Another Pvc question, please read

[Dave-Ponticeli]

  About 2 years ago I had chest pains, went to the emergency room they did an x-ray and said my heart looked enlarged, but not conclusive, I guess they had an expert look at it and said it was fine. Well it didn't stop there, the pain and skipped beats continued so they scheduled me for a stress test and that went well, but I overheard the Doctor say something about borderline MVP, but they sent me home with a clean bill of health, though my ekg read abnormal T-wave. I didn't press the issue about borderline MVP at the time but the more I got to thinking about it I wanted to know what they were talking about, so once again I went in and they told me that because of my concerns they would do an ultrasound of my heart which turned out to be normal. They also put me on a holter monitor and they said that they recorded some Pac's they said nothing to worry about, but the Pvc's were getting worse along with the chest pain so I went in again and the cardiologist said that because my ekg's were abnormal over the last few months he wanted to do a Thalium treadmill, so off to the ol treadmill I went, now while I was on the treadmill as my heartbeat started to get faster I experienced what I call a few silent pvc's (the kind you just barely feel, not the kind that thumps in your chest) anyway the Doctor saw them and said they were just pvc's, nothing to worry about, so I concluded the test and they said that I had to come back the next day and get a resting image. Well to my suprise and shock the Cardiologist scheduled an angiogram the next morning, they said that there was an abnormality on the thalium test. They did the heart cath the next morning and the Cardiologist performing it was amazed , he told me that my heart was in great condition with no blockage and that my pvc's were caused by stress and nerves. My Mother died at the age of 47 of a massive heart attack, I am 35 and I am also stupid, I still smoke:o( but have cut my tobacco consumption in half, I was smoking 2 packs a day for many years and am still weening off of them, I also grew up eating horrible, so I was very suprised that I had no blockage or damage to my heart, how can that be? Now if pvc's are caused by stress and nerves how come I get them in a perfectly relaxed state? I am not as nervous as I was before about my heart but when I get the pvc's it kind of gets me thinking about why all the tests..what did they see that made them do more and more tests, especially the angiogram ? They told me that thalium tests were not always accurate, but if they were looking for something in the left ventrical, they must have seen something, isnt that where pvc's originate from? I read that pvc's can cause sudden death so I am assuming that they ruled that mine are benign. Sorry about the long message but I am so confused about all the stuff I have been through, I hope that maybe you all can give me some insight into what I went through. One more question can a pvc come in groups, I sometimes get 2 or 3 in a row without a pause in them, and sometimes I feel like a pressure in my chest before I get them, is that normal too? I should also note that in all this I have seen four Cardiologists.
  Thank you in advance,
  Confused in California (Dave Ponticelli)

[CCF Cardio MD - MTR]

Dear Dave, thank you for your question.  First, I encourage you to look back at
previous questions in the forum about PVC's and to scan the forum where you can
look up questions based on the disease being inquired about.  The bottom line
from what you describe is that you have a normal heart.  Your ultrasound and
angiogram were both normal so that should alleviate some of your worries.  Even
though your mother died of a heart attack and you have continued to smoke, your
coronary arteries are clean of plaques.  Common risk factors for coronary artery
disease include a family history of premature coronary disease (which you have),
smoking (which you have), high blood pressure, obesity, diabetes, and high cholesterol.
Thus, I strongly encourage you to stop smoking, eat right (avoid fats and cholesterol
rich foods), and modify any other risk factors that you have.  These steps will
help prevent coronary disease from developing in the future, even though you have
no blockages now.  The thallium test was false-positive with regards to showing
a blockage but only angiograms are 100% accurate when it comes to this condition.
Thus, I would discount the results of your thallium since your cath was normal./
  As for the PVC's, common causes are alcohol, caffeine, tobacco, and stress. PVC's
commonly occur and are benign in most instances.  Some people are more bothered
by PVC's than others but you don't have to worry about the PVC's being life threatening
with the results of your other tests.  PVC's can occur in salvos (which you may
notice more commonly) and can occur at any time, even when you're not stressed. I
would advise you to eliminate tobacco, alcohol, and caffeine and continue to try
to relieve stress.  Medications can be used to suppress PVC's but they commonly
have side effects that may be worse than the PVC's.  If you would like more information
on PVC's, I'll list a reference in a medical journal that you could obtain at any
medical library (New England Journal of Medicine, May 7, 1998, Vol. 338, pages
1369-1374).  This is a review article on treating patients with palpitations and
you may find some useful information in it.
  I hope you find this information useful but please write back with any more
questions.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.