Palpitations

Notatestpilot

Notatestpilot

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Notatestpilot
Hello,
I'm 54 years old.
I'm in good health, good numbers from recent blood work. Blood pressure is 110 over 75. Been having mild shortness of breath and heart palpitations. This is going on 6 weeks. I had a cardio stress test and results were normal.
However, I noticed the palpitations after every meal...
My doctor dont think there's anything wrong. Is this anxiety?
Sorry, but if you have heard of food causing heart palpitations let me know.
Thanks!
 
You've had a workup by your doctor who thinks there's nothing medically wrong. If you want a second opinion, you should go to another doctor, not an Internet pilot board.
 
Well, if you want advice from someone who's entire medical training consists of watching episodes of "Emergency!" when I was about 5.... I had a friend who was maybe having random episodes of a-fib, so her doc gave her some kind of heart monitor to wear for a few days. I think it ended up being nothing.

Now I have the theme song from that show stuck in my head...

Oh, and if you watch TV and the news while eating, THAT could do it.
 
lsaway said:
Its called a holter monitor. Its a portable ECG worn 24 hours a day for a few days prescribed by doctor.
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Actually for intermittent things like this they will prescribe for like 40 days. With stuff like this, unless it's debilitating, I would tend to believe the doctor and move on. Also if it's after meals, keep a log of what you eat and figure out if something is causing it. Obviously you should stop caffeine and limit alcohol.

There are a lot of people out there who get palpitations, most are harmless.
 
Dry Creek said:
Full tummy stimulating the vagus nerve?
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Pretty good answer.

OP, you better be VERY careful who you see and how you're worked up from here. We do a TON of echocardiograms and a lot are on pilots that had an "abnormal EKG" at the general physician office ... we have a couple of cardiologists in our area that have absolutely saved pilots of TON of money and time getting things correct the first time in order to avoid a lengthy Oklahoma review that would/could result in PET scans and angiograms not covered by insurance.
 
danhagan said:
Pretty good answer.

OP, you better be VERY careful who you see and how you're worked up from here. We do a TON of echocardiograms and a lot are on pilots that had an "abnormal EKG" at the general physician office ... we have a couple of cardiologists in our area that have absolutely saved pilots of TON of money and time getting things correct the first time in order to avoid a lengthy Oklahoma review that would/could result in PET scans and angiograms not covered by insurance.
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An easy way to test would be for the OP to take a very full breath, and with lungs full bend over at the waist - as far as possible. If the result is an obvious change in heart rate, then I would go along with vagus nerve stimulation issues.
What makes it worse is if you have an existing condition with extra "fast" pathways. In that case the visalva will send your rhythm off to the races (extended PSVT). A trip to the electrophysiologist can straighten that out (radio frequency ablation).
 
danhagan said:
Pretty good answer.

OP, you better be VERY careful who you see and how you're worked up from here. We do a TON of echocardiograms and a lot are on pilots that had an "abnormal EKG" at the general physician office ... we have a couple of cardiologists in our area that have absolutely saved pilots of TON of money and time getting things correct the first time in order to avoid a lengthy Oklahoma review that would/could result in PET scans and angiograms not covered by insurance.
Click to expand...

I know for Class 3 and student/private pilot certificates, the consensus is to go for a “consult” before filing out the form and doing an official medical to make sure you have “all your ducks in a row” before going to OKC, or at least knowing that you’d possibly be denied or face an uphill/expensive battle, thereby being able to go Sport Pilot with a drivers license.

So my question is this: Assume you meet the Class 3 requirements have your PPL, and end up getting your Commercial certificate and want to get a Class 2 medical. One difference between the Class 3 vs 2 is the EKG. You don’t know what you don’t know, so you go get an EKG on a “consult basis”...that consult is part of an official record and if it turns out badly, you’re done, right? It’s now part of your official medical record. Said another way, if you already have a Class 3, no more consults “allowed”. You also have an ethical duty to not exercise your flying privileges until and unless you go to OKC with your new knowledge, right? Almost makes one nit want to know and not get a higher class medical, even if you have the Com cert (teach only).
 
"Almost makes one nit want to know and not get a higher class medical, even if you have the Com cert (teach only)."

If you are just instructing, you do not need a 2nd class medical, only 3rd class. (OR BasicMed, but that comes with some caveats)
 
455 Bravo Uniform said:
So my question is this: Assume you meet the Class 3 requirements have your PPL, and end up getting your Commercial certificate and want to get a Class 2 medical. One difference between the Class 3 vs 2 is the EKG.
Click to expand...

Here's a great example: My wife had an "abnormal EKG" at her primary physician office which repeated with a cardiologist with results indicating there could be an issue. A PET scan for several thousand was ordered which revealed a "possible myocardial infarct at the left ventricle" which was also explained could simply be a possible artifact ... thus requiring the $6,0000 angiogram with possible stent. Angiogram was 100% normal and wife was told she has the arteries "of a teenager" ... insurance has a $3500 deductible and $7500 family deductible, but because the PET scan was in December, we got to pay that fee and the current angio in full (that's WITH insurance).
 
Cricket1 said:
"Almost makes one nit want to know and not get a higher class medical, even if you have the Com cert (teach only)."

If you are just instructing, you do not need a 2nd class medical, only 3rd class. (OR BasicMed, but that comes with some caveats)
Click to expand...

Yes, that was my point with the above quote, that CFI could be the lone option for someone with the Com cert who didn’t want to risk denial via the unknowns of a new Class 2 (EKG example) and a “never fly” risk, and thus opt for sticking with Class 3.

But my main comment is that you can’t even get a Class 2 “consult” because you’d be “in the medical records system” with a “code”. I guess you could go to Mexico and have a doc do a mock Class 2 to see if you’d pass, then the only bar would be your own ethics if you couldn’t pass.
 
If there are 2 or more extrasystoles on the standard EKG, the FAA has guidance for the AME:
https://www.faa.gov/about/office_or...app_process/exam_tech/item36/amd/arrhythmias/

For a medical of any class, I think it's better to clear it up before seeing the AME and bring a statement from the cardiologist that there is "no evidence of structural, functional or coronary heart disease" (see disposition column). The AME will ask for that evidence and it's next to impossible to arrange a stress test, Holter monitor, echocardiogram, etc within the 14 days the AME has to submit the application to the FAA. If you can't satisfy the AME in that time span, it's an automatic deferral, and then you're stuck in the months-long queue in the FAA Aerospace Medical Certification Division.
 
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