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Heart Disease (Expert Forum)
Arrhythmia//PVC's
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Arrhythmia//PVC's
by twhgait, Oct 09, 2004 12:00AM
I am a 39 y.o. female with no big PMH. I am a nurse and on occasion check my radial pulse. While doing this for the past couple months, I have noticed frequent "skipped beats" in my pulse (just a pause in a chain of beats). I do have the occasional palpitations that I can feel in my chest also. I cannot consciously feel these radial pulse "skipped beats" in my chest and wouldn't have even noticed them if I had not been checking. They seem to disappear when my heartrate increases and are most noticeable at rest (at least every 40 beats or so). I went to my FP doctor and my EKG was normal. I pick up my holter monitor on Monday (48hr) and will also have some fasting labs drawn at that time. He also ordered an echo which I have not scheduled yet. My thyroid size appears normal although there were some cysts on it. My doc feels these are probably benign PVC's as I have normal cardio results so far. I've read thru these forums extensively and most pt's describe the "fluttering, flipping over" sensations. Can PVC's like mine (not noticiable unless I am checking my pulse) still be benign? Or, is this another possible arrhythmia that I may be dealing with? How reliable is the ECG stating "normal sinus rhythm" considering other possible arrhythmias? Of course, my heart behaved in the doctors office (I was very nervous and my pulse shot up to 96 bpm). I am worrying myself into a panic over this
Doctor's Answer
by CCF-M.D.-MJM, Oct 09, 2004 12:00AM
Hey,
Stop worrying. Your biggest problem is that you work in the health care industry and you see all the worst case scenerios--you are acting like every other health care professional I know.
Consider yourself fortunate you don't feel them. For some reason, some people feel every blasted PVC or PAC and others don't notice anything.
A 24-48 hour holter should answer the question of PAC versus PVC. A normal EKG, echo, and holter should reassure you to move on. It is normal to PVCs and PACs and does not indicate there is something wrong.
If you are not having symptoms of chest pain, shortness of breath, lower extremity swelling, passing out or almost passing out, increased exertional shortness of breath.....the echo probably wasn't even necessary, although a normal echo will certainly help reassure you.
After you get you normal results back, stop checking your pulse (just kidding, but don't convince yourself you are sick when you are not. The mind is a powerful tool, don't let it work against you).
Stop worrying. Your biggest problem is that you work in the health care industry and you see all the worst case scenerios--you are acting like every other health care professional I know.
Consider yourself fortunate you don't feel them. For some reason, some people feel every blasted PVC or PAC and others don't notice anything.
A 24-48 hour holter should answer the question of PAC versus PVC. A normal EKG, echo, and holter should reassure you to move on. It is normal to PVCs and PACs and does not indicate there is something wrong.
If you are not having symptoms of chest pain, shortness of breath, lower extremity swelling, passing out or almost passing out, increased exertional shortness of breath.....the echo probably wasn't even necessary, although a normal echo will certainly help reassure you.
After you get you normal results back, stop checking your pulse (just kidding, but don't convince yourself you are sick when you are not. The mind is a powerful tool, don't let it work against you).
Erik
Are you diabetic, hypertensive, overweight? What about alcohol, tobacco or excessive stress?
I would suggest a stress test and a workup by a cardiologist. A GP simply does not have the knowledge to deal with these issues.
My own diagnosis was sinus tach and unifocal PVC's. I was told everything was fine. Then I found not one but TWO letters warning of sudden cardiac death in my records.
Doctors are notorious for telling you what you want to hear, not what you NEED to hear. Please seek another, better informed opinion regarding your case.
I guess saying "sense of relief" is not totally descriptive of my situation (I still have tests to finish....), but in all honesty, it provides me with an optimism I didn't have before. It's one thing to sit at home and feel an irregular heartbeat and imagine the worst, but it's another to read stories about other peoples PVC's and start to understand this "disorder" (for lack of a better word) and that it's NOT a life-ending event in and of itself. I am completely healthy, no other medical conditions to speak of. I could stand to lose about 25lbs, I smoke and I drink coffee. I have no other signs/symptoms of a cardiac nature. I usually handle my stress well (I think that's where the cigerettes come in, so "well" might not be accurate). I think when these tests are complete and if all's well, I will not dwell on this anymore. Life's too short and I have too much left to do. I guess had I not checked my pulse that night (and I'm still not sure why I did), I still wouldn't know this was even going on. I've worked with the Cleveland Clinic in my past job and have nothing but respect for the clinic and it's MD's. Thank you so much for your concern and I will not allow myself to be brushed off until I am completely satisfied with the answers and long-term outcomes.
Erik
BTW...this forum is NOT the private playground of a handful of regulars (with multiple user names) attempting to dominate and factionalize the discussion. From what I read, there is a lot of idea injecting going on here.
Back to the Playground for regulars and multiple screen name users. I shortened my screen name so it wasn't so long. If that's mutiple screen name using then I guess you've got me there. Maybe in a figurative sense you could call this a playground, and if you continue not to play nice, then maybe no one will want to play with you anymore.
I am 40 with PVCs diagnosed a couple of years ago. I have only felt PVCs lately when I have slight indigestion. I started a