Menopause and extra heart beats

20 years ago I started having episodes of nearly fainting associated with sensations of my heart quivering in my chest. I wore a Holter monitor and was diagnosed with a ventricular arrhythmia. Asthma medication and stress made it worse. By reducing my stress and managing my asthma in such a way as to improve overall health, I've been able to reduce the asthma medications and improve my symptoms. To date, I have successfully lived with the problem without further fainting.I am now middle aged and entering perimenopause. A few years ago I noticed the quivering sensation getting worse so my doctor suggested trying magnesium to see if it helped. It did. I now only have that sensation very occasionally. Because it had been 20 years since my initial diagnosis and I've been having a problem I will describe below, my doctor ordered another 24 hour Holter test. The results stated "Supraventricular ectopic beats (29 during the recording). Episodes of 3 and 4 consecutive supraventricular ectopic beats. No symptoms are recorded."So, even though I am no longer feeling the abnormal rhythms, they are still there. I understand this is nothing to be overly concerned about. However, my questions follow:1) As I prepare to enter the second half of my life as healthy and as strong as I am able, I wonder what kind of long term impact this irregular heart beat may have on my overall health, if any.2) I have difficulty with vigorous exercise, which is of some concern to me as exercise is a vital component of a healthy lifestyle. For example, even though I have a very good diet, am at a healthy weight, and exercise regularly by walking, hiking, gardening, bicycling, horseback riding, and tennis... I am unable to hike uphill without great difficulty. I run out of breath and must stop, gasping for air, and catch my breath before I can go on. This has always been a problem for me, even when much younger.Additionally, when engaged in exercise like bicycling and tennis, even though I am otherwise healthier and fitter than my partners, I am still the one breathing hard and having trouble catching my breath while my partner is barely winded. It is noticeable to the point of being strange and seems to be getting worse not better as I age. My face also turns bright red. I am confident this is not an asthma attack. This is something different. I have long suspected it was related to the arrhythmia. Am I crazy to think that?Is it possible it's my heart causing these problems with exercising and if so, do I need to worry about it or is it safe to keep doing the best I can in spite of it?In case it makes a difference, I also have multiple (well managed through diet and exercise) autoimmune disorders including Hashimoto's, Interstitial Cystitis, Eczema, and Psoriasis as well as severe allergies, food sensitivities, chronic sinusitis, and high CRP along with their associated complications. I only take thyroid replacement hormone and occasionally (once every few months) a hit on the inhaler.

Palpitations are common for menopausal women. However, before labeling your problem as nothing to be concerned about, the most common cause, coronary artery disease should be excluded, best done with a stress ECHO. This will also help you with question 2, namely whether your heart (vs. for instance your lungs) is responsible for your exercise induced shortness of breath.

You already live a heart healthy lifestyle, and assuming therefore your risks are low, moderate vs. vigorous exercise will achieve the same cardio-vascular benefits, and may cause less breathing problems. Do yourself a favor and calculate your cardiac risks and prove me right!

If indeed (as I expect) your cardiac risks are low, minimizing your symptoms can be achieved by some minor adjustments, as I mentioned in the menopause/palpitations article:
Lifestyle changes that may help to reduce the incidence of irregular heartbeats during menopause:

  • Reducing intake of caffeine,
  • Limiting   consumption  of stimulants, cigarettes, and alcohol,
  • Practicing yoga, breathing exercises, or other relaxation techniques.

Hope this helps,
Dr T


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