Confused

Since the birth of my child last November, I started having/ noticing my palpatations. I went through all of the test (EKG, ECHO, Holter and Nuclear Stress test) and all of them came back normal with the exception of 8 Premature Ventricular Contractions. The palpataions can vary to very little to many but never out of control. I did notice on a restricted carbohydrate diet though, the palps seemed to disapear or occur very little. Is there anything to this or coincidence?  This past June, I had a Gasrtitis/Gerd flare up and that briefly increased the palps again. I asked my cardio about this and he put me on Toprol XL 25mg a day to ease my mind I guess. I did not want to take them because I tend to be very sensitive to medications. Here is were the concern comes in. Since Septmeber, while taking Nexium,Advair(atshma) and Toprol XL, I had 2 episodes were my heart would race for say 6-10 consecutive beats,1-3 seconds, and then return to normal.I did not feel light headed or faint just scared. I went to my cardio about this after a trip to the ER and he sent me to a Electrophysiologist. He said if it were not for the 2 "runs" that I had, he would not have much concern. He took me off Toprol XL right away and put me on a Mag. Oxside (800mg) supplement daily. He said if I get another run over the next 3 weeks, he wants to do the EP test. What could have these brief runs be and what will the test show that the holtier can not. Is this extreme for this or is this part of the protocol. I am 32, don't smoke, no history of H Disease or Sudden Cardiac arrest, Chol= 152 hdl=85, BMI=25

[CCF-M.D.-RCJ]

Deerman,

Thanks for the questions.

Q:"Is there anything to this or coincidence?"
Yes there can be a connection between the stomach and the heart.  Some patients experience a worsening of palpitation frequency with heightened vagal tone, as can happen with GERD.

Now, in regards to the EP study, I'm not sure why this would be done.  I have not heard a good indication for it from the information provided.  In someone with an otherwise normal heart, even VT would not warrant an EP study, because we would do nothing more than treat it with beta-blockers, at least as intial therapy.  Furthermore, the 2 "runs" could be anything from NSVT to afib to PACs to bigeminal PVCs to an SVT (perhaps in association with the advair).  I would err towards an event monitor as a decision aid for diagnosing what indeed were the "runs".  However, you may have left something out that would indicate why the EP study was indicated, although you provided a pretty dang good history.

Hope that helps.

[medking]

Not surprised at your post. As a matter of fact, when I had my first child at 32 thats when all the pvc's started. So u are not alone. If you are getting runs of them they are more significant. But I suppose how many runs are you getting? And how often does this happen? Also if you have a normal structure heart then they are less significant. I have been battling this and it has ruined my life and believe me I dont get them too often but when I do they are erratic. I get runs to ... My cardio who is considered one of the best in Canada says that I should not be concerned with them ...ignore them. All my tests are normal - echo, ekg, holter, stress etc ... He also said even if you get the non-sustained runs for a few seconds dont freak out just ignore.  Of course its hard to ignore when u are in that situation. My suggestion for peace of mind ... go to the electrophysiologist and get tests done to relieve your fears. My father has been living with these for 30 yrs and still ok but he has something 99% of the people dont have on this post. He has managed to ignore them and they dont bother him the least. Psychological impacts are much greater than the PVC itself- this is what I am learning. Good luck u are not alone!

[jespinks]

Well, guess what?  I'm a 32 year old female who also started having PVC's for the first time after the birth of my son this past November....In the last month or so they have subsided some..I used to have them once every 30 seconds (Holter picked up 4,000 of them in 24 hours)...but now I go most of the day without them but have moments (like when I change position or go from activity to nonactivity or vice versa) then I have a little bout with them for a couple of minutes....I sure wish someone would come up with a link to what really triggers these things!  I'm 32, don't drink, don't smoke, don't drink caffeine, and have no other known health problems...not overweight, nothing!  Due to the number of females acquiring them after the birth of their first children, makes me think it has to be horomones, change in blood chemistry, or from the meds/epidural that was given...I had an epidural for a csection and was OVERLY numb...wonder if there's a connection?  What do you think?...I've had an echo and Holter done-should I have any other tests?  Doctor said all results were normal except for PVC's which are benign because I have a structurally normal heart...Interesting to see there are other women having kids that have picked up these horrible PVC's...Let me know what you think!  Jen

[Deerman]

I should clarify a little further.  I had a machine gun type heartbeat for what felt like 6-10 beats (1-3) and then it continued to beat normally. This has happened only 2 times since I started taking Toprol XL in late August and the last one being 2 weeks ago. I am convinced that it has something to do with those darn beta blocker pills. Besides, they only worked for the first few weeks and the palps came back so why deal with the side effects. These beats are my biggest fear because Sudden Cardiac Arrest goes through my mind for that brief second. I find myself holding back on things I enjoy the most(hunting,fishing,camping etc. My wife has been so suportive of this and this board really helps. I think if it all works out in the end, I will go for some counseling to get past this. I lived a carefree life for many years and now I get nervous driving to work. Thank you to anyone who responds.

Scott

[shelbert6]

I had my first child at age 24.  No problems with PVCs after that.  I waited another 8 years before I had my 2nd child.  After having her at age 32 (turned 33 a week later) the PVCs began.  Every night while I'm laying down.  Lasts for 30-45 mins. I had my 3rd child 2 yrs later at 34 yrs, got a little worse.  Now I have them during the day, usually at rest.  I am 39 yo now, and pregnant with my 4th child.  After having my 2nd daughter I developed chronic hypertension.  I have always had pre-eclampsia with each of my pregnancies.  So I do take a beta-blocker.  I always thought the beta-blocker had something to do with it.  Maybe not.  Now, because I am pregnant, I have switched to an alph-beta blocker combination.  The incidence of PVCs have actually increased this time, but I believe that to be more related to the pregnancy that the meds.  I am 7 mos. pregnant.  Very interesting.  I thought, all these years, it was just me.  Hmm.  I guess I mention them at my next prenatal.  See what the Dr. says.

[jespinks]

Sorry Scott for assuming you were female!  I meant no harm...Hi hank...I still haven't gotten to the doctor to try a betablocker or antianxiety med...I've actually had several really good days with only a couple pvcs all day!  Question about supplements- Is it Magnesium supplements that tend to help?  anything else? Thanks! I'm still wondering this question that I keep asking and I never get an answer to (probably because I ask too many other questions! :)...Are an Echo and a Holter sufficeint tests or should any additional ones be done-Echo showed structurally normal heart and Holter revealed normal sinus rythym with moderate PVCs...(4,000 in 24 hours)...Thanks for your support everyone-It's sooooo nice to know we are not alone in this mess! Jen

[Deerman]

The reason the EP doctor suggested the EP study was to eliminate as much probability into having a Sudden Cardiac Arrest. He said he wants to make sure this happend above the lower chambers of the heart. He wants to be 99.5% sure I will not be at risk for S.C.A. The hospital is The General Hospital of Passaic in NJ. From what I hear and have read, they and Hackensack are the 2 best Hospitals around me for Clinical Cardiology. I live in Clifton, NJ. Has anyone heard of these?  I have tried to educate myself on this as much as I can and I always thought that this  EP test was a little much for Palpataions.  I guess that being cautios is not a bad thing, but I am a little worried about probes in the heart. My cardiologist did not jump on the idea, but he talked to my internist and they decided to send my to the EP. The EP said if I did not get anymore "runs", it was up to me. I have been battling with constant fear over this lately and I want to put this to anxiety to rest already. I need my life back and I need to provide for my family. My health history is very minimal except for the athsma. I am a computer geek so there is little stress in my life. I have been healthy all of my life and my Cardio said that my heart is "structually/perfectly normal" for my age. Sorry for all of the details but if I do not need to get an invasive procedure because of this, I will look into other means of determining what the "runs" where and if they are worth worring over. PS, so far the palps are not as intense as they were with the Toprol XL. Thanks again to all of you......

Scott

[pandora9049]

how about tacycardia for 3 hours, which is what i had today. does anybody have this kind of palpitation?  i refuse to believe this is from anxiety.  the only thing that really gives me anxiety is my heart.  ive had tests done, an echo that was "normal" but the doc hears a click when he listens to my heart.  what's that about?  i think im dying.  any thoughts, hankstar, or anybody w/ similar symptoms???

[kate38]

Hankstar,

Thanks for the info in your earlier post.I'm not sure if you know the answer to this, but I'll ask anyway. The Cardiologist wanting to preform the angiogram Is taking his Boards in early November. Is this good or bad? I know they all have to start somewhere, but I'm a little nervous. Maybe I should be more worried if he fails. Do you happen to know how it works?


Thanks,

Kate :O

[kate38]

Hankstar,

Thanks for the info,I will check the post you refer to.
Actually, the insurance i have is one of the best.
so thats really not a problem.

I thought maybe I should be more concerned if he failed his boards.

Thanks for responding,hope I have'nt been to much of a pain.

Just from reading alot of your responses to others and myself you seem to be a very nice and caring person.

Thanks again
Happy Halloween to you and your family
K

[pandora9049]

thanks, hank.  i hope u r right.  you have a way of making me (and im sure many others on this forum) feel better, even if ur not a doctor:) thanks for responding to my post.

Pan

[jobob52 ford]

Hi Hank and All, I think you'll remember me, a 30 yr. WPW veteran, had 3 ablations and finally a successful one. Its been almost 2 months now and all is smooth as silk. During the first 3-4 weeks there were a few events(tachy) not lasting more than 30 seconds and a few flutters a day. This second month has been literally "uneventful". Sweet!

Thats not why I'm writing though. One area that isn't being discussed much is diet. For me, a sure fire trigger for an event was eating MSG(Monosodium Glutamate) sometimes as little as 3 chili flavored Freetos was a ticket to ER. Another thing is if I had more than 2 glasses of wine or drinks. All would be good while I was consuming them but then as I'd begin to relax--she'd take off purring(250 BPM, tachy). Another culprit was fatigue, ie. working an all night shut-down, I'd pay later.
I hope these experiences help some of you.
In case you're curios, even though I'm doing a low carb diet I did check out a couple handfuls of chips and did work a 26 hr. all nighter, No probs. Haven't got around to tying a good one on yet but I think I could if I wanted. Oh, and I have cafine now from time to time. Livin' on the edge, eh?

Regarding a question/statement from Sue 143 a few days ago, it is my experience that eliminating the tach, did in fact eliminate A-Fib.

Happy Birthday Hank,   Bob

[mightymuppet]

Deerman, sudden cardiac death in 30 yr olds is pretty uncommon considering the billions of people on this planet...the chance of you having SCD is extrememly unlikely because of some weird beats for about 6 secs....There's people who have weird beats for 48 hrs non stop so i think you're maybe going a little over the top here...Like the doctor said i'm surprised you're getting an EP study because of that.

I remember having a weird run of irregular beats for about 6 secs when i was 31(i'm 34 now)and i remember thinking "my heart threw a wobbly then"...in other words the heart was beating a bit funny(i felt fine during it though and forgot it within 5 mins)....The same thing happened about 3 years later(6 months ago or so)when my heart done it again for about 6-8 secs...This time though i had my exercise heart rate monitor on and the beats which felt very uncoordinated were going something like this....90, 120, 110, 85, 110 for about 6 secs and then back to normal(again i felt fine during it).

I certainly never EVER thought of SCD concerning them....I had a 6 day heart monitor about 4 months ago which captured extra beats, supraventricular in nature(pac's)....I used to get much more violent pauses and thuds though before i went on the beta blocker so i guess i had some pvc's as well(similar to the pac's but stronger..The stronger beats haven't happened once since i've been on the beta blockers)....I had a chest xray as well and countless ecg's which found sinus tachycardia a lot(my heart got stuck at 125bpm a lot of the day sometimes(again, never happens on the beta blockers)...The thing that really scared me back then was a weird feeling in the chest(jolt)and then my heart started racing for about 15 secs up to 160bpm(definately an attack of some kind, i never caught that on the monitor but the symptons seem so close to an SVT of some kind(maybe PSVT)....I mentioned to the cardioligist that it wouldn't be VT would it? He shook his head firmly and went "no way".(and again, it's never happened since i've been on the beta blockers)

All my symptons seem to be coming from the top of the heart....sinus tachy, maybe a small run of SVT(if that's what it was), pac's etc......i don't know if you can have a run of atrial fibrillation for 6 secs or so? but again, with most of my symptons coming from the top of the heart, it's possible that's what i had when i had those uncoordinated beats....maybe it was just pac's which were irregular.

I can understand that you are tense during it but i think SCD is unlikely.

[Deerman]

After further review from the Doctors response, I found that ADVAIR can cause and I quote" Cardiovascular:Arrythmias(including a-fib, extrasystoles,svt), ventricular tachycardia. How is that? This is right off of their paperwork that comes with the medicine. I had to go on Advair becuase of the Beta-Blockers and it could have damn well made the palpatations worse, and caused another arrythmia that scared the **** out of me. I tossed the advair in the trash and I will meet with my Internist for a new prescription next week. All Atshmatics please be carefull,you might go into a vicious cycle(Beta blockers cause more wheezing,increase palps etc) and that will wreck havoc on your nerves. I am going to run all of this past the EP in 2 weeks and I hope he will give me an external monitor I can wear or at least look a little further if needed at all. You people have been great and Hankstar, can't say enough about him, he is great for this forum because his knowledge and comfort with this makes people feel a little more at ease.

Scott

[kate38]

Scott,

I know how you feel my asthma was doing really well until starting beta blockers.I had a horrible time in the begining. I take advair plus two sometimes three others for my asthma. However, when I was changed to a cardioselective beta blocker and dropped down to a 100mg,doing much better.

Sometimes, I think it's just a process of sampling different beta blockers to find the one that works for each individual person.

There are different types of asthma medication out there, I've had pretty good luck with Singulair.Hang in there, it may take some time, but you will find the right combination.


Good Luck and
Have a nice day
K :)

[jobob52 ford]

I wish I was 30! What I meant was, I'm 50 yr old but have been dealing with irregular heart for 30 years.
Good Luck, Bob