Palpitations: Causes and Concerns for Athletes - Cardiology

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Palpitations, or the sensation of feeling your heart beating, can be a common experience, especially among athletes. Given your background as an athlete and the changes you've noticed in your heart rhythm and sensations, it's important to understand the potential causes and concerns associated with palpitations.

Firstly, it's worth noting that palpitations can be triggered by various factors, including physical activity, stress, anxiety, and even dietary choices. As an athlete, your body is accustomed to higher levels of physical exertion, which can sometimes lead to heightened awareness of your heart rate. When you are sedentary, such as when you are sitting and using your phone, you may become more aware of your heartbeat, especially if you are not engaged in other activities that distract you from it.

Your observation of a resting heart rate in the 60s is generally considered normal for an athlete, as regular training can lead to a lower resting heart rate due to improved cardiovascular efficiency. However, the occasional drop in heart rate to the 40s or 50s during sleep is also not uncommon among well-conditioned athletes. This phenomenon, known as bradycardia, can be a normal adaptation to endurance training. Nevertheless, if you experience symptoms such as dizziness, fainting, or persistent fatigue, it would be prudent to consult a healthcare professional.

The discomfort you describe in your left shoulder area, which coincides with your heart's location, could be muscular in nature, especially if it occurs during certain activities or positions. Muscle strain or tension can often mimic cardiac symptoms, leading to confusion. The occasional "twitching" or "spasms" you feel in your chest could also be benign muscle contractions, particularly if they are not associated with pain or other concerning symptoms.

Regarding the sensation of nausea or "reflux" when lying down, this could be related to gastrointestinal issues rather than cardiac problems. Stress and anxiety can exacerbate these feelings, leading to a heightened awareness of bodily sensations, including your heartbeat.

Given that you had a normal electrocardiogram (ECG) last year and no signs of edema, it is less likely that you have a serious underlying cardiac condition. However, if your palpitations persist or worsen, or if you develop new symptoms such as chest pain, shortness of breath, or significant changes in your exercise tolerance, it would be wise to seek further evaluation. A follow-up ECG, Holter monitor (which records your heart's activity over 24 hours), or even an echocardiogram may be warranted to rule out any arrhythmias or structural heart issues.

In summary, while palpitations can be concerning, they are often benign, especially in athletes. Factors such as anxiety, physical inactivity, and muscle tension can contribute to your symptoms. Maintaining a balanced lifestyle that includes regular physical activity, proper hydration, and stress management techniques can help alleviate some of these sensations. If you continue to experience discomfort or have concerns about your heart health, please consult a healthcare provider for a thorough evaluation and personalized advice.