Palpitations and Tremors: Causes and Concerns

Palpitations and generalized tremors?

1.
Last week, I had a mild cold with a runny nose, nasal congestion, and a slight cough.
After drinking coffee, I felt dizzy and nauseous, so I went to see a doctor.
He diagnosed me with a gastrointestinal flu.
The next morning, I had a small bowel movement, but since then, I haven't had any more.
However, my stomach keeps churning, especially at night, and my heart races, making it hard to sleep.
Therefore, I take a medication he prescribed before bed to help me sleep.

2.
Last night, after taking the medication and lying in bed, my stomach continued to churn, my heart rate increased, and I began to shake all over.
However, it seemed like my stomach had stopped churning.
My heart was beating very fast, and I was worried I might faint, so I went to the emergency room.

3.
At the hospital, I had an electrocardiogram (ECG), and the doctor said my heart rate was within the normal range.
They also drew blood to check my thyroid, and the results were mostly normal, with only a slight elevation.
Then, they prescribed "Jing An Ning." The doctor asked me what medication I took before bed, but I forgot to bring it, and I wonder if it is related to the medications I took, which include BUSCOPAN, DIFENAT, Tagament, and Primperan.

1.
Could my palpitations and shaking all over be related to the medications mentioned above?
2.
The doctor only prescribed Jing An Ning, which is an anti-anxiety medication, but I don't have an anxiety disorder.
I'm unsure whether I should take it.

3.
Should I undergo further testing? My heart rate is still fast, but I am no longer shaking.
However, I feel dizzy and sleepy, even though it has been 12 hours since I received the sedative.
After the first injection, I was still shaking and had a fast heart rate, so the doctor gave me another injection and an IV drip, and I left the hospital in the morning.
Now, I still feel sleepy, and I don't know if it's due to my illness or the sedative.

4.
What could be wrong with me? The emergency doctor couldn't provide a clear explanation.
I can really feel my heart racing; why was the ECG normal? The uncontrollable shaking is really frightening...
Could it be a stroke? I've never experienced this before, and there is no family history of heart disease.
I'm very anxious and unsure whether I should seek further evaluation, and I don't know which department to visit.
The ECG was normal, and the blood tests showed only slight hyperthyroidism.
What other reasons could there be for these symptoms?
P.S.
I don't have chest tightness or pain; it's just a fast heartbeat and constant gastrointestinal motility.
I haven't vomited or had diarrhea, and I currently don't feel nauseous, but I feel very dizzy.
I apologize for having so many questions; this is my first experience like this, and I'm very anxious.
Thank you for your help, doctor.

Dàxuéshēng, 20~29 year old female. Ask Date: 2010/01/25

Dr. He Dongjin reply Cardiology

Dear Maruku, based on your description, it seems that discomfort from illnesses like a cold has caused autonomic nervous system dysregulation, which stimulates the heart and leads to an increased heart rate.
Therefore, the physician has prescribed you some anxiolytic medications to reduce the stimulation to the heart.
In fact, changes in both internal and external environments can cause various stimuli that affect the heart.
The so-called gastrointestinal flu is also a viral infection, which certainly acts as a stimulus to the heart.
Moreover, the continuous peristalsis of the gastrointestinal tract can lead to dizziness and discomfort, making it difficult for the heart rate to stabilize.
Generally speaking, an increased heart rate is not a disease; it merely reflects the body's condition.
For instance, if I were to prick you with a needle, you would feel uncomfortable, and your heart rate would also increase.
The stimulus needs to be removed for the heart rate to relax and stabilize.
There is no need to consult a physician about heart issues at this point; focus on resolving other problems, and the situation can improve.
It appears that your gastrointestinal discomfort has triggered hyperventilation syndrome, causing uncontrollable shaking.
Since there are no heart issues, the increased heart rate is normal, and the electrocardiogram is fine.
The medications you received are primarily for gastrointestinal issues and may not necessarily relate to heart rhythm.
Thank you for your concern from Changhua Hospital.

Reply Date: 2010/01/25

More Info

Understanding palpitations and tremors can be quite concerning, especially when accompanied by other symptoms like dizziness, gastrointestinal discomfort, and anxiety. Based on your description, it seems you have experienced a series of distressing symptoms following a mild illness, which can be quite overwhelming. Let’s break down your concerns and provide some clarity.

1. Palpitations and Tremors: Palpitations are often described as the feeling of having a fast-beating, fluttering, or pounding heart. Tremors, on the other hand, are involuntary, rhythmic muscle contractions that can lead to shaking movements in one or more parts of the body. Both symptoms can be triggered by a variety of factors, including anxiety, stress, caffeine intake, medications, or underlying medical conditions.

2. Possible Causes: Given that you mentioned feeling dizzy and nauseous after consuming coffee, it’s possible that caffeine could have exacerbated your symptoms. Caffeine is a stimulant that can increase heart rate and cause jitteriness or tremors, especially in sensitive individuals or when consumed in large amounts. Additionally, the gastrointestinal symptoms you experienced could have contributed to your overall discomfort and anxiety, leading to palpitations.

3. Medication Concerns: You mentioned taking medications such as Buscopan, Difena, Tagamet, and Primperan. While these medications are generally used to treat gastrointestinal issues, they can have side effects. For instance, some medications can cause dizziness or affect heart rate. The medication "景安寧" (likely a form of tranquilizer or sedative) prescribed by your doctor is often used to manage anxiety and can help with sleep. Even if you do not have an anxiety disorder, it may help alleviate some of the physical symptoms you are experiencing.

4. Follow-Up and Further Testing: Since your heart rate was within normal limits during the ECG, this is reassuring. However, if you continue to experience rapid heart rate, tremors, or dizziness, it would be wise to follow up with your healthcare provider. You might consider seeing a cardiologist or a neurologist for further evaluation, especially if symptoms persist. They may recommend additional tests, such as a Holter monitor (to track your heart rate over 24 hours) or blood tests to check for electrolyte imbalances or other conditions.

5. Anxiety and Stress Management: It’s important to address the psychological aspect of your symptoms. Stress and anxiety can manifest physically, leading to palpitations and tremors. Engaging in relaxation techniques such as deep breathing exercises, mindfulness, or gentle physical activity can help manage these symptoms. If you find that anxiety is a recurring issue, speaking with a mental health professional could provide additional support.

6. Lifestyle Modifications: Consider reducing your caffeine intake and ensuring you are well-hydrated. Eating small, frequent meals can also help manage gastrointestinal discomfort. Additionally, maintaining a regular sleep schedule and practicing good sleep hygiene can improve your overall well-being.

In conclusion, while your symptoms are understandably alarming, they may be linked to a combination of factors including medication effects, anxiety, and dietary choices. It’s crucial to communicate openly with your healthcare provider about your ongoing symptoms and concerns. They can help guide you through the next steps and ensure you receive the appropriate care. Remember, you are not alone in this, and seeking help is a positive step towards feeling better.

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