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Questions posted in the
Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: 3000 PVCs in 24 hrsForum: The Heart Forum
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I recently had a holter monitor evaluation and was found to have approximately 3000 PVCs within a twenty-four hour period with some bigeminy. It seems to be worse at night. I had an echocardiogram done and all was normal except for the PVCs. I was told that the PVCs were benign and it was something I would have to live with. I am 28 years old, in school full time. have 2 children and work on a PRN basis. It seems to me that the PVCs are too excessive to be normal. They drive me crazy because I can feel almost every single one. I do feel lightheaded sometimes, but it is not a frequently occuring thing, about every 2-3 weeks. Also I could swear that all of this began after the birth of my second child 1 year ago. The other symptom I am havinf is pain below my left breast and sometimes in my arm pit, but it does not last very long. I also get a tightness in the same area under my left breast in the rib area when I jog sometimes. Could this pain be related to my heart? I was told by an ENT that the pain I was having could be related to TMJ which I do have. It seems crazy!! I am going in for a stress test in a few weeks but the cardiologist who has a great reputation has told me that this is not a life threatening situation. I just can't stop thinking about all of those PVCs and how it doesn't seem logical that they are not a problem. Is there specific number of PVCs that are considered normal, and a number that are considered dangerous? Could all of these PVCs cause me to have a heart attack? Erin _____ Dear Erin, Topic Area: Palpitation Thank you for your question. I have addressed your specific concerns below and attached a more general discussion below. Q: Is there specific number of PVCs that are considered normal, and a number that are considered dangerous? Q: Could all of these PVCs cause me to have a heart Below is a brief summary of what a PVC is, what causes them and the treatment (if any) for PVC’s. You can find additional information in an article in New England Journal of Medicine, May 7, 1998, Vol. 338, pages 1369-1374. Your local medical library will have a copy of this. Hope this helps. PVC’s (premature ventricular contractions) are "extra" heartbeats occurring out of sync with the normal regular rhythm of the heart. PVC’s may cause no symptoms at all or may be felt as a "irregular" heartbeat or as the sensation of a "hard heartbeat". PVC’s are common findings in persons with otherwise normal hearts, in which case the prognosis is excellent and there is no decrease at all in life expectancy. On the other hand, they may indicate that there is an underlying abnormality of the heart muscle (from any number of reasons). If there is an abnormality, then the prognosis and treatment depends upon the specific problem of the heart. The usual evaluation of PVC’s is a history, physical examination, and electrocardiogram (ECG). Also your doctor may wish to check an ultrasound of the heart. If all those tests are normal, then you would fall into the category of people who have PVC’s but otherwise no underlying heart problem. In that case, treatment depends on how much the PVC’s bother you. If they are essentially asymptomatic, then no treatment is required. If they bother you, then a medication called a "beta-blocker" may reduce the frequency of the PVC’s. PVC’s can’t be "cured", but the medication can decrease their frequency. The potential side effects of beta-blockers are tiredness, impotence in men and breathing difficulties in individuals with underlying lung disease. Be sure to discuss these issues with your doctor and under no circumstance should you take medications for the heart without the supervision of a doctor. Below are some web sites with additional information about PVCs. http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/prevent.html
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