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Heart Disease  (Expert Forum)
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Palpitations
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Palpitations

by Carrie41, Nov 21, 2006 12:00AM


History: Fourty-five year old female with no health problem except PVC's/PAC's/nsvt.



1.  Can you tell me what is considered "frequent" and what is considered "occassional" palpitations.  I get probably between four and ten feelings of dropped or skipped beats a day.  They freak me out to no end.  I think it seems like a lot but I have read that "frequent" means more than 30 an hour?  Could you please clarify for my peace of mind?



2.  I have been for two EP studies because a holter caught a short non-sustained run on v-tach.  I have been told not to worry because I have a normal heart?  True?  Would they have been able to make my heart to go into v-tach if it could in the EP study?



3.  If it is true that "everyone" gets palpitations then how come when I ask my sister or my friends if they feel anything weird in their hearts like skipping or fluttering they always say no?  



4.  I am on 20 mg celexa because of my anxiety about my heart.  I think about it 24/7.  I avoid social situations because I am afraid of having a panic attack about these things.  The celexa just does not seem to take my obsessing about these things away.  What would you suggest a person do about my constant anxiety/obsession about my heart.  I have been told by numerous doctors and cardiologists that I am not going to drop dead but I am so sure these things are going to kill me.  I obsess after having a bad bought of them and just can't stop thinking about them.

by CCF-M.D.-MJM, Nov 21, 2006 12:00AM
Hello Carrie,



1. Can you tell me what is considered "frequent" and what is considered "occassional" palpitations. I get probably between four and ten feelings of dropped or skipped beats a day. They freak me out to no end. I think it seems like a lot but I have read that "frequent" means more than 30 an hour? Could you please clarify for my peace of mind?



Believe it or not, I have never read a defintion of what defines the frequency.  It is more just looking at it and deciding how frequent they are.





2. I have been for two EP studies because a holter caught a short non-sustained run on v-tach. I have been told not to worry because I have a normal heart? True?



This is true.



Would they have been able to make my heart to go into v-tach if it could in the EP study?



That is hard to tell.  We can make anyone go into ventricular fibrillation.  Ventricular tachycardia can be more difficult.  If you heart is normal and you have pvc's, pac's and nsvt, an EP study is not indicated.



3. If it is true that "everyone" gets palpitations then how come when I ask my sister or my friends if they feel anything weird in their hearts like skipping or fluttering they always say no?



Everyone has PVCs and PACs.  Not everyone has palpitations.  Remember that palpitations means that you can feel them.  I will tell patients in clinic that they aren't cursed because they have PVC/PACs, they are cursed because they feel them.



4. I am on 20 mg celexa because of my anxiety about my heart. I think about it 24/7. I avoid social situations because I am afraid of having a panic attack about these things. The celexa just does not seem to take my obsessing about these things away. What would you suggest a person do about my constant anxiety/obsession about my heart. I have been told by numerous doctors and cardiologists that I am not going to drop dead but I am so sure these things are going to kill me. I obsess after having a bad bought of them and just can't stop thinking about them.



Honestly it sounds like your biggest problem is not your heart, it is your anxiety.  It is very unlikely that these will go away.  You need to ask yourself "what will it take to convince myself that these pvc/pac aren't going to kill me"....that is a question that only you can answer.  It situations like yours, reassurance is the best we can do.  Your risk of sudden death is the same as anyone else with a normal heart.



There are others on this forum with similar concerns.  Hopefully they will post there thoughts.



I hope this helps. Good luck and thanks for posting.
Member Comments (28)

by NurseKagome, Nov 21, 2006 12:00AM
To: Carrie41
Hey girl!



I totally know where your coming from. I feel the exact same way! It is so hard dealing with these little buggers day after day with some days feeling hundreds and others feeling 1 or 2. It definatly is stressful. I am just getting myself back into exercising full time again cause my fears had me stopping it. I'm 23 and graduating from University this year, so I really need to get a grip on these things before going solo to who knows where after grad. I was just walking for about 50 mins and about 20mins into the walk I had about 10 nasty flips and strange sensations, thought I was a gonner for sure! But so far so good, still kicking. It is so hard to wrap your head around the fact that these things won't kill u? I am sure alot of us, including myself, can totally agree. Why can't we you ask? Who knows, probably because we have anxiety problems among other things. I hope you are feeling better soon and something besides exercise that I have been trying is cognitive behavioural therapy. (talking with a councellor) and it is helping me bit by bit. I wish you the best, hope to hear from you soon! :)



Nurse Kagome :)

by 3dognewt, Nov 21, 2006 12:00AM
Hi,

I am a 55 year old woman with a history of PVCs. I too went through countless hours of anxiety over them. Here's my story in a nutshell, hopefully it will help you in some way.

Every since I was in my late 20's I've been feeling the occasionaly PVC. (a few a day) Then when I was in my 30ies, I had 3 episodes of almost constant PVCs (every 3rd beat). Each episode lasted about 2 weeks. They stopped on their own, no one seemed to be worried except me. Then about 3 years ago, I started getting runs of every 2nd beat was a PVC for hours or weeks at a time. I had all kinds of tests, and worried myself sick over them. I too obsessed like crazy, searched for the defination of "frequent", "occasional", etc. I hung onto to every bit of information I could find and tried to define my symptoms to those of other, trying to give myself hope. Anyhow this went on for a couple of years, even restricted my lifestyle to some degree. But one day, I decided that if there is nothing wrong with my heart, I have to get a hold of by obsessivness and try to live a normal life. I took "newborn" steps. I decided that for 1 hour I would not check my pulse and I would push all thoughts of pvcs and heart issues out of my thoughts if they happened. Even if I felt the pvcs in that hour I refused to allow them to get to me. This wasn't easy, but I took it an hour at a time. Just one or two hours one day, and then 2 or 4 hours the next time. Yes, I couldn't always do it, but I kept trying and eventually, I realized that I had forgotten to obsess about my heart for a few hours or half a day and eventually the times that I obsessed got fewer and fewer. Now I hardly ever get pvcs or if I do, I don't notice them anymore. Yes, there's time when I still get anxious, but you really have to train your mind to not think of them. Stop trying to get definitions of "frequent" etc. and just try one baby step at a time to not think about them. There was a time that I was having over 40,000 of them a day for weeks on end, and here I sit years later, writing about them now. Please stop obsessing, its the only thing that will help the anxiety in the long run.

Hope this helps.

by robbiecriss, Nov 21, 2006 12:00AM
Several years ago I could have written your exact note. I had regular pvc/pacs and even nsvt although it was never caght on the holter. I have taken mulitple meds and done many echos, stress tests, etc... all cominmg up with the same answer, in a structurally normal heart the symptoms are benign. I guess what helped me most was when I simply decided to believe my cardiologist and when the symptoms hit I would not freak out. Instead I would call to mind what he said and depending on where I was I would either shut my eyes and repeat again and again "I am not dying"; "These are not going to kill me" and that was several years ago. Do I still get them? Yes, daily. Do they aggravate me? Absolutely! Do I worry about sudden death? Not any more. After several years, my cardiologist finally said. Don't you think if they were going to kill you they would have by now since you have been getting them for years and you haven't died yet? I felt a little stupid but then had to admit he was right. So I go about my day with a flippy heart and deal with them as they come and have simply decided living with them is better than being crippled by them. I hope you can come to terms with them and get the help you need. I even decided to get off all medication because the side effects sometimes are worse over the long haul than the symptoms. God Bless! Robbie

by Carrie41, Nov 21, 2006 12:00AM
Thanks for your posts everyone.  I hope that I can somehow get over this obsession as well and just get on with it.  I am going to see my family doctor in two weeks and I want to ask if there is anything (other than a punch in the head) that will take my mind off these god forsaken things.  It is like a vicious cycle.  I have a PVC and get anxious.  I get anxious because I know another PVC is going to hit.  It is just a circle I can't seem to escape.  I don't know that I want therapy.  I just want some type of drug that will totally take my mind off these things.  I mean you would think that after 20 years of having them I would get over it, but I don't.

by finetilthree, Nov 21, 2006 12:00AM
I've had these things daily since giving birth 7 months ago.  I was having panic attacks big time, couldn't even stay home alone.  Got up and went somewhere every day, just drove around in the car b/c I was so afraid to be home alone.  One day, I just convinced myself that my mind was stronger than the urge to run, and I convinced myself to stay home and deal with it.  The thing I keep telling myself is what is the worst that will happen... I will die... that is the absolute worst thing that will happen... and it hasn't happened yet, not once in 7 months.

by woodruff, Nov 21, 2006 12:00AM
To: carrie
"I don't know that I want therapy."



Why would you be reluctant about therapy?  Don't get me wrong; I'm a big fan of using the right medications for anxiety, but people who have therapy along with meds often do better than people who use only one or the other.



" I mean you would think that after 20 years of having them I would get over it, but I don't.



That IS the point of therapy.  The PVCs will probably recur throughout your life, and therapy helps you deal with them so that if they show up when you don't have your meds on hand, you will not freak so badly.  The idea is to learn, deep inside yourself, that these odd beats are not going to kill you.  Learning takes practice.



Don't let the notion get to you that having therapy means you're some kind of nuts.  You just need help for a specific problem here.

by mmfd, Nov 21, 2006 12:00AM
Carrie, truthfully, between 4 and 10 a day would be considered *rare*.  Remember that anxiety fuels them also, the more you get anxious the more you will have!  Perhaps try telling yourelf that you won't drop dead until God wants you to.  I would caution you to not take any addictive drugs like Zanax for this either, but that is just my opinion!

by Carrie41, Nov 21, 2006 12:00AM


Get outta here!  Is it really considered "rare" to have four to ten a day?  I feel like it is a lot. You know you read so much about "occasional" or "frequent" but it doesn't tell you how many that would mean.  I guess I just look for a number (must be OCD or something)!  



I can't believe it when I read this board and see that people have 40,000 of them.  Do they actually feel the skips all day long?  I would be a darn basket case if I had 40,000 of them.  I have only had two today and feel strung out just thinking when the next one is coming.  I don't know, maybe I will go the therapy route.  I know that I will probably have them the rest of my life and have to find some way to deal with them.  I envy people who have found out how to do it!

by NurseKagome, Nov 21, 2006 12:00AM
wow 40,000 a day? omg, i should stop complaining...wow. Do you feel them all? how do you cope with that ??? wow i think you are super strong.

by yoshi74, Nov 21, 2006 12:00AM
To: Everyone/Carrie41
Oh...this is definitely a battle...I have had several runs of them today and I am sitting here crying with two 3 year olds in the bathtub.....I have had these things for 14 years and it never gets easier to deal with them....I KNOW I need to seek out professional help (counselor) but I keep putting it off for some reason...I think I am scared that it won't help and then where do I go...I feel like such a freak because nobody understands...I mean, that is why I come to this forum and I am so grateful for it...but I am so upset right now because this scares me so much and I don't know how to get a handle on it. I just want to be happy and enjoy my family. I just don't know how to do that when I am woken up with them out of my sleep..and don't know why...usually I can pinpoint a trigger...that time of the month..had a couple of beers...caffeine..that type of thing...but when it happens and I feel like there is no reason...it sends me over the edge...Anyway..I'm sorry for venting so vigorously...I am just really upset right now because I started the day off with them and I have been panicky all day...and of course I wanted Carrie41 to know that she not alone in this....thanks for listening....

by Carrie41, Nov 21, 2006 12:00AM
To: nursekagome
Just curious?  Are you a nurse?  Just wondered with the name.



Anyways about the 40,000 skips, I don't have that.  I have just read that some people do.  And you are right - I think they are super strong as well to be able to put up with that.  I couldn't stand it.



Myself, I get around maybe 5 - 10 skips or weird sensations a day which is more than enough for me!



I am still convinced that I am going to die from that amount!

by Carrie41, Nov 21, 2006 12:00AM
To: Yoshi74
My gosh Yoshi74.  I feel bad for you.  I actually feel a little better right now reading all of these posts.  It is kinda comforting in a strange way to know I am not the only sufferer out there.  I remember going to the doctor when my youngest was a couple of weeks old and crying