Heart fluttering and rumbling sensation starts after apnea and goes for hours

by Paul
(China)

I was diagnosed with mild/moderate sleep apnea in 2005 for the first time.

I did not have the courage to start using a machine...at the time, I had this horrible 'vibration' in my chest which was quite frightening.

It started suddenly, and lasted for several years.

After running from pillar to post for years (16 different doctors, several cardiologists, several hospitals in two countries) a young locum in the UK said she could hear a loud systolic murmur, and put me on 120 mg of propranalol.

I was under great job and relationship stress at the time and my father died in 2005 suddenly.

I also put my heart under some strain by putting a tourniquet of sorts on my privates for hours at night...sort of exercises.

I believe now that I have had sleep apnea for many years before 2005 but did not know it.

In 2007 the symptoms abated and for that year I took no medication, and was fine. I was living in the UK.

But in 2008 when I went to Singapore to try and marry my long-distance girlfriend, the symptoms started coming back...she refused to leave Singapore...and I took on a very stressful job there, even though it was a very bad fit, hoping she old change her mind.

I stayed on propranalol 40 - 60 mg a day or more until 2011, when again I was able to reduce he dose to 40 mg. I began to feel that the beta blocker might be hurting my heart and slowly weakening (decinditioning) it...so I tried to get off the medication.

Unfortunately, suddenly in 2011 the symptoms came back and very aggressively. I now have a 'fluttering' when I get ANY apnea or possibly hypotonia...and it is very aggressive and frightening.

I saw a new Cardiologist in July 2011 and also got a Holter done in November...but the docs have not detected anything serious, so they give me some pills tell me it's stress and send me away (each time costing me up to $1000).

I finally got a new sleep study done in Augusts 2011 but did not ever want to buy a CPAP. AHI this time was 21 supposedly (portable PAT used at home. $800 for the sleep specialist to print out and interpret the results at the expensive private clinic in Singapore).

I resisted using the CPAP for another five months but the 'rumble' became continuous; and it has become a low level fluttering sensation. It now happens through the day ur dies down.

The mental anguish over my relationship has definitely contributed to central apnea...it doesn't happen as much now but several months ago it was intolerable...and I was forced to take 3 months off work to try and rest (at the girlfriend's home) and to find the cause of my symptoms (I had not bought the CPAP then).

I am currently living in Shanghai China with few friends. While waiting for my gal friend to be willing to marry me and settle down in Canada (she wants to marry me...just not relocate for several years as she enjoys a fabulous career in Singapore).

The stress of living in China, alone, is quite high...never mind the fact that my Mother died of colon cancer about a year ago...my question is, I have tried BIPap on this machine and AUTO BIPAP but I still seem to get a lot of central apnea or hypotenuse or OSA; so I went on CPAP and it does help a gat deal. But even one apnea seems to be affecting my heart now; so how do I eliminate every single major apnea?

I think if I can do this (current setting is 12.5 the doc put me on 10) the flutter will disappear as my heart recovers and shrinks to normal (I have two mild mitral and tricuspid leaks...I am convinced the apneas have made these slightly worse).

But I worry that even using CPAP/BIPAP might do even more damage, because if my condition is primarily central (psychological possibly) then an APAP machine would be more helpful.

But I cannot afford to buy another machine (the fancy Singapore clinic I went to wanted $4000 for the same new machine I bought on Amazon for $1000). Can you please, please assist me with titration?

My Specialist wants $800 probably to reset the machine...what I also want to ask is is it possible we get sleep apnea from weakening leaky heart valves AND NOT THE OTHER WAY AROUND?

If so, valve repair will be the best option (I am 47 smoke 4 to 6 sticks a day and have smoked altogether for about 4 years...started in my 40s). I do not have hypertension, a history of heart disease or stroke in my family...

I have a stethoscope...I can vouch that when I have a bad apnea even with the CPAP, I have a third heart sound, or my heartbeat sounds quite forceful, abnormal (but regular) and possibly with an S3. But after about 10 to 20 minutes, my heart sounds perfectly normal (but I can still have the 'flutter' which I can't really hear with the stethoscope).

I desperately want to cure the 'flutter' but I do not know if, by staying with the gal friend in Singapore, it might never resolve due to he stress of living with someone who is at cross purposes with you...

I can't really conceive od breaking off with my fiancée, because I have put ten years into our relationship, and I love her very much...and I cannot return to Canada alone, having failed to win my wife...so how to cure this flutter?

By he way, my regular GP in the UK refused to treat me unless I agreed my problem (wild and awful chest vibration) was mainly psychological. I was quite offended but I agreed there is a psychological component...

So he prescribed Sertaline (SSRI) which, in retrospect, I now feel may have contributed to curing me...perhaps I should get back on I as I may be significantly clinically depressed ( my younger brother and father suffered from depression...my brother is on an antipsychotic...my father also suffered from hypo or hyperthyroid)...

But in my case, apart from the diagnosis of slep apnea, I have never been treated in a hospital except for anxiety as an outpatient (over 'heart issues').

I cannot imagine going on like this, feeling the flutter all day, and not knowing if it is damaging my heart but also knowing that the docs won't do a thing for me, unless I become very sick (symptomatic)....



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Mar 06, 2012
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My answer
by: Remy

I hope I'm not the only one who feels a sense of fear or worry from your story. I'm not talking about the worries of being unhealthy, but an exaggerated fear about your heart sensations.

Now, this is perfectly normal. You know you have sleep apnea and you feel heart palpitations, so you visit your GP to check your heart.

But what happens here? You learn from your doctor that you don't have heart problems. Still, you receive a breathing machine to treat sleep apnea.

This story should finish here, when you continue to use the CPAP every night. But you still think your heart has huge problems.

I know you have a difficult situation, but having a trustworthy doctor is crucial. Why? Because if your heart is fine, you increase the anxiety unnecessarily. And this can only affect your sleep quality, which is very important to treat sleep apnea.

Did you know that psychiatric disturbances (including anxiety and depression) are often found in patients with sleep apnea? Furthermore, people with anxiety often have symptoms of heart palpitations, similar to your description. Read more about sleep apnea and anxiety here.

I think you have to figure out if you really have a serious problem with your heart and start the treatment. But most importantly: use the CPAP machine every night.

The CPAP can reverse the damage of the heart, so I think you should be very interested about this breathing machine. Please read here the CPAP benefitis and watch the video about the "Most Important CPAP Benefit in Severe Sleep Apnea Patients". I believe you will be pleased about the news.

What can I say, Paul? I would prioritize your health, so you could love like a healthy man. Or to enjoy love like a healthy man. In any case, I would use the CPAP every time I sleep, even if I travel with an airplane.

Mar 13, 2012
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Thanks
by: Paul

I have been using the CPAP more (every night for the last month or so) and it has made a tremendous difference. My stamina is up; my energy is up; my alertness is up...i am very grateful for it. However, the 'flutter' is still there although it has definitely subsided. I think it is still there because I have not been able to find the best settings yet with the CPAP. I tried BiPAP, Auto-BiPAP and CPAP and have stayed with the CPAP at 12.5 because it eliminates almost all hypopneas and apneas, which are clearly causing the 'flutter' (by the way the 'flutter' did not show on a Holter in October).

I try not to worry about my heart; but it is obvious now that my chronic stress from my relationship and employment in China (away from home in Canada, my church, and relatives for nine years now); and the death of my Mother last year, all conspired against me to push me to extremes of anxiety well beyond my physical and psychological endurance curve.

To cope, I smoked and drank (more) and this caught up with me. I have had very little spirits now for almost a year and I recently stopped smoking (i foolishly started smoking 5 years ago and was down to 4 sticks a day BUT these are CHINESE cigarettes). The pollution in China and the Chinese air conditioning (a stupid system where hot air from a filthy air conditioner is pumped into your closed room and into your face) probably tipped the scales and made it almost impossible for me to breathe normally; so the 'vibration/flutter' came back.

I am grateful to God that the really bad pulsating flutter has now gone and only a very low-level flutter remains, which will go forever, once my heart shrinks enough on the CPAP.

But for this to happen, I need to have zero apneas and hypopneas and it is quite difficult to find the best setting...

Any help from others suffering from having to be strapped into a machine to sleep every night, and having to deal with the fear of death caused by a 'heart flutter' of unknown etiology (I have two mildly leaky valves and I expect the sleep apnea either CAUSED these leaks or else vice versa), please can you help me find the best settings? Thanks!

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