Greetings all,

I am a 45 year old white male, 5 11, 240lbs.
I have had two tachycardia attacks in the past 6 months bad enough for
a visit to the ER to be on the safe side. I have had several ECGs,
extensive blood tests, chest X-rays, nuclear medicine treadmill test
(not only passed that, but with flying colors from what I gather),
echocardiogram, thyroid test, and a two week event monitor. All tests
negative, except for High Normal to Stage 1 Hypertension for which I've
been given Avilide and a slight LVH (heart enlargement) detected by the
echo, which my internist expected because of my high blood pressure.

I have occasional panic attacks which of course cause palpitations and
tachycardia.
But I also get palpitations without my usual panic attack symptoms
(feeling of impending doom, breathing deeply, pacing back and forth et
cetera), or being in a stressful situation. These episodes usually come
on gradually rather than suddenly. Usually I start to feel warm and
flushed and then become aware that I can feel my heart laboring
(basically the same feeling I'd get walking up hill). My pulse will
go from the 80's to the 90's and sometimes to the 100's (120 is the
highest it ever gets, but that's rare). At these times I feel a
little light headed, breathing is a little labored with slightly tight
chest, somewhat fatigued (again, exactly the way I'd feel trudging up
hill). Sometimes this is chronic over a period of days, other times
it's mild and passes after an hour or two, and sometimes I go days or
weeks with no palpitations at all.

A board certified cardiologist I went to says I have no cardiovascular
disease or abnormal heart rhythms. He even said that that my LVH was
too insignificant to cause any concern. He said that my palpitations
are anxiety related. My internist had also leaned towards this
diagnosis and even suggested that I give Zoloft a try.
But I'm wondering if I should just to let it go at that.

I have come across something called pulmonary embolism which causes
these symptoms, and I did have low grade respiratory congestion and
discomfort with occasional coughing during the entire time I had my
last (worst) three week palpitation occurrence. Now the repertory
problems did start with typical cold symptoms (and the blood test done
in the ER showed a couple of deficiencies which I'm told are
indicative of someone coming down with a cold), but the low-grade
wheez, cough et cetera dragged on for three weeks (along with periodic
low-grade sore throat and or low-grade nasal congestion) and then
relapsed again for a few more days. Both episodes seemed to have begun
and subsided at about the same time. For the last few weeks my
breathing has been excellent. Likewise, except for occasional brief
usually mild palpitations, my heart rate has been normal.

I will admit that I've been experiencing these symptoms off and on
for several years now untreated, it's only within the past few months
that it's gotten bad enough for me to be provoked into seeking medical
attention.

Does anyone think I should pursue this with any further tests?

Thank you

Ref. 103004