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Heart Disease (Expert Forum)
BP, L-BBB, PVC's, SVT.
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
BP, L-BBB, PVC's, SVT.
by Bodoni, Dec 05, 2000 12:00AM
I posted not long ago...but need a follow-up.
I am a 57 year old male, 178 lbs. Some family history
regarding heart disease. I do not smoke and eat a fairly
low fat diet. Weak point is I'm deconditioned from lack of
exercise program. LDL is 129. HDL, 48. Triglycerides, 85.
I have some 'White-Coat' BP, but BP is 125/75 most times at
home during morning hours. And 110/65 in late evenings.
[ In doctor's office setting - it is 150/100. ]
3.5 years ago, during a routine EKG, they found I have a
Left Bundle-Branch Block. Docs all said not to worry, since
I presented no symptoms.
A new internist ordered an Echo-cardiogram last year and that
test yielded nothing out of the normal stats. Later, he did
an EKG that was normal with the exception of the L-BBB, of
course. [ He said he may have detected a couple of PVC's. ]
Back in September I began to have some mild to moderate
daily episodes of possible PVC's. Just a few pauses and
skips per minute, here and there. I wore a 7-Lead Holter
for 24 hrs. and NOTHING showed up except a short 4 second
episode of SVT. For the last 5 weeks or so, I have had
NO skipped beats that I am aware of.
A couple of weeks ago I ended up in the ER with rapid pulse,
[ 98-110 ] elevated BP for a while [ 160/110 ] and some lightheadedness. After a chest x-ray, EKG and monitoring for
about 1.5 hrs. and a series of blood tests, they sent me home
saying all looked ok and I probably just had an anxiety attack.
[ The ER doc did comment that sometimes a L-BBB can mask
certain things. And he did ask me WHY I had the L-BBB, but
I had no answer for that question.] * My internist said this
EKG matched the one he did a few weeks earlier - with no
apparent changes.
During the last few weeks, I have had several episodes of
mild to moderate rapid pulse [ 100 - 125 bpm ] with some degree
of lightheadedness. Things usually return to normal after 30
minutes to an hour, or so.
I am scheduled for a Thallium Stress Test later this week.
* I take 30 mgs of BuSpar for anxiety and 40 mgs of Prilosec
daily for a slight hietal hernia, spastic esophagus and non-
uncerative stomach gastritis.
Please comment on the following:
1. I know I need to get on an exercise program. Is there
anything you see in my posting that would preclude something
like brisk walking 3 - 5 times per week for 45 minutes?
2. Please comment on my LDL, HDL ratios. Are these numbers
a bit better than average? Should I do anything to attempt
to get the HDL higher?
3. Now for my BP. Is 'White Coat' syndrome worth treating?
Some docs now say yes. Some say, no. If so, would a drug
like Atenenol be okay? And could help my anxiety and rapid
pulse episodes as well? Start with 25 mgs? My resting pulse
is 55-65 at night. Would a small dose make my heart rate
too slow?
4. Without alarming me too much, is the L-BBB anything much
to worry about since I had a clean Echo? I have been told
that left blocks can progress sometimes and that a Pacemaker
might/could be in order down the road? Do left blocks repsond
well to Pacers? And do you always find out WHY someone has
a heart block?
5. After one has a couple of base-line EKG's, is it safe to
assume they would be able to detect heart damage even with
the L-BBB present?
6. Regarding the one minor SVT that was detected on the 24 hr.
Holter - is this any big deal? My doc said lots of people off
the street, should they wear a Holter, would show a couple of
tiny SVT's now and then. Do my symptoms sound like SVT, or
something from the L-BBB, or just anxiety? And even if it is
minor SVT, would my symptoms warrant any medical treatment
at this time?
Thank you very much for your time and attention.
I am a 57 year old male, 178 lbs. Some family history
regarding heart disease. I do not smoke and eat a fairly
low fat diet. Weak point is I'm deconditioned from lack of
exercise program. LDL is 129. HDL, 48. Triglycerides, 85.
I have some 'White-Coat' BP, but BP is 125/75 most times at
home during morning hours. And 110/65 in late evenings.
[ In doctor's office setting - it is 150/100. ]
3.5 years ago, during a routine EKG, they found I have a
Left Bundle-Branch Block. Docs all said not to worry, since
I presented no symptoms.
A new internist ordered an Echo-cardiogram last year and that
test yielded nothing out of the normal stats. Later, he did
an EKG that was normal with the exception of the L-BBB, of
course. [ He said he may have detected a couple of PVC's. ]
Back in September I began to have some mild to moderate
daily episodes of possible PVC's. Just a few pauses and
skips per minute, here and there. I wore a 7-Lead Holter
for 24 hrs. and NOTHING showed up except a short 4 second
episode of SVT. For the last 5 weeks or so, I have had
NO skipped beats that I am aware of.
A couple of weeks ago I ended up in the ER with rapid pulse,
[ 98-110 ] elevated BP for a while [ 160/110 ] and some lightheadedness. After a chest x-ray, EKG and monitoring for
about 1.5 hrs. and a series of blood tests, they sent me home
saying all looked ok and I probably just had an anxiety attack.
[ The ER doc did comment that sometimes a L-BBB can mask
certain things. And he did ask me WHY I had the L-BBB, but
I had no answer for that question.] * My internist said this
EKG matched the one he did a few weeks earlier - with no
apparent changes.
During the last few weeks, I have had several episodes of
mild to moderate rapid pulse [ 100 - 125 bpm ] with some degree
of lightheadedness. Things usually return to normal after 30
minutes to an hour, or so.
I am scheduled for a Thallium Stress Test later this week.
* I take 30 mgs of BuSpar for anxiety and 40 mgs of Prilosec
daily for a slight hietal hernia, spastic esophagus and non-
uncerative stomach gastritis.
Please comment on the following:
1. I know I need to get on an exercise program. Is there
anything you see in my posting that would preclude something
like brisk walking 3 - 5 times per week for 45 minutes?
2. Please comment on my LDL, HDL ratios. Are these numbers
a bit better than average? Should I do anything to attempt
to get the HDL higher?
3. Now for my BP. Is 'White Coat' syndrome worth treating?
Some docs now say yes. Some say, no. If so, would a drug
like Atenenol be okay? And could help my anxiety and rapid
pulse episodes as well? Start with 25 mgs? My resting pulse
is 55-65 at night. Would a small dose make my heart rate
too slow?
4. Without alarming me too much, is the L-BBB anything much
to worry about since I had a clean Echo? I have been told
that left blocks can progress sometimes and that a Pacemaker
might/could be in order down the road? Do left blocks repsond
well to Pacers? And do you always find out WHY someone has
a heart block?
5. After one has a couple of base-line EKG's, is it safe to
assume they would be able to detect heart damage even with
the L-BBB present?
6. Regarding the one minor SVT that was detected on the 24 hr.
Holter - is this any big deal? My doc said lots of people off
the street, should they wear a Holter, would show a couple of
tiny SVT's now and then. Do my symptoms sound like SVT, or
something from the L-BBB, or just anxiety? And even if it is
minor SVT, would my symptoms warrant any medical treatment
at this time?
Thank you very much for your time and attention.
Doctor's Answer
by CCF CARDIO MD - DLB, Dec 05, 2000 12:00AM
1. I thiink exercise is a good idea for you. I would wait until the stress test results before starting though.
2. The LDL and HDL are both OK. Exercise may help raise the HDL.
3. If your blood pressure is consistently elevated in your doctor's office, it ought to be treated.
4. Progression to needing a pacemaker is a possibility, but is still not very likely. The cause of a LBBB is not always discovered.
5. No.
6. I agree with your doctor, the short run of SVT does not seem to be a cause for concern.
2. The LDL and HDL are both OK. Exercise may help raise the HDL.
3. If your blood pressure is consistently elevated in your doctor's office, it ought to be treated.
4. Progression to needing a pacemaker is a possibility, but is still not very likely. The cause of a LBBB is not always discovered.
5. No.
6. I agree with your doctor, the short run of SVT does not seem to be a cause for concern.
