photo credit: @wildsoulmagsyogi via Unsplash
TL;DR: The echocardiogram and the Zio patch came back normal. Who is surprised? But I’ve had two episodes since the last update and I still don’t know what triggered them. Both episodes were like the first one in May: 15-20 minutes long, started with a racing heart and lightheadedness and ended with chills/shaking before my nervous system returned to normal.
Here’s finally an update on my health situation. As a quick reminder, I had an episode of heart palpitations and lightheadedness back in May, but had a normal ECG and troponin test a couple of days later. My heart seemed fine. The doctor I saw for a follow up in June still recommended an echocardiogram, and a Zio patch (14-day EKG patch) to further eliminate any possible heart issues.
I had my next follow up appointment at the end of July. I was scheduled with Dr. H, who I had seen in June, but when I checked in at the practice, I was told that my appointment was canceled because Dr. H was out.
Apparently, she had called in sick in the morning or something, with no time to inform me beforehand (I had the first appointment at 8 a.m.), but luckily, I was able to be rescheduled for an appointment with Dr. J at 8:20 a.m. I wasn’t necessarily thrilled to see yet another doctor, but I also didn’t want to have come in vain, and it turned out that Dr. J is one of the supervisory MDs, not another resident doctor, so that made me feel a little better.
The bad news: the results of the Zio patch had not come back yet even though I sent the patch back 3 (!) weeks prior). So we couldn’t take a look at it.
The good news: Dr. J discussed the results of the echocardiogram with me and said that everything looked great and that there is nothing structurally wrong with my heart.
I had already looked at the results in MyChart prior to my appointment, and the only thing that was noted in the report was “sinus bradycardia” (slow heartbeat) and mild dilation of the left and right atrium (upper chambers of the heart), which is not uncommon in endurance athletes. (Thanks again, Sarah, for reaching out and inquiring about the heart monitor results. I appreciated your insights!)
Dr. J was also enthusiastic about all my other test results – they were all great and he thought I was taking excellent care of my health. Blood pressure 111/69, HR 55 bpm, all other blood values in the normal range. I mean, I would be lying if I said that I was NOT happy that all the test were negative… I would just like to know why I have these symptoms occasionally, and more importantly, how to prevent them.
That was my next question to Dr. J: if all tests come back negative, what then?
He said we should wait for the results of the Zio patch to really rule out any cardiac arrhythmia, and if that comes back normal, we can talk about other scenarios.
The Zio Patch results came in a week later and I received a message from Dr. H that the readings did not capture any signs of heart rhythm irregularities (surprise!) and that this most likely means that the palpitations were due to other causes (no sh*t, Sherlock). But I did mention to her that I had had another episode just before wearing the Zio Patch at the end of June, and then again at the beginning of August.
Dr. H thinks we need more information before we make any more moves. She asked me to keep a log of these episodes (which I’ve been doing already!), in particular, date of occurrence, what I was doing prior, how long they last, any other associated symptoms, anything I was doing out of the ordinary/any new changes to my environment, stress level, and anything else I think is relevant.
A NEW THEORY
So, what is a(n impatient) girl to do? Of course I scrutinized my current symptom log, looked at the patterns, and came up with a new theory.
Could this be something like reactive (postprandial) hypoglycemia (blood sugar drops below normal levels, usually 2-4 hours after eating) possibly triggered by perimenopausal hormone fluctuations? Classic symptoms for hypoglycemia are dizziness, chills, a pounding heart, and shaking — exactly what I’ve been experiencing. The episodes were always between lunch time and late afternoon.
I was also able to track both recent episodes to my luteal phase, because they happened about 3-7 days before my period (though there was one skipped cycle in between). So what if erratic hormones are to blame? Do you think that could be a reasonable explanation? Just because my blood work looks normal and I don’t have the classic perimenopausal symptoms like weight gain, insomnia, or hot flashes, it doesn’t mean that there are not a gazillion other symptoms that can be related to the hormonal changes in women’s bodies.
I don’t want to blame things on perimenopause just because, but since I don’t have any other explanation yet, isn’t it something to consider? And why hasn’t any doctor thought of it yet?
Interestingly, every time I have brought this up with a doctor, they instantly dismissed any connection with hormonal changes, which is really surprising to me. They haven’t even considered it. But how would they know if they haven’t even tested my hormones? Basic gynecological care is done in my primary care clinic, but maybe the doctors there are not educated enough about perimenopause and maybe it’s time to see a OBGYN who knows a bit more about these matters! It feels like perimenopause is still such an insufficiently researched field, although I am glad things are improving now that women are finally talking more about it and do not suffer in silence.
So, I am just ver here trying to fit the puzzle pieces of my particular situation together, but as you can tell, I am still poking in the dark here. The most scary scenarios (heart-related issues) seem to have been ruled out, which is obviously a big relief. But maybe I now should consider a glucose monitor and/or a hormone test.
Because of my newest theory, I’ve been more mindful with my eating habits, caffeine, and water intake and I carry around Dextro Energy Glucose Tablets, just in case. I am happy to say that I have not had any symptoms for the last 3 weeks. Encouraging, of course, but I’ll still be carefully logging any new or recurring symptoms, especially since I am in my luteal phase again. If I end up not having any symptoms this cycle, I think I’ll still message Dr. H and share the information about my two most recent episodes, and see what she says. I am not very keen on waiting for new episodes to occur (they’re not fun) just to gather more information, if something – anything – else can be checked or ruled out now.
I know some of you have talked about (peri)menopausal symptoms and HRT before. I’d like to know more about which symptoms you were experiencing and how you connected them to your cycle.
Also, stay tuned for more updates.
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