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Dr. David
Dr. David, Doctor
Category: Cardiology
Satisfied Customers: 45945
Experience:  Experienced physician with cardiology experience
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I'm a 35 year old male, with subclinical hyperthyroidism. My

Customer Question

I'm a 35 year old male, with subclinical hyperthyroidism. My TSH is typically low, but not suppressed and sometimes goes back to normal. My T3 / T4 are always normal. I suffer from palpitations, sometimes a lot of them and sometimes I can go days or weeks without any at all. I've been to a cardiologist about 5 months ago, nothing was caught on my echo or holter, but my echo came back normal. The palpitations that feel like skipped beats, with a hard thud are simple enough to ignore, but sometimes I get these "fluttering" kind that last just for a second and some that last for several seconds. The fluttering ones really scare me because they seem to last longer than any others. I'm curious if there's any significance to these and whether or not they're dangerous?
Submitted: 8 months ago.
Category: Cardiology
Expert:  Dr. David replied 8 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 8 months ago.

these flutters and palpitations don't sound dangerous

they can be caused by your hyperthyroidism.

caffeine use, excessive anxiety symptoms can cause palpitations as well.

it sounds like all of your heart testing is normal

so you don't have to worry.

Customer: replied 8 months ago.
Thanks Dr. David. Yes my Echo, Holter and numerous ECG's have all come back normal, nothing has ever been captured. On my bad days I'll feel anywhere from 15 - 20 palpitations and on good days, none at all. I've been told that my TSH isn't low enough to be concerning, last time it was .25 and before that it was .31. I'm curious though, what is the difference between a palpitation that feels like a skip and a hard thud, versus the ones that feel like fluttering that last for a few / several seconds.
Expert:  Dr. David replied 8 months ago.

you could be having atrial fllutter or PVC type skipped beats causing your different palpitations.

cutting down on caffeine can help

more regular exercise can help.

do you have bad anxiety symptoms?

Customer: replied 8 months ago.
I do suffer from anxiety, mostly when I'm having palpitations, especially these fluttering kind. They always last the same amount of time, usually 3 - 5 seconds or so and then they stop and they're rare, I don't usually get these fluttering ones very often, usually only once every few months. 9 times out of 10 I get the ones that feel like a skipped beat.
Expert:  Dr. David replied 8 months ago.

bad anxiety symptoms can cause palpitations.

you may benefit from medications to help decrease anxiety

meditation, regular exercise, yoga, stretching can help

Expert:  Dr. David replied 8 months ago.

let me know if you have other questions.

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you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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Thanks for using

Expert:  Dr. Scott replied 8 months ago.

Hi there, I was typing this up, but my computer froze!

Palpitations are one of the most common problems of outpatients who present to internists and cardiologists.

Although the cause is usually benign, palpitations are occasionally a manifestation of potentially life-threatening arrhythmia. Palpitations are a sensory symptom. They are defined as an unpleasant awareness of the forceful, rapid, or irregular beating of the heart. Patients may at times describe the sensation as a rapid fluttering in the chest, flip-flopping in the chest, or a pounding sensation in the chest or neck, and these descriptions may help elucidate the cause of the palpitations. The differential diagnosis of palpitations is extensive: including cardiac, psychiatric, medication, habits (caffeine, alcohol, tobacco, drugs), metabolic diseases, or stress.

Expert:  Dr. David replied 8 months ago.

This is Dr. David

I'm glad you have seen a cardiologist 5 months ago and had cardiac echo and holter and echo and all results came back normal

at your age of 35, potentially life threatening arrhythmia after normal heart testing is extremely unlikely.

you have excessive anxiety symptoms which is much more likely to be causing your heart palpation symptoms.