Confused about Symptoms

[MightyLovelyMan]

I'm a 43 year old male with no family history of heart disease on either side.  Recent blood work was total chol 231, hdl 39, ldl 140, tri 90. I used to work out faithfully lifting weights etc.  I have not done as much exercise in the last couple of years as I should have and I am working to correct that.  I'm 6'-5" and weigh about 290 lbs right now (not all fat).  I've been doing a modified low-carb diet and have lost down from 357lbs.  I was put on atenolol for anxiety in 1999 and began to experience what I now know were pvcs.  I went to a cardio and had a full work up.  Nuclear stress test (cardio-lite) was normal, ecg was good.  I had a holter and it showed a 4-beat run of SVT during the night.  All was okay, but I still worried it was something else.  Then in Sept of 2000 I woke up in afib.  I went to the ER and coverted to NSR after a few hours. I was sent home on Norpace and digoxin.  Given an echo that was normal also.  I worked harder to lose weight soon after and my doc took me off the digoxin and cut my dose of Norpace 150mg once daily.  He said if I get to 260 he might let me try get off the Norpace as well.  Thankfully no more afib since 2000, but I have been troubled daily/weekly by the ectopics.  I sometimes barely notice them and other times they are more severe and make me a bit sick at stomach for a few minutes.  Getting up in the morning to shower for work I sometimes feel sick/a bit weak. Or if I get up during the night to use the bathroom as well.  I know I worry too much, but should I have further tests or stop worrying?  I not refelt same since the AF

[CCF-M.D.-MJM]

Hi MightyLovelyMan,

Great job with the weight loss, but you still have a ways to go.  When I calculate your body mass index, you are 34.  A BMI greater than 30 is considered obese and greater than 25 is considered overweight.  A weight of less than 210 lbs for someone your height will do wonders for your lipid profile, although a bit less would be even better.

you can go to this link to calculate your bmi:
http://nhlbisupport.com/bmi/bmicalc.htm

Regarding the further work up question, it concerns me that write:

"Getting up in the morning to shower for work I sometimes feel sick/a bit weak."

This is a symptoms I have heard from several patients that were depressed / had to much work related stress.  They were having small anxiety attacks that would occur almost every day while they were showering for work.  To rule out an arrhythmia, I would try a holter monitor, but I don't think this a rhythm problem.  Does this sound like it may apply to you??

I hope this helps and good luck.

[MightyLovelyMan]

Thank you so much for the response.  Yes, I do think that anxiety is a major player for me.  I don't seem to have any symptoms of depression though.  But at various times during the day I sometimes get that weak/sick feeling.  During these episodes my pulse always seems normal.  My resting heart rate is in the low 60's.  My BP is normal.  I just have such a darn hard time relating this to be scared or nervous.  I certainly wouldn't mean to disagree with your comment, but I've I weighed 210 lbs, you would think that I was skin and bones.  I just don't fit the size chart.  My skeleton probably weighs 100 lbs :-))  However, I do still want and need to lose some more weight!!  When I go for my yearly check up in March, I will mention to the cardio about another Holter.  Again thanks.

[MightyLovelyMan]

Another think I forgot to mention is that I have found myself avoiding doing many of the things that I love to do just because I worry about something happening.  I went out the other day and played basketball with my son.  It didn't take long until I was out of breath and thinking to myself...you better stop something might happen.  Of course then I start feeling uneasy.  But something has occured to me.  As long as I've been feeling this way, if something "were" really wrong, more than likely I would have experienced some type of event by now, wouldn't you think??

[gregory_usa83]

I also feel the same as you, Im 6' tall and 190lbs..  total colesterol is 139 , my bp is like always 115/75 (I check it alot) My heart beat is always 60-70 bpm. One day I had an episode of doom and gloom, where my heart skipped a beat and the next one was a big one.. I had instant thoughts of heart attack and Im only 36. Stranger things have happened so I went to the ER.. etc.. had all the tests said Im fine, wore a holter to catch PVC's and they are non dangerous. But Doc ..I say why do I feel this way now.. never did before.. he said stress.. and finally the axiety word..  well 4 years later and Im still learning to control them..  almost med free even. I also avoided going places and doing things on fear of lets say it Dying.  Im basically over all that but no shrink helped me.. I went to 3 they just wanted to pump me with drugs.. forget that i said and also started thinking..  what if I didn't try to fight this feeling just went with it.. well Im not saying it happened overnight but eventually I did .well here I am.. still alive.. didn't have a heart attack. And Im actually not afraid to go or do things anymore. Good luck and just try letting go when you have theses feelings come over you.. it worked for me.. fighting them will not work... And if the docs say your fine.. being out of breath after playing basketball is normal especially if your not in tip top shape.

[Barbarella]

You're so right when you say "just go with it and not fighting it".  I know all about shrinks wanting to pump you with drugs.

[dreamboat]

I just wanted to to comment on what your Dr. said about you being depressed. My Dr. told me for a long time that their is a type of depression that can cause strange body sensations known of course as anxiety. He kept trying to sell me on an antidepressant.I did not feel sad only a nervous wreck. I tried the antidepressant finally after I got so tired of being like this and it worked!I guess alot of my anxiety is brought on by a chemical imbalance. I have not taken the meds for  a few years now(stopped when i became pregnant). I have pvcs alot now. That wasn't my problem before though it was a racing pounding heartbeat, panic and alot of fear. Good luck to you.

[dreamboat]

Thanks for the name of the book, I went and ordered it at the bookstore.

[MightyLovelyMan]

Thanks for your response.  I've just gotten so fed up with all of this.  It has started to affect my quality of life and recently I started taking Xanax Extended release.  It has helped with the more acute symptoms, but not all.  I still get anxious but my heart rate is not elevated.  I get more of the feeling that there is a knot in my stomach just below the sternum and a general state of what I call "hightened awareness".  I feel all sorts of sensations as I've had others tell me that too experience that as well.  I truly don't feel sad.  I'm a very happy person with a good sense of humor.  But I'm to the point where I'm willing to try something like an SSRI.  It cant' hurt to give it a shot.  You can always stop!  When I go to my cardio in March for a check up, I'm going to ask him if I can try stopping the norpace also.  I'm only taking a small dose once a day and even sometimes I skip a day.  Other people have told me that their cardios wouldn't but them on an anti-arrythmic after only one episode of AF.  But, other docs have told me that is normal protocol.  So, go figure.  I just don't want to take the Norpace if I don't have to.  It does have some side effects and they could be contributing to some of my symptoms.  If you don't mind me asking, what kind of anit-dep did you take?  I've heard they will make you gain weight!  I don't want that because I've been doing great with my weight loss.  :-))

[dreamboat]

I took Prozac. I started feeling the way i did years before the anxiety started. It probably wouldn't hurt me to go back on it but I haven't.I did gain a few pounds but just a few. I really don't think it was due to the pills though. I use to be so nervous that I couldn't eat. I felt  like i couldn't breathe while i was eating( pretty bad huh?!!)I started feeling less tense and I started eating more. I was 5'4 and weighed around 130 after I started them from around 124.I felt normal for the first time in a long time.I have these pvc's now' I let them stop me from doing things some. I have them alot!They are annoying and uncomfortable.I have heard that antiarrythmics can bring on more arrythmias and can do more harm than good.have you heard that?
Dreama