Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Heart palpitations, PVCs, murmurs

Forum: The Heart Forum
Topic: Heart Murmur


I started having PVCs in December of 1998 and my doctor has done 2 EKGs which
were normal. I am a 43 y/o healthy, overweight mom with a very busy life and I just
thought it was stress. However, when I went to my family practice doc with
one of my children she listened to my heart and heard PVCs. Now she's scheduled
me for an appointment with a cardiologist to do an echocardiogram. She says she's heard a
murmur and an irregular heart beat. I seem to be getting PVCs much more
frequently. Is this something I should worry about? I've cut down on caffeine
somewhat.



___
Dear Sherry,,

Thank you for your question. PVC's in themselves harmless and not cause for concern or reason to do an echocardiogram. I suspect that your doctor is more concerned about the heart murmur and this is her reason for the test. I have enclosed some additional information about PVC's for you. Good luck.

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
http://www.nhlbi.nih.gov/nhlbi/cardio/other/gp/arrhyth.htm
http://www.MedicineNet.com/Forum.asp?li=USA&ag=Y&ArticleKey=1946

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist



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