[Oldmanmatt]

Medical peeps.
If, several times over the last few months, when at rest and without any particular stress or activity, you feel your heart begin “palpitations”, feel ill and dizzy and your Apple Watch records something similar to the embedded photo and chirps on about you needing to seek medical attention (on at least four different occasions), would you be worried?



That’s a 30 second read.

[SA Chris]

I'd check with a doctor to be safe.

My stepdad had a couple of dizzy spells, and was struggling for breath sometimes just went to the doc (down your way) and now has a pacemaker due to a faulty valve.

[Oldmanmatt]

I'd check with a doctor to be safe.

My stepdad had a couple of dizzy spells, and was struggling for breath sometimes just went to the doc (down your way) and now has a pacemaker due to a faulty valve.

Yeah.
The person in question couldn’t get passed a telephone appointment  with a GP, who wasn’t interested in seeing the recorded incidents, wouldn’t even allow an actual appointment and told them it was anxiety and “a few extra beats is quite normal”.

I’m not an expert, but I’ve had to train to use a variety of Defibrillators etc and some basic diagnostic stuff, so I kinda know what’s “normal”
Ish.

The person has a three different recordings like that. If it was me, I’d be pretty worried..

I was with them yesterday, during the above (the whole thing lasted about 30 minutes) and they were proper poorly. I was bullied into not dialling at least 101, though I was strongly tempted to dial 999.

[RobK]

From my girlfriend who's an A&E doc:

Don't stress about it, but you should definitely be seeing your GP.

Edit: she's pretty appalled, but not entirely surprised, that the GP didn't want to know.

[Oldmanmatt]

From my girlfriend who's an A&E doc:

Don't stress about it, but you should definitely be seeing your GP.

Edit: she's pretty appalled, but not entirely surprised, that the GP didn't want to know.

Cheers!

[submaximal gains]

Hi, I am not confident interpreting the electrical activity recorded by an apple watch but the strip you have posted looks like it goes between a normal sinus rhythm and an irregular rhythm.

 You should see your GP to be properly assessed. The next step would be to get a 12 lead ECG, which even if done while you are feeling normal can show other heart problems.

 If you experience palpitations which do not stop, especially if associated with feeling dizzy, fainting, or feeling as though you are about to faint, have someone take you to A&E or call an ambulance.

For general information the British heart foundation have this https://www.bhf.org.uk/informationsupport/conditions/palpitations

[User deactivated.]

Sounds like atrial fibrillation?

I have 'flutters' fairly regularly and have had 2 bouts of proper AF which required overnight stays in hospital and plenty of intravenous drugs to get me back into normal rhythm at ages 23 and 27. All scans and tests showed my heart appears normal, but I was told it's likely going to become more regular and will most likely need a surgery in future. I'm now 31 so possibly due another episode...

As I understand it, AF isn't too dangerous in the short term, but risk of stroke and other more dangerous conditions goes up if you've been in AF for quite a while, I think due to (beware: extreme layman's interpretation) blood pooling and clotting as a result of it not being pumped properly. Some people can be in AF and not know it, which sounds insane to me because I feel like my heart is going to summersault out of my mouth, and although i've felt dizzy/ill with it, I think this has just been anxiety as it has subsided whilst remaining in AF.

During my 1st hospital stay for AF, I was in for over 48 hours until I eventually came out of it. On the 2nd incident they pumped me full of flecainide and warfarin then sent me on my way after 1 night, still in AF. I got bored on day 2 at home so went to the depot and as soon as I got my already very high heart rate up even more it flipped back into normal rhythm and I haven't seen a doctor or had anything more than flutters since!

Interestingly, both times it happened were just as I had laid down to go to sleep, both times on my side in a way that squeezes my chest. 99% of the time I ever get any flutters it's also when laid down and if I jump upright it subsides. I explained this to the heart specialist and was almost laughed out of his office for recognising this coincidence which has happened hundreds of times...

Of course, what you (or friend) are seeing could be something else entirely, so demand a check up and my post just serves as random anecdotes!

[submaximal gains]

It's unlikely to be atrial fibrillation - the QRS complexes are broad not narrow.

See an actual doctor and get an ECG done.

[T_B]

I’ve been diagnosed with Ectopic heartbeats in the past. It’d wake me up in the night as a heartbeat would ‘drop out’, then my heart would speed up again. Anyway, I had the full gamut of tests presumably to establish that it wasn’t arterial fibrillation? It went away after a while.

[Oldmanmatt]

Thanks a bunch everybody.

It really isn’t me (I hope not, I’ve just picked up the pad after a 39min 5k all up a 10% slope).
It’s Mrs OMM, but she gets antsy about me using her name online.

FiL and (Step) MiL are both doctors. She contacted them last time, around a month ago, but was told not to worry and see her GP.
However, she hadn’t mentioned to then that she could both feel the palpitations and had dizzy/faint spells and headaches with it.

She’s just had a bollocking from him for not being clearer, they’d assumed it was just something she’d noticed on her watch/phone.
Frankly, I was worried and just not satisfied with the explanations I was hearing.

[battery]

I get palpatations that feel bloody weird and are really unsettling. Often at night when I've just sat down to relax and watch TV or just got into bed. It was investigated when I was pregnant and I get regular ectopic heart beats which are nothing to worry about.

I say this to empathise but also reassure - it's horrible but it isn't necessarily anything to worry about.

It absolutely has to be checked - go back and bang you fists on the desk (over the phone!).

Mine is worse when I am dehydrated, stressed, and when my iron levels are low.

[GCW]

That trace has some features of an intermittent left bundle branch block. If someone feels unwell at the time, this definitely needs checking out. And if they are feeling unwell for 30 minutes with this 999 is appropriate.

[nick63]

Was just going to say the same as GCW. Elements of LBBB. Needs checking out as a priority

[submaximal gains]

 It's not a left bundle branch block - given that it is mainly sinus rhythm with normal, narrow QRS complexes we can say that the left bundle is not blocked. If it were blocked all the QRS complexes would be broad and notched.

 The fact that there are two different morphologies of QRS complexes indicates that ventricular depolarisation is being initiated from two different places - most of the time the QRS complex is narrow and preceded by a P wave, in these ventricular depolarisation is starting at the AV node and conducted normally. The other times the QRS complex is broad which suggests it is being initiated elsewhere in the ventricles.

 I would describe this as a normal sinus rhythm with normal QRS complexes with intermittent runs of irregular, broad complex tachycardia.

 I don't think it is reasonable to say more given that it's a trace recorded from an apple watch and these have not been validated to diagnose anything other than atrial fibrillation as far as I am aware. Again, please can the person who's trace this is be assessed by a doctor which is likely to include getting a 12 lead ECG in the first instance.

 Concerning features that should prompt being taken to A&E or calling an ambulance are palpitations that do not stop, faints, shortness of breath, and chest pain.

Reference https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.044126?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

[Oldmanmatt]

She’ll be sorting it.
She posted the read on her FB, a Paramedic friend was on the phone within ten minutes insisting she head to A&E.
The incident was already 48hrs passed, so we haven’t taken that route. However, we will if it happens again and she’s booked for an ECG next Monday. Though I’m not sure that’s a “12 lead” as I think the GP is peeved by our Dr Google insistence...
Bloods booked too.

[submaximal gains]

Sorry for not being clear - a standard ECG is a 12 lead ECG and records the electrical activity across 12 different axes using 6 electrodes placed on the chest and 4 on the limbs. The apple watch produces a single lead ECG as it records only one axis.

[saltbeef]

its not AF and its not LBBB. its a lot of ectopy in a short time period and probably warrants further investigation and I've sent you a message. I'd warn against getting unsolicited advice over the internet.

[Oldmanmatt]

its not AF and its not LBBB. its a lot of ectopy in a short time period and probably warrants further investigation and I've sent you a message. I'd warn against getting unsolicited advice over the internet.

You have a very good point and normally, I wouldn’t have broached it on a forum. However, four months of her being ignored by the surgery and the latest brush off, triggered my ire. So far, they had refused to let her even make an appointment or let her show/email/print and hand over the desk a copy of the watch readings. Unfortunately, I can’t just bully my way in and demand for them to listen. She wouldn’t let me take the 101 route.

On the back of this conversation and a shitty message from her father, she mow has an ECG booked and bloods on Monday.

I get that there’s a Pandemic on, but we haven’t been able to see any of our GP’s since it began, only the Paramedic Practitioner actually meets people at the moment. He’s a great guy, but as he said, out of his depth sometimes. He described himself as “cannon fodder”, when I went in with some pretty awful abdominal pain, that was referring into my left testicle and, frankly, scaring me quite a bit. Apparently, there wasn’t even a GP in the building, though he did manage to phone one. On his advice, I ended up self referring myself to the Ultrasound dep. in Torbay, who decided I had a Spigelian hernia and referred me to the specialist. All of those people had some choice words about my GP practice.

[sherlock]

Skimming through the thread, I feel incredibly fortunate to live in a small community where the GP practice takes an ongoing and personal interest in your health.
Coincidentally, a couple of days back my wife started having heart flutter/palpitation. She left it a day then phoned the practice.
She had an ECG this morning an after a face to face with her doctor. A YYFN, all good plus bloods taken to rule out some other stuff. And still some locals complain about the service, oddly enough (or not) the folk that were born here and never lived in a city...

OMM, hope you get a good result and just a thought- could it be connected to the menopause? Don't mean to be personal and don't want an answer obviously.

[Oldmanmatt]

Skimming through the thread, I feel incredibly fortunate to live in a small community where the GP practice takes an ongoing and personal interest in your health.
Coincidentally, a couple of days back my wife started having heart flutter/palpitation. She left it a day then phoned the practice.
She had an ECG this morning an after a face to face with her doctor. A YYFN, all good plus bloods taken to rule out some other stuff. And still some locals complain about the service, oddly enough (or not) the folk that were born here and never lived in a city...

OMM, hope you get a good result and just a thought- could it be connected to the menopause? Don't mean to be personal and don't want an answer obviously.

It would not surprise me. Not that I realised before, but I’ve been doing a lot of reading, recently.
She’s also been getting odd “allergic” reactions and itching/rashes. She has a family history of pet/dust/mite allergies, so we kinda figured she was finally following the family tradition. Child 2 of 4 is allergic to frickin everything like his uncle and grandfather, but she never was.
Apparently Thyroid function is one of the things being checked, too.

Funny, but they never covered this in me Ships Captain’s medical courses (8/10 days every 5 years, I is a h’Ex-spUrt ‘n I got a bit o’ paPer wOt saYs so).

Never ceases to amaze me how complex animals are, or what can go wrong.
By the time you hit 50, you kinda think you’ve at least watched a BBC documentary on just about every possible medical condition known to humanity, or had some elderly relative relay in detail some bizarre illness they’ve just been diagnosed with.

But, in fact, you’ve hardly even skimmed the blurb on the back of the textbook.

[sherlock]

Bloody hell, I think we're married to the same woman.
I wondered where she disappeared to at weekends....

[Oldmanmatt]

Bloody hell, I think we're married to the same woman.
I wondered where she disappeared to at weekends....

This lady has a few good podcasts and an interesting book on the subject:

https://instagram.com/amanda.thebe?utm_medium=copy_link

Not at all sure why the subject isn’t more widely discussed. It’s a pretty significant thing, that most people have to deal with eventually, either as a (very) partial observer or unwilling participant.
Way more complex than I’d considered, mainly because I really hadn’t considered it...

[sherlock]

Agree with all the above.
I didn't actually realize how protracted the menopause could be in some women but after talking and reading up a little...
Thanks for the link.

[Fultonius]

It would not surprise me. Not that I realised before, but I’ve been doing a lot of reading, recently.
She’s also been getting odd “allergic” reactions and itching/rashes. She has a family history of pet/dust/mite allergies, so we kinda figured she was finally following the family tradition. Child 2 of 4 is allergic to frickin everything like his uncle and grandfather, but she never was.

My OH has had chronic unexplained leg itching for the last few months. Creams / antihistamine making no difference. I'm prone to blame covid for everything, but there have been a lot of odd symptoms.

I'm very interested to see what future analysis throws up on the data for this period. I'm suspecting a lot of vascular / heart and skin related issues. Whatever happens, until she's been seen I'd would say (in my entirely unprofessional non-medical opinion - encourage her not to do any strenuous exercise, just to be safe.) What's the harm.

[tomtom]

Hi OMM and others who posted - this article in today’s NYTimes looks at wearable heart monitors. Covers some interesting points (the too much data means lots of false noise points interested me).

https://www.nytimes.com/2021/05/20/well/live/smartwatch-heart-rate-monitor.html