Newly Discovered PVC's and what's next?

[gb36]

I'm 53 year old man.  Echo stress three months ago all fine.  Last Cholesterol- Total 196, HDL 61, LDL 124, CRP 0.3, Triglcycerides 56.  Taking diuretic for slightly elevated blood pressure. Also take Flomax and baby aspirin.  Also started taking Folic Acid for deficiency discovered by hematologist (had small DVT year and half ago - resolved quickly with Lovenox).

I recently had a abdominal ultra-sound and upper GI series two weeks ago which were all negative.  (was having some unexplained weight loss which seems to have stopped.

SO NOW.. about a week and half ago I woke up feeling a fluttering sensation when I walked or got up.  I have had very brief feelings like these in past but this time it was odd because it continued.  When driving, sitting, etc I felt ok.  It felt almost like a physical reaction to me moving or walking.  The first day I tried to ignore and had a afternoon in hot sun of tennis for a few hours and felt fine.  But that sensation continued on and off.  

Cardiologist ordered holter monitor for 24 hours.  He called the next day concerned because it show irregular beats (PVC)  with one lasting over 20 beats (12 seconds).  He put me on Metoprolol right away.  I still feel occasional flutter but they have been on decrease since initial feelings from last week. (but it seems I only recorded 4 episodes on the monitor log)

So he now is wanted to repeat stress test using Nuclear imaging.  He wants to make sure there wasn't a blockage missed that could be causing this.  

I have two concerns.  FIRST is after reading that these PVC's that have go more than 3 in row can be deadly, what is the course of action if stress test is negative?  I'm having anxiety now thinking about all this and consequences.  Plus I want to get active again (dr doesn't want me doing exercise)  
SECOND since I just had a upper GI series two weeks ago which exposed to me to radiation, how dangerous is having this Nuclear test in regards to radiation?

[Lee Kirksey, MD]

Hello
I would want to know about your stress level, caffeine intake, family history for CAD
Providing the stress test is negative, one might consider a stress echo. Finally, if the symptoms persist then a cardiac cath might be done as there is a false negative rate for stress tests.

As I state in my book, Your Guide to Optimal Health, often times we focus on one single cause of symptoms like yours and neglect the other causes such as hormonal changes including hypthyroidism.

Finally, depending upon your cardiac risk stratification profile including family history, hgbA1C and other factors. Aggressive risk factor reduction with LDL focused therapy might be helpful.

See also Berkley heart panel to learn more information about cardiac risk profiling

Hopefully, everything will be normal and this may all be stress related. Dont forget that stress can cause profound physiologic changes with actual symptoms.

Best of Health
www.personalwellnesswheel.com