Cardiac Changes Later in Life/Menopause Experience

[Christine]

Reaching out to the DIS here to see if anyone has had any type of personal experience with this issue. Let me first state that I have already been to the doctor, so not looking for any sort of diagnosis, but I guess I just need someone to talk to. What has come up for me could be "nothing" or "something."

So, I am 53 years old and officially am in menopause. I'm not sure this even matters, but I thought I'd throw it out there. About one year ago, I started experiencing skipped beats. Heart rate was normal, however, there would sometimes be a pause, then a thud as the heart went back into rhythm. I've had palpitations/skipped beats before and had them checked out (benign) but these seemed a little different than what I had before. I went to a cardiologist back in 2008 when it first happened and had a stress echo. All normal, but I never saw the report. I then can go for years without a SINGLE palpitation. Also, I've historically had a high heart rate.

Over this past year, with the skipped beats, I've also decided to lose a little weight and exercise, which I have done. During this past winter when I resumed getting on my treadmill (which has a chest heart rate monitor), I noticed that my heart rate was lower when I first stepped on. For years, I'd hop on the treadmill and start out at around 80. Now I was hopping on and in the 60s. Then for Christmas, my husband bought me a Garmin activity watch. Sitting at the computer, I would sometimes go down into the 40s. That kind of freaked me out. Called my endocrinologist (I am on thyroid medication) in case maybe I had gone hypothyroid, but I was not. He seemed thrilled about the low heart rate. When I went to his office, I was very nervous, and my heart rate was only about 65. My TSH, in fact, was a little on the hyper side.

Yesterday, I had my physical with my GP. Told him everything about this. He congratulated me for having the heart of an athlete. I still feel something is not right about the change because I've always had a higher heart rate. Anyway, he did an EKG which came back with a borderline Long QT interval. He was non-plussed about it but then changed his mind and is sending me to a cardiologist for an exercise stress test. He told me not to worry.

I'm not *overly* worried but I am a little concerned. To my knowledge, even on the last cardiac testing, I've never had a Long QT interval but it's possible I did and I wasn't told so I am going to try to get that report. There is also no family history. I'm not on medication that would cause it. Although I had been taking Benadryl but stopped 48 hours prior to the physical. I just feel like there has been a dramatic change in my the way my heart works over the last year. The only other change that coincided with the heart palps is that, after 15 years, I quit taking Prilosec. I sort of thought going off it may have caused palps due to more stomach acid. Who knows. Anyway, my GP said that "menopause doesn't cause any changes in the heart" despite what women are told.

Just wondering if anyone has any personal experiences with something like this. Thanks! Now, I'm going out for a bit because my house has just been overtaken by a painting crew so if I don't respond to anything for awhile it's because I can't. TIA.

 

[lsyorke]

When I first started into menopause I had many palpitations. Lasted about 6 months and then just went away as quickly as they started. Long QT can be drug related..so I would look at any other drugs you are on.

 

[The Mystery Machine]

#1, most certainly this could be from stopping your reflux med. I would recommend going to a gastro and getting an endoscopy before stopping it. (I recently did the same thing and ta-da...I have to be on it as I have a lot of erosion AND drum roll a hiatal hernia. You could also be experiencing symptoms of that.)

Are you taking Benadryl all the time or was this just for a temp. condition because that can cause heart palps. Hope you figure it out!

Cardiovascular
Cardiovascular side effects have included hypotension, tachycardia, and palpitations.

https://www.drugs.com/sfx/benadryl-side-effects.html

 

[Christine]

#1, most certainly this could be from stopping your reflux med. I would recommend going to a gastro and getting an endoscopy before stopping it. (I recently did the same thing and ta-da...I have to be on it as I have a lot of erosion AND drum roll a hiatal hernia. You could also be experiencing symptoms of that.)

Are you taking Benadryl all the time or was this just for a temp. condition because that can cause heart palps. Hope you figure it out!

Cardiovascular
Cardiovascular side effects have included hypotension, tachycardia, and palpitations.

https://www.drugs.com/sfx/benadryl-side-effects.html

I take Benadryl sporadically and was taking it due to a slight rash.

As for the Prilosec, I was put on it years ago due to just feeling "off" in my stomach with only mild reflux diagnosed. I never had anything severe but gastro was at a loss for what to do. Stayed on it far too long. With all the recent side effects, decided enough was enough. I've been off a year and feeling just fine without it as long as I eat a normal diet and very little junk food.

 

[Christine]

When I first started into menopause I had many palpitations. Lasted about 6 months and then just went away as quickly as they started. Long QT can be drug related..so I would look at any other drugs you are on.

No other drugs at all except sporadic benadryl and a small dose at that. Thyroid meds too, but they don't cause it.

 

[DLgal]

I'm 38 and have that happen with my heart ALL the time. Been like that since I had my first panic attack about 8 years ago. It's an anxiety symptom and totally harmless.

Low heart rates are considered a sign of health. Mine is about 60 at rest. If your heart rate goes up with exercise, and comes back down pretty quickly once you stop, that's a good sign.

Unless you have been fainting, it's probably a benign issue.

 

[mamamary]

Well I've had a big medical experience two weeks ago. I'll start off by saying that I've been having alot of palpitations, skipped beats etc. lately. I'm also a worrier about everything so I know I have some anxiety thing going on. Anyway, yes I should have had this checked out but I'm from a family where we all kinda have the palpitations, skipped beats etc. I've gone go the cardio for it in the past but it has been awhile. Anyway, fast forward to two weeks ago and I was at my friend's house just sitting and talking when I got a very bad backache all of a sudden. It then went into my chest. So i went home and contemplated what to do. It wasn't that bad at this point but something made me head to the ER just in case. Well imagine my surprise when it came back that I had a minor heart attack. All my tests came out fine so they are thinking it was some plaque that got loose, a blood clot or something else that they just can't get an answer for.

So what I'm trying to say is that if you feel something is not right you probably know your body. I knew something wasn't quite right lately but I just ignored it. So now I'm on lots of meds for the time being. I see my regular doctor in a few days so I'm anxious to hear what she has to say. My blood pressure and chol. tested high in the hospital but at my physical last time they were just borderline. (edited to add that I am a few years younger than you).

 

[Christine]

Well I've had a big medical experience two weeks ago. I'll start off by saying that I've been having alot of palpitations, skipped beats etc. lately. I'm also a worrier about everything so I know I have some anxiety thing going on. Anyway, yes I should have had this checked out but I'm from a family where we all kinda have the palpitations, skipped beats etc. I've gone go the cardio for it in the past but it has been awhile. Anyway, fast forward to two weeks ago and I was at my friend's house just sitting and talking when I got a very bad backache all of a sudden. It then went into my chest. So i went home and contemplated what to do. It wasn't that bad at this point but something made me head to the ER just in case. Well imagine my surprise when it came back that I had a minor heart attack. All my tests came out fine so they are thinking it was some plaque that got loose, a blood clot or something else that they just can't get an answer for.

So what I'm trying to say is that if you feel something is not right you probably know your body. I knew something wasn't quite right lately but I just ignored it. So now I'm on lots of meds for the time being. I see my regular doctor in a few days so I'm anxious to hear what she has to say. My blood pressure and chol. tested high in the hospital but at my physical last time they were just borderline. (edited to add that I am a few years younger than you).

Wow, glad you are okay. My cholesterol has always been low with and excellent ratio of good to bad. I know those are just numbers and anything can happen, though.

I won't know much until March 9th when I go to the cardiologist for the stress test.

Low heart rates are considered a sign of health. Mine is about 60 at rest. If your heart rate goes up with exercise, and comes back down pretty quickly once you stop, that's a good sign.

Yes, that's what I'm hearing and had my heart rate been that low all my life, I wouldn't think anything of it. While I was on the table having the EKG (and nervous) it was at 66. Last time I went to my endo I was in the low 60s while waiting for my appointing. Driving around today in my car, I got as low as 57. Yet, when I do exercise it appropriately rises. I also don't seem to have any sort of symptoms like dizziness or feeling faint.

 

[mnrose]

Menopause caused me to have PVCs something fierce. And, I've been on metoprolol ER ever since (going on 10 years now). My PVCs are absolutely benign from a cardiac perspective (I've had many types of tests!), but crazy making. The metoprolol works great to control the crazy making.

 

[Lady*Belle]

YES, absolutely, without question, my tachycardia/palpitations are definitely due to hormonal changes. Same thing happened to my mother, her twin, her maternal grandmother (her mom died very young so we don't know if it would have happened to her as well), her aunt on her mothers side, etc. once they hit about 45-50 years of age and entering peri/menopause. It doesn't happen to every woman, but it definitely is a symptom of menopause.

When mine starts, it's almost like it will skip a beat and then race to catch back up. Sometimes it feels heavy, like it's pounding out of your chest. It will beat hard if I've had any alcohol the night before (I only drink a glass or two of red wine a couple of times a week), if I've not had enough sleep, and if I am getting sick the first way I know is that heavy heart beat in my chest. It's uncomfortable.

My dr made me have an EKG in 2013 and I've been on Inderal since then, even though everything was benign other than periods of rapid heart beat at times. I used to take 60 mg extended release but have switched to 40 mgs twice a day. My mother, once menopause stopped for her, dropped down to 10 mg as needed so I'm hoping to one day be there as well. It does help a ton.

Another thing I have found when it starts flipping/racing is to bear down and cough as deep as you can. This increases the abdominal pressure within your chest cavity and if the heart is in an abnormal rhythm, it will cause it to revert.

 

[Pea-n-Me]

I started writing this this morning, but had to go out. Let me see if I can finish...

First, yes, I know that feeling you're talking about; I get it, too. It almost feels like a constriction, then a klunk, then you feel normal again, lol. I get it at most a few times a week. I agree it's a little weird. I was put into surgical menopause two years ago when I had my ovaries out (during hyst), so it was sudden and dramatic for me (as opposed to natural menopause which is more gradual). To the best of my knowledge, menopause absolutely does affect cardiac health. But what this feeling is exactly, I'm not sure. Perhaps a PVC or a couplet or triplet. I've been tempted to throw myself on a cardiac monitor at work just to observe my rythm, but I haven't had the time yet, plus I never quite know when it's going to happen, so the likelihood of catching it might be pretty low. I saw a cardiologist around the time of my surgery because the anemia had caused me to become very tachycardic. Everything was normal, including my ECG and echocardiogram. But that is no longer an issue and my heart rate is now back at baseline around 80. I have been watching heart rythms for thirty years on many thousands of patients, and know them in and out, upside down, see them in my sleep, teach them to others, etc., and I can say this: there can be a lot of funky things happening but generally people are fine, even with these isolated strange types of beats. And that's probably why they don't make a big deal about them if everything else is normal. (Note I said isolated beats, as opposed to abnormal rythms.)

That said, forty is too low. A couple of things I can think of. Sometimes monitors don't pick up beats correctly so might call them something they're not (e.g 40 instead of 80 if every other beat is skipped). There is no substitute for human evaluation when it comes to monitors. Though oftentimes someone can be in bigeminy, but that doesn't usually change the heart rate. But I will share a story that happened to us recently. My mother had had a fleeting funny feeling in her head off and on. She's been seen for it before and fully evaluated but nothing abnormal was found. One morning she had it, so I checked her vitals and everything was within her normal range, including her heart rate which registered on the electronic BP cuff she has, and I took it manually as well. So later that day, she falls and hits her head, and we have to call 911. Heart rate was her normal in the ambulance. But we get to the ER and they hook her up to a monitor and right away I see that her heart rate is in the 40s but she's in a second degree heart block, type II. Both the paramedic and I were scratching our heads because she'd had a normal heart rate and rythm for us. She stayed in that rythm for about an hour, then went back into sinus rythm for about six hours, then back to second degree heart block for about twenty minutes, and this pattern continued for a couple of days. So she bought herself a pacemaker. And boy, was she mad! But they said it wasn't optional, that it would progress to a third degree heart block and she would essentially die from that. Two weeks in and she's recovered and feels great. So I don't know if that feeling you have is related, or anything to worry about, but it is possible to have a fleeting (or paroxysmal) arrythimia that can be difficult to pick up on a real time monitor. They do have something called a Holter monitor that follows your heart rythm for days, and you can press a button if you feel something unusual so they can correlate it to your symptoms. They follow it remotely. But do have that heart rate of 40 checked out, please. (Have you taken your heart rate yourself for a full minute when that happens? And do you feel ok when your heart rate is that low?) If accurate, it bears watching.

As for the prolonged QT interval, yes, that is a very serious issue, as it can cause R on T phenomenon, and that can be a lethal arrythmia. A problematic QT interval can be determined on an ECG as a QTc.

 

[Christine]

I started writing this this morning, but had to go out. Let me see if I can finish...

First, yes, I know that feeling you're talking about; I get it, too. It almost feels like a constriction, then a klunk, then you feel normal again, lol. I get it at most a few times a week. I agree it's a little weird. I was put into surgical menopause two years ago when I had my ovaries out (during hyst), so it was sudden and dramatic for me (as opposed to natural menopause which is more gradual). To the best of my knowledge, menopause absolutely does affect cardiac health. But what this feeling is exactly, I'm not sure. Perhaps a PVC or a couplet or triplet. I've been tempted to throw myself on a cardiac monitor at work just to observe my rythm, but I haven't had the time yet, plus I never quite know when it's going to happen, so the likelihood of catching it might be pretty low. I saw a cardiologist around the time of my surgery because the anemia had caused me to become very tachycardic. Everything was normal, including my ECG and echocardiogram. But that is no longer an issue and my heart rate is now back at baseline around 80. I have been watching heart rythms for thirty years on many thousands of patients, and know them in and out, upside down, see them in my sleep, teach them to others, etc., and I can say this: there can be a lot of funky things happening but generally people are fine, even with these isolated strange types of beats. And that's probably why they don't make a big deal about them if everything else is normal. (Note I said isolated beats, as opposed to abnormal rythms.)

That said, forty is too low. A couple of things I can think of. Sometimes monitors don't pick up beats correctly so might call them something they're not (e.g 40 instead of 80 if every other beat is skipped). There is no substitute for human evaluation when it comes to monitors. Though oftentimes someone can be in bigeminy, but that doesn't usually change the heart rate. But I will share a story that happened to us recently. My mother had had a fleeting funny feeling in her head off and on. She's been seen for it before and fully evaluated but nothing abnormal was found. One morning she had it, so I checked her vitals and everything was within her normal range, including her heart rate which registered on the electronic BP cuff she has, and I took it manually as well. So later that day, she falls and hits her head, and we have to call 911. Heart rate was her normal in the ambulance. But we get to the ER and they hook her up to a monitor and right away I see that her heart rate is in the 40s but she's in a second degree heart block, type II. Both the paramedic and I were scratching our heads because she'd had a normal heart rate and rythm for us. She stayed in that rythm for about an hour, then went back into sinus rythm for about six hours, then back to second degree heart block for about twenty minutes, and this pattern continued for a couple of days. So she bought herself a pacemaker. And boy, was she mad! But they said it wasn't optional, that it would progress to a third degree heart block and she would essentially die from that. Two weeks in and she's recovered and feels great. So I don't know if that feeling you have is related, or anything to worry about, but it is possible to have a fleeting (or paroxysmal) arrythimia that can be difficult to pick up on a real time monitor. They do have something called a Holter monitor that follows your heart rythm for days, and you can press a button if you feel something unusual so they can correlate it to your symptoms. They follow it remotely. But do have that heart rate of 40 checked out, please. (Have you taken your heart rate yourself for a full minute when that happens? And do you feel ok when your heart rate is that low?) If accurate, it bears watching.

As for the prolonged QT interval, yes, that is a very serious issue, as it can cause R on T phenomenon, and that can be a lethal arrythmia. A problematic QT interval can be determined on an ECG as a QTc.

Thanks for your very thorough reply!

To be clear, the skipped beats and stuff as you and others have mentioned, aren't overly bothering me. I have had them off and on for years. I just happen to be in a very long spell of them.

Like you Pea, prior to menopause, I had heavy periods, low ferritin, sometimes mild anemia and all with that I would often have tachycardia. In fact, the other two visits I've ever had to a cardiologist were because my "walking around" heart rate was often at 100-120 and I would feel funny and breathless when that happened. Now that my periods have stopped, I actually feel a lot better, but I guess I'm concerned about the change in heart rate.

Over Christmas, when I got my heart monitor (and I was really exercising a lot and dieting), I tracked a heart rate of 47-49 bpm while sitting around on the computer. I felt fine with it and when I get up and move around it goes up appropriately. I manually checked it with a timer and it was agreeing with my monitor. At that time, I was on Pepcid AC. Since I have stopped that, I have not seen my heart rate go that low, but I do go down into the 50s now. When my mother was with me sitting around (she is 73 and in great shape), she checked hers and it was 51. But yeah, it all worries me and I'm glad to have an appointment with the cardiologist.

The real issue worrying me was the long QT interval. The QTc was at 453, which I understand is borderline rather signficant. I had been fasting when I had it done (hadn't eaten since about 7PM and the ECG was done at around 11AM). Also, apparently I was moving during the test (she never told me not to move and then kind of freaked out when I started twirling my ankle around so not sure what that may have done). Back when the tachycardia was going on, I did wear a Holter monitor, had a echo and and echo stress. Never once was I told that I have that. I guess it can just develop?

 

[kuhltiffany]

Similar thing happened to me a year and a half ago. 2 cardiologists and many tests later, one doctor wanted to do surgery while the other tried the natural route. A few days after starting Vitamin D and Magnesium supplementation it stopped. Baffled my regular doctor (and me!), but I've been totally fine since...

 

[Christine]

Similar thing happened to me a year and a half ago. 2 cardiologists and many tests later, one doctor wanted to do surgery while the other tried the natural route. A few days after starting Vitamin D and Magnesium supplementation it stopped. Baffled my regular doctor (and me!), but I've been totally fine since...

Just curious: did you have the long QT interval or the skipped beats (or both!!).

 

[Bilberry]

This article might be helpful, might not. I imagine any number of issues could bring on palpitations.

PPIs, which Prilosec/ (omeprazole) is, is associated with increased incidences of CVD. PPIs also can lower the mineral content in people, minerals that I've seen some write about helping prevent palpitations.

What causes heart disease part XXI

https://drmalcolmkendrick.org/2016/09/21/what-causes-heart-disease-part-xxi/

excerpt:

"...Leaving this issue aside I was interested to find out, why do PPIs have this effect? Well, it is well known that they lower magnesium levels and sodium levels, which is not a good thing. They also seriously inhibit vitamin B12 absorption – leading to Vit B12 deficiency in many.

In my medical role, I have seen around twenty patients with such severe low sodium (hyponatraemia) due to PPIs, that they were diagnosed with delirium and required hospital admission. Which means that I have become increasingly wary of PPIs, and try to prescribe alternatives wherever possible.

That though, is an aside, as the adverse effects I mentioned do not increase CVD risk. So the question remains. How, exactly, do PPIs cause such a significant increase in CVD death? They do not raise blood pressure or blood cholesterol – or affect any of the traditional/mainstream risk factors for CVD

They do, however, have an effect on platelet aggregation. By which I mean thaty make platelets more likely to stick together – and thus start blood clotting. But this does not seem to the main mechanism at work here [although it does fit very nicely within the hypothesis that CVD is due to blood clotting abnormalities]. To quote the paper that found the increase in CVD risk with PPIs again:..."

 

[kuhltiffany]

Just curious: did you have the long QT interval or the skipped beats (or both!!).

Both were recorded at different times, as well as my pulse would go from 120 to 40 and back, even when I was sleeping. I had numerous ECG's, Holter monitoring, stress tests, cardiac ultrasound, blood and urine tests, etc.