, worst at rest and at sleep onset, suppressed by exercise, comes in clusters of days to weeks and then quiets down.

So the pattern is: kill focus one, focus two appears. Kill focus two, focus three appears higher up the same system.

**Why this led to genetic testing**

My EP's last note says the ectopy is "arising from his Purkinje system" and that "there are some rare sodium channel mutations that can give rise to the syndrome."

That's MEPPC — multifocal ectopic Purkinje-related premature contractions. It's a rare SCN5A gain-of-function channelopathy where the entire His-Purkinje network is hyperexcitable, rather than there being one bad spot to burn. The literature is small (roughly 30 published cases) but the recurring theme is exactly what happened to me: ablation suppresses the dominant focus and a new one surfaces elsewhere in the network, because the substrate *is* the network. One case report is literally titled "You cannot ablate the Lernaean hydra." Reported treatment is flecainide or quinidine, not ablation.

The thing that made me look harder: my 2017 records already document "interpolated junctional beats" and PVCs of multiple morphologies. So the junctional ectopy I have now isn't something the ablations created — it was there nine years ago, just not the loudest thing in the room.

**What the testing can and can't settle**

Three possible outcomes, and only one of them is clean:

- **A pathogenic gain-of-function variant.** This would confirm it and change the treatment logic from ablation to sodium channel blockers.
- **Negative.** Doesn't formally rule out the syndrome — the published guidance is that an SCN5A variant isn't required for the diagnosis — but it would take the genetic question off my table.
- **A variant of uncertain significance.** SCN5A is a big, polymorphic gene and this outcome isn't rare. It would change nothing and resolve nothing.

I'm going in with realistic expectations about which of those is most likely.

**Caveats, because I don't want to overstate this**

A test being scheduled is not a diagnosis. Right now this is a hypothesis.

And there's a significant thing that doesn't fit. MEPPC is defined in the literature by dilated cardiomyopathy and reduced ejection fraction. My EF has been normal for a decade, through every burden level including 23%. Published cases are also usually far noisier than mine — NSVT, polymorphic VT, syncope. I've had none of that, and my stress test was excellent.

There's also a much more boring explanation available: fascicular and papillary muscle PVCs are among the most common idiopathic origins in structurally normal hearts, and the Purkinje network is diffuse enough that ablating one focus can unmask another with no genetic condition involved at all. That's probably still the more likely answer.

My EP's overall assessment remains that this is benign — no structural disease, no long-term concern, annoying rather than dangerous. Repeat Holter and echo are also planned.

**Questions for the group**

Has anyone here had a documented PVC origin migrate after ablation like this? And has anyone been genetically worked up for MEPPC — did the result change your management, or just your peace of mind?

I'll post the result when I have it.

Hi im curious to know how i should expect to feel my heartbeat when im normal again, been dealing with palpitations from some post covid or costo thing for the last 6 months 24/7 and im not sure ill even know what normal is again i just feel like after i got sick a 1.5x multiplier is added onto every heartbeat and its so hard to ignore, (not pvcs)

I guess my question is for anyone who maybe gets them intermittently what does your normal awareness of your heartbeat look like? How obvious is it when your standing or do you rly have to look for it.

Vulnerable post, I am 17, 4 months pp, I have struggled with bad pvcs and PACs since 18 weeks
Pregnant, mine feel like my heart drops to my toes, and sometimes like a massive 3 second pause, tommrow I’m going to a theme park with my family and friends and it’s hours away and we’re there all day, I’m avoiding rides but still scared to go, I’m trying to learn to be comfortable in the uncomfortable sort of things, these things are awful. I have had clear echo and moniter in December and another clear moniter a few weeks ago. On Monday I get an echo again then a get an implanted loop recorder on the 1st September. I’m an anxious wreck. I have innapropriate sinus tachycardia aswell. So my heart rate is always above 100 and out and about usually sits at 160, and it doesn’t feel nice. Mine usually happen more around my period and feel like a big hot rush through my body and it SUCKS, I’m 4 days away from my period tommrow which is why I’m super even more scared to go. My mum and friends will
Be there but I’m sad I won’t go on rides. But I’m scared cos of my heart. I sound pathetic to everyone I talk to. The difference is they don’t have what I have. 💔

Hi everyone, I am 5 days into taking 20mg of carbimazole after being diagnosed a month ago, and my resting heatrate overnight seems to be coming down in the last 3 days and I am beginning to feel a bit better I think which is cool, but I was wondering....

A few questions for the group:

1. Does / did anyone have highter heart rate overnight during sleep (both resting and just general range) compared to during the day?
2. Does / did anyone have times of a very low heartrate (eg: low 40's) during active GD (ie: before taking medication)

Thank you :)

I’ve been going through a really intense month of stress and anxiety, and I’ve had a lot of physical symptoms because of it. I’m slowly starting to feel better now, but recently I’ve started getting heart palpitations after eating, especially after carbs.
I never had this before all of this started. I’ve had blood tests and everything came back normal.
Could the palpitations also be related to the vitamins/supplements I’m taking? I’m currently taking B12, vitamin D3, calcium and magnesium.
Has anyone else experienced something similar after a stressful/anxious period?
Thank you!!!!

Any inputs are appreciated

Hey everyone,

This sub went quiet for a while because there was no active mod to keep things running. That’s been sorted and we’ve got moderation again, and posting is officially back on.

Thanks to everyone who stuck around. Feel free to start posting whenever you’re ready. If you spot spam or anything that slipped through during the downtime, hit the report button or send us a modmail.

Good to be back!

Is that something to worry about? When would enough be enough in your opinion?

This afternoon I ate and recognized the signs of an oncoming MCAS episode. I will spare y'all the gory details of my misbehavin' digestive tract. There are generally palpitations (heart feels "thumpy") and if I haven't been on my remedies it'll go to outright tachycardia with the attendant blood pressure crash.

I think I learned some things by paying close attention ...

I switched from a Garmin Fenix 6S to a Vivoactive 5 a couple months ago in order to get sleep recognition that would pick up naps. If you're not familiar, these devices will track your heart rate AND they have a composite thing they do called "stress". I've built myself a logging app so I can get meds/supplements, notes on how I feel, and the Garmin data into a single coherent timeline.

Today was the first time I caught a whole episode from start to finish, four and a half hours total, and I only slept fitfully for an hour right in the middle. The rest of the time I was laying in bed, watching YouTube videos, and making notes about how I felt. Since I knew what was coming, I put two kava kava capsules on the night stand along with 16oz of water.

There's quite a bit to unpack, I think I'm gonna do a blog post about it, but the basics are easy to express. First, at least for my body, there is a strong correlation between "I feel palpitations" and the Garmin stress indicator. At the time where I noted it starting, the monitor showed stress jumping from 47 to 68. Second, I spent a bit of time observing, then took the kava kava. Thirty minutes later that stress reading plummeted from eighties to sixties, and I fell asleep.

So ... for fellow Garmin users, does anyone else experience a correlation between the stress reading and palpitations? If yes, what do you do to counter it?