Differential Diagnosis for Hearing Heartbeat when Laying Down
- Single Most Likely Diagnosis
- Benign Vasovagal Syncope or Orthostatic Hypotension: This condition is characterized by a sudden drop in blood pressure when standing up, but can also cause awareness of heartbeat (palpitations) when laying down due to changes in blood flow and pressure. It's a common and usually harmless condition.
- Other Likely Diagnoses
- Anxiety or Stress: Anxiety can cause an increased awareness of bodily sensations, including heartbeat. Laying down can sometimes exacerbate this awareness due to the quiet environment and focus on internal sensations.
- Hyperthyroidism: An overactive thyroid gland can lead to increased heart rate and forcefulness of heartbeat, making it more noticeable, especially in quiet or when laying down.
- Mitral Valve Prolapse: A condition where the two valve flaps of the mitral valve do not close smoothly or evenly but instead bulge (prolapse) upward into the left atrium when the heart contracts. It can cause palpitations and is often more noticeable when laying down.
- Do Not Miss Diagnoses
- Aortic Stenosis: A serious condition where the aortic valve narrows, potentially leading to heart failure or sudden death. It can cause palpitations and is crucial to diagnose early.
- Cardiac Arrhythmias (e.g., Atrial Fibrillation): Abnormal heart rhythms can be life-threatening and require immediate medical attention. They can cause palpitations that may be more noticeable when laying down.
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, which can cause chest pain and palpitations. It's a condition that needs prompt medical evaluation.
- Rare Diagnoses
- Panic Disorder: While not rare in the general population, in the context of hearing one's heartbeat when laying down, it's less likely but still possible. It involves recurrent unexpected panic attacks and fear of experiencing another episode.
- Hypertrophic Cardiomyopathy: A condition where the heart muscle becomes thickened, which can lead to obstruction of blood flow and increased risk of sudden cardiac death. It's less common but critical to identify due to its potential severity.
- Cardiac Tumors: Extremely rare, but tumors of the heart can cause a variety of symptoms including palpitations, depending on their location and size.