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Heart Disease (Expert Forum)
PVC's and Vagus Nerve
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
PVC's and Vagus Nerve
by PED, Jul 23, 2006 12:00AM
I've had chest pains and PVC's for 7 months now. Good news is I'm finally more or less convinced I don't have cardiovascular disease. I suppose at 35 yrs old, having passed Thallium and Stress echo's, combined with acknowledgement that I do have PVC's but I am able to exercise at 85-90% of my max HR without chest pain is enough to get me 90% of the way to "thinking normal rational thoughts". It has been difficult for sure as I do have a lot of jaw and left arm pain, but I now believe that has a nerve/muscular cause as those symptoms are getting worse, but are easier to pinpoint now. That said, a few questions.
1. My PVC's generally get worse as the day goes on or after I exercise. I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal? Any reason for this?
2. During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120. Cardiologist said this was normal?
3. Is it possible that a vagus nerve problem can cause PVC's?
4. The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this? Or does it have a mech of action?
I want to thank you and everyone here for their time/posts. This has been a difficult 8 months, and while I'm not back to normal yet, I'm no longer convinced I'm going to die, I still have thoughts that concern me but I'm at least 85-90% better mentally.
1. My PVC's generally get worse as the day goes on or after I exercise. I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal? Any reason for this?
2. During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120. Cardiologist said this was normal?
3. Is it possible that a vagus nerve problem can cause PVC's?
4. The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this? Or does it have a mech of action?
I want to thank you and everyone here for their time/posts. This has been a difficult 8 months, and while I'm not back to normal yet, I'm no longer convinced I'm going to die, I still have thoughts that concern me but I'm at least 85-90% better mentally.
Doctor's Answer
by CCF-M.D.-MJM, Jul 23, 2006 12:00AM
Hi PED,
1. My PVC's generally get worse as the day goes on or after I exercise. I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal? Any reason for this?
PVCs present diffently in different people. There is still no clear explanation for when they decide to show their face. Some people can recognize triggers like coffee, soda, sugar, exercise, etc.
2. During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120. Cardiologist said this was normal?
This is normal. Faster heart rates tend to suppress PVCs.
3. Is it possible that a vagus nerve problem can cause PVC's?
There is no data that I know of to suggest this.
4. The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this? Or does it have a mech of action?
beta blockers decrease PVCs in some people and not others. Beta blockers do decrease the sensation of PVCs. These are the reasons we use them. If you think the beta blocker makes them worse, there is no harm in not taking them any longer.
I hope this helps. Thanks for posting.
1. My PVC's generally get worse as the day goes on or after I exercise. I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal? Any reason for this?
PVCs present diffently in different people. There is still no clear explanation for when they decide to show their face. Some people can recognize triggers like coffee, soda, sugar, exercise, etc.
2. During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120. Cardiologist said this was normal?
This is normal. Faster heart rates tend to suppress PVCs.
3. Is it possible that a vagus nerve problem can cause PVC's?
There is no data that I know of to suggest this.
4. The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this? Or does it have a mech of action?
beta blockers decrease PVCs in some people and not others. Beta blockers do decrease the sensation of PVCs. These are the reasons we use them. If you think the beta blocker makes them worse, there is no harm in not taking them any longer.
I hope this helps. Thanks for posting.
Yup, they wanted to load me up on Xanax also for "Anxiety" which seems to be the cop out these days. I tried it, it did nothing other than get me all wound up after trying to ween off of it.
My anxiety, if I had it was over potential heart problems. Chicken or the egg.
It was nice when I finally got a cardiologist (3rd I went to) to finally listen and talk a bit. I could tell he also felt it was a bit of anxiety, but at least took the time.
Young people get short changed when it comes to cardiology. I'll bet many additional appointments could be avoided by an extra 5 minutes during a first.
It took me MONTHS to figure out what was going on...feeling was so bad...thought I was dying. Once I found out it was these beats and found this forum...I was relieved to see it is somewhat common but still worried SOMETTHING WAS WRONG WITH MY HEART AND THEY JUST DIDNT FIND IT YET. I am trying to find a way to cope with this the best I can. I can handle the little ones, bu the BIG ONES, I still panic. I just can't help it.
Believe me I know how you feel to a T! It's totally normal for someone to feel the way you do considering the terrifying feeling associated with these darn palps. I have a routine check up tomorrow with my cardiologist and I am really looking forward to another conversation and the chance to ask some more new questions I have regarding PVC's since...you can't learn enough about them before you hear something else new! haha.
I hope that you are able to put the past scary and difficult 8mths behind you and that you can move on step by step into a worry free or at least very low stress life style. And everyone is different so don't compare yourself to anyone else, just listen to your cardio, trust them ok? Once a 3rd opinion comes around good, trust it, believe in it, your ok. A 1st opinion from a good cardiologist is great too.
I wish you the best and keep reading this forum, the archives on palps are a great place to start! :)
Take care,
Nurse Kagome :)
Talylor, have you read any literature, on the internet or in a book on heart disorders at the bookstore, about what is happening in your heart when you have a pvc? The heart's chambers are elastic; they receive and pump out basically as much or as little blood as comes into them from other parts of your body.
When you have a premature or early beat (that's the one you will probably NOT feel), there will next be a pause in the regular rhythm, until the next scheduled beat. This pause or delay is not long enough to be dangerous, but it is likely the cause of the weird, sinking, or 'going down the hill" feeling you describe. Some people are more sensitive to it than others, but I feel this one, too. Anyhow, during this pause, when you don't feel a pulse, your ventricle has time to get a little more full with returning blood than usual. Since the ventricle is elastic, it easily expands to receive any extra blood.
Of course, the ventricle also has to pump OUT the blood it receives. It's a muscle, and a strong one, so it contracts HARD, like a fist, to pump out what has come in. That's probably the "BIG ONE" you feel. It's scary, but's it's almost certainly a perfectly normal response to a small delay in the heartbeat.
These feelings are almost impossible to ignore once you are sensitized to them. As the doctor here has said, beta blockers may or may not reduce the frequency of these funny beats--but they seem to change the way we perceive them. You might want to ask your doc for a try. These drugs are usually not dangerous, but they can make you tired, among other things.
You say you are still worried that something is wrong with your heart, and that the doctors just haven't found it yet. This is something you simply must get over, because it is not helpful in any way. Believe it or not, docs do learn very difficult stuff in medical school. and we all understand that--otherwise we'd all go to medical school, right?
Doctors learn how to recognize dangerous conditions, and they have no interest whatsoever in missing a diagnosis or having a patient die on them. That hurts their pride, for one thing. You have been checked out very thoroughly, and have been told that your heart is healthy. You have undoubtedly noticed by now that you can do your usual, daily activities, right? This means that you are healthy, in spite of the irregular beats.
It is not difficult to get an understanding of how the heart