Coughing and PVCs and PACs

[BlondieCO]

Hi, A week ago after 10 days post gallbladder surgery, I started to get skipped beats.  I had thyroditis 13 yrs ago with a pregnancy, so I were familiar with PACs and were not too startled, just thought I was tired.  But I began to get them every one minute, then 3-5 mins.  Some were back to back.  They would go for hours and then just stop, then kick up again for hours. I went to the ER, all bllodwork was normal (electro, magnesium, cardiac enzymes, thyroid, etc..)Had skipped beats for 3 hours in the ER, was told my heat "looked" strong on the monitor. The skipped beats also started 3 days before my cycle.  That ended 2 days ago, on that day I had none.  Then yesterday they kicked up again for about 7 hours straight.  I noticed that I cough with the skipped beats.  I don't know if that's nerves or indicative of something else.  If I take my pulse and I am having these skipped beats I can feel the pause and then "thunk."  My blood pressurehas always been low, pulse in the 60's-70's.  No caffiene, some stress, non smoker, non drinker.  I don't think about it, they just start and then after several hours stop.  My surgeon scared me yesterday and said three or more in a row could lead to sudden DEATH?  I already get two in a row at times???  I didn't sleep for days after surgery, so I thought that could have contributed, or the hormonal thing.  But now I read about blockages?  I have no shortness of breath, etc...but I am definitely scared about the cough?  Any help?

[CCF-M.D.-MJM]

Hi Blondie,

It is reflex to cough when your heart pauses or skips beats.  The coughing is nothing to worry about.

I doubt the skip beats are anything to worry about but they should be evaluated by your doctor.  Typically they will put you on a 24-48 hour monitor and watch for arrythmias.  If you have a structurally normal and heart disease, PVCs are nothing more than an annoyance.

Your surgeon mentioned that 3 or more PVCs in a row (called nonsustained ventricular tachycardia) puts you at higher risk for sudden death.  This is true in a population with structural heart disease or coronary artery disease, but nothing you said leads me to believe this is you.

You should have your premature beats worked up by your doctor, but I would not be too worried about it.

I hope this helps.

[hankstar]

Hello,

    Being a PVC sufferer off and on for years with the same episodic PVCs you describe, I feel your concern and confusion.
    
    First I am not medical doctor , but worked in the medical profession for over 18 years and have seen alot.

    There are certain doctors out there that are referred to in medical profession as "alarmist", no disrespect meant to them.

    See an a good EP cardiologist to get some reassurance as they are specialized in the field of arrhythmias and to rule out other possibilities.

    if all your other test are negative for heart disaease or other heart syndromes , such as ARVD, HCM, bruguda or long qt syndrome, even WPW in rare cases, it is well documented that even while symptoms are alarming and uncomfortable, PVCs are no more than a nuisance in most cases and pose no threat to life.

    It is very distressing to be reassured by one doctor and alarmed by a next, see doctor that specializes in this field for the best reassurance, I have been in the same boat as yourself. I doubt that you have anything to worry about besides that uncomfortable feeling in your chest, why some are so symptomatic and others not is anyones guess, but whether asymtomatic or symptomatic the prognosis is the same in the vast vast majoritry of cases.

Take care.

[BlondieCO]

Hankstar, thank you:)  Do you also cough then?  That is the most unsettling, well besides the thunk I feel.:)

[hankstar]

Yes, i have the feeling to cough some times with the PVCs, it is common for person with pvs to experience this sensation, this is usually because when PVC occurs the heart muscle contracts against some valves that are closed at the time, this produces what is called a Cannon A waves, and the following contraction is so strong it is felt in the throat area, like it takes your breath away for a split second and you need to cough.

This again from my understanding is no cause for concern, too bad some are afflicted with feelings that comes with this "benign phenomenon".

Good luck , hope you feel better soon.

[BlondieCO]

Anacyde,
Thanks, it seems like many people here are in the same boat.  I guess the obvious worrying about a blockage or your heart just stopping can put most sane people on edge.  I would have preferred he not used the words "sudden death."  I don't think about them and they pop up, so the fact that I have them and who knows why is frustrating. Thank you for the reassuring words, I  hope it's just hormonal.:)

[BlondieCO]

Thanks Hankstar - I thought coughing was a bad sign, especially after hearing sudden death - nerves weren't a factor until I heard that.  Hopefully when I see my primary care doc today they can push my referral time up and I won't have to wait two weeks for a cardiologist -I may go from sane to a nutcase by then.:)

[Erik36]

Hankstar is correct in everything he tells you. Three PVC's in a row means nothing clinically significant. Five PVC's in a row is characterized as Ventricular Tachycardia, however, it is non-sustanined which is benign in the setting of a normal heart. Listen to a Cardiologist before you listen to your surgeon. I wouldn't go to a surgeon for an irregular heartbeat or to a cardiologist to have a hernia repaired.

Erik

[mrbh]

Hank and Erik are right on the money. I share the problem and understand it.

Good Luck!

[lak]

Erik,

Question:  I started taking a potassium supplement because I heard it was good for arthymia but I don't want to take to much.
I had been taken to the er and few months ago for dizziness and I thought I was going to pass out. Turned out that is what it was.  I went to my family physician and he said it was not low enough for prescription.  I know this will be only your opion, but how much do you think.  They are 99 mg.  I would appreciate your opion.

Thanks, Lisa

[Erik36]

I would take whatever it recommends on the bottle or whatever your doctor suggests. Too much potassium could be a problem as too little is. They both cause Arrhythmias. You have to find a happy medium. I would start with the 99 mg and see if you feel any better and go from there. Make sure your doctor endorses whatever you do. Good luck!


Erik

[lak]

Thanks Eric

[ozark]

does anyone ever get a feeling of weakness or your body has a feeling of being light as well as one's head....i could be just standing or sitting, get a pvc and i feel weakish all over....my head feels very lightheaded.....at times it feels like pending doom.........it really scares me but it eventually subsides in a few seconds     thanks

[mrbh]

Yes, I get those same sensations with a PVC episode or in conjunction with a Panic attack. My doc never expressed any concern and said it could be a reflex reaction to the panic attack or maybe fear connected to the PVC's.

Remember, I'm not a medical professional. Your mileage may vary.

Be well.

[BlondieCO]

Thanks for all the input, I saw my primary care doc today.  He says he feels the surgeon should not have said "sudden death," and based on my labs from the ER he thinks they are most likely benign, these things can happen for absolutely NO reason.  But I will see a cardio for a holter, stress, and echo.  He prescribed the lowest dosage of Xanax to help curb my anxiousness.  I don't know if I will need it or not.:)  He did tell me that you can get up to 20-30% of PVCs or PACs in a 24 hour period and live healthy lives if there is no cardiac related problems.  But that I should be aware multiple series of skipped beats that could be a more serious arrhythmia problem.
Thanks all - anyone take Xanax?:)

[Momto3]

Hi!

Glad to hear your primary doc gave you some reassurance about your pvcs.  Like the other forum members, I was kinda shocked at your surgeon's comment.  Nonetheless, having the holter, stress test and echo will further validate your PCP's suspicion that all is well with your heart.  

OH, those darn pvcs can come on out of nowhere.  Many of us her can attest to that.  My last several checkups (July/Sept/Oct) I had no pvcs!!  I used to have close to 25% daily...Anyway, was in for a stress echo the other day and the tech told me I was having pvcs while I was just standing/sitting there...During the exam, I had one!! I suppose it could have been anxiety, but I've had so many tests that I don't think that was the case.  Generally, I can feel pvcs, but I didn't really notice these...oh well.  

As for the Xanax, some people find that helps take away some of the anxiety that accompanies pvcs. I use it when I really, really feel stressed...probably a handful of times/year. I find that it relieves the anxiety, but not necessary the pvcs.  

Prior to ablations last year, I had runs of 10+ pvcs.  As long as you have had the tests and you're doctor is comfortable with the results, try to forget about those pesky ectopic beats. Take care.  I'm sure you will feel better when you get your results.

Connie

[Barbara]

I am now into bigeminys.  
Do you know how long this can go on?  I'm at my wits end.
I may get a rest in between for about 1/2 hour, but that's it.
This has been going on for about a week.
As you may remember, I've had every test done, and they all tell me there's nothing to worry about.  God, this is disgusting.

[hankstar]

Bigeminy PVCs , I had episodes of them lasting up to 5-15 minutes at a times several times a day, but haven't  experienced any for over 2 years , it is an awful feeling , feels as though your heart is rolling over and over with no rhythm at all, besides if you feel your pulse it will be a beat pause beat pause, then you realise it is more regular than it feels, alot of times i suspect this is what persons calls a run of PVCs, when bigeminy isn't caught on a holter.

It is my understanding that some persons are in ventricular bigeminy most of their lives and live a normal or longer than average life span without any problems. Most are never aware of it, unbelievable. I know a guy that is in bigeminy most of the since 1994, he basically can go 5 beats without a PVC, but he isn't aware of one, only on a rare occasion!!

the prognosis of ventricular bigeminy is basically the same as isolated PVCs, even though they would fall into more complex ventricular category in the absence of any heartdisease, structural abnormality or any of cardiac syndrome.

  There has been some association of very frequent PVCs inducing cardiomyopathy, usually when more than 20% of your total heart beats is PVCs, again this is very rare and there is no clear cut evidence whether cardiomyopathy cause the PVCs or vice versa, usually some other abnormality is detected along with the PVC and cardimyopathy , such as valve leakage that was previously thought to be insignificant or got worse with time.

  Remember that I am not a doctor, but I  worked in the medical profession and had access to alot of medical situations and learned a lot about them. Never take my comments or anyone's else over the advice or direction of your trusted doctor as only they know your history and can make a call regarding your ventricular bigeminy.

If you doctor tells you despite this 'horrible feeling" that you will okay, trust him, if in doubt get a second opinion, as you can many of us are in the same, not that it is much comfort when you feel that your heart is about to stop, but be assured that it won't.

Take care, hope you feel better soon.

[BlondieCO]

Thanks mom, I have been getting about 3-5 per minute since I got home.:)  I have an occasional break - so frustrating if this is all "benign."   But getting 3-5 in a minute's time is not a string of them is it?  I assume that's when they go back to back to back, not one at 10 seconds, then another at 30 and another at 45 seconds? But I guess it's better than the alternative, I will try the Xanax tonight - I hate getting them so frequently.

[Momto3]

Hey friend!!

"It is my understanding that some persons are in ventricular bigeminy most of their lives and live a normal or longer than average life span without any problems."

Why did I have those ablations?  hahahaha!!!!  Maybe I could have lived a more "normal" or longer life : )


Barbara,

I was one of those people who was in bigeminy a LOT!  Lots of couplets, runs, etc.  I lived with that on/off (never could figure out what would set them off) for years. Most of the time I was aware of the extra beats, but over the years, I think I adjusted to them as my "normal" beat.  Anyway, as Hank said, if your doctor gives you a clean bill of health, try to relax and be rest assured that you will be OK.  

Hope tomorrow is a better day : )
Take care.

Connie

[BlondieCO]

Are strings then back to back skipped beats - not having 3-5 within a minute's time (spread out)?  I think turning 40 this year has been too traumatic.:)
Thanks,
Amy

[BlondieCO]

Thank you, I just read your comment - I am sure this is just one of those things that can't be easily explained - but yet it leads to more problems as far as anxiety.  Thank you for the explanantion and reassurance - sanity is my better trait:)

[Momto3]

OH...you should have said you turned 40 this year!!  That explains it!!  hahahahaah.......Many of us women on this forum experienced a definite increase in pvcs around 40.  I asked my doctor if she feels there is a hormonal connection, and she said, "YES!"  Oh great!!  LOL

Yep, strings of pvcs are back to back premature ventricular contractions - that definitely felt weird for me.  I counted to 15 once and just started moving around to get them to stop - used to freak me out.  3-5 a minute is not a "run."  However, strangely enough sometimes I feel the isolated pvcs with more force than bigeminy.  For me, bigimeny episodes were like tumbling, but runs were kinda chaotic.  I never had any pain with pvs, but some people on the forum have anywhere from twinges to downright pain.  

connie

[Guss]

I have been doing a lot of research on PVC's during the past couple of weeks because I had my first PVC very recently.  This is really a nuisance.  This week I had an echo test and it was normal.  I am 43 years old and used to be very active.  I found a corrolation between PVC and smoking (even one cigarette), body position, and blood pressure.  I seem to have an elevated blood pressure with PVC's so I will try to get back in exercise again.

This whole PVC thing is a curse.  Everyone tells you not to worry but the darn things cause anexiety, depression, not to mention inability to sleep.  I am praying that my PVC's are just temporary and that this whole thing will be a nightmare that I will wake up from.

This is a wonderful forum and I am praying for all of us.

Gus

[BlondieCO]

Guss,
Hang in there, it's been 11 days with me and there are people here who have had them longer.  "Who knows?" is exactly it..."who knows?"  My doc told me there are so many cells in the heart and that on any given day a few might decide that they feel like adding that extra beat.:)  For no reason!  I have low blood pressure, low pulse, exercise, and have never smoked in my life.  No caffiene, not a health nut, but not a slouch either, so it it a crazy thing.:)  I wish you luck, and based on what the people here say, listen to your doc and hopefully they will go away like my doc told me.  They just don't know why benign ones start up someimes.  I took the lowest dosage on Xanax last night - my PVCc actually went a way.  Maybe calming me down and taking away the adreneline rush that probably pops up when we are aware of them might help some.  I don't know.  Good luck to you, and I am thankful for this forum.:)

[kellebelle]

Yes, can relate....!!! I am 43 female and my pvc's started a year ago. I actually have been good this past month very infrequent pvc's. Had a thallium stress test two weeks ago and all was well not even one pvc...!! My cardio stressed that sleep is important, that not enough kind of messes with our nervous system/autonomic system and for some of us our signals get haywired.

Anyway wouldn't you know last night ....pvc's came on strong in the evening! Of course I had been thinking they would be gone forever lol( hopeful thinking)...Is hard to be patient when they happen...My body is extremely sensitive, when I feel good I may skip a meal, etc. and not nuture my body as much. Also for me delayed stress seems to trigger the darn things. When life slows down they roll back in.Just helpful to read this forum and know that you are not alone. Question??? I know a few of you have Hashimoto's thyroidits, I have this but am not medicated for it since my thyroid numbers are in the normal range.What things do you do to help this condition. I believe it has something to do with the pvc's and pac's.

Have an awesome weekend, Kelly

[BlondieCO]

Kelly,
When I had Hashimotos with my first pregnancy they were definitely linked to my PACs at the time.  Since it is the one thyroid disorder that can resolve on it's own I was only given Valium for two months - they eventually went away when the condition resolved.  So there is HOPE for you:)  Good luck - Amy

[cabonna]

Hi!

I've been reading this thread with great interest.  I too suffer from what I think are either PVCs or PACs.  Could someone please comment on my situation as I can never get through to post a question.

I am a 36 year old caucasian female who is currently 36 weeks pregnant.  I have had the occassional skipped heart beat during times of stress/anxiety over the past few years, but they now come every day 24/hours a day at the rate of one or two skipped beats a minute. This has been happening since I was about 27 weeks pregnant.  They terrify me to say the least and when I'm really focused on them and worried I can experience up to 6 skipped beats a minute for hours on end.

I have had a heart ultrasound and ECG done by a cardiologist and structurally my heart is fine.  At the time of both tests I did not experience any skipped beats - typical! Bascially, the cardio said it's fine, the skipped beats were ectopic (?) and not to worry about it.  Fine for him to say be he isn't the one who has to live with it.

I also spoke at length to my GP about it and he was fantastic.  He said that since my heart was structurally fine then I have no reason to be afraid.  He did say that he thought that pregnancy may have induced the skipped beats and he is confident they will go away after my baby is born.  I am scared though and worry that this will turn into something worse.  I have tried acupuncture and yoga to help decrease my stress/anxiety associated with both the pregnancy and the skipped beats and while it worked at first, it's not really helping anymore.

Has anyone else had pregnancy induced PVCs/PACs?  Did they go away once you had your baby or will I have to live like this forever?

Any feedback to my situation would be most gratefully received.

Donna

[BlondieCO]

Donna,
My first bouts with PACs were definitely linked to my pregnancy.  I did not get them with my second one. This bout I hope is hormonal or related to lack of sleep after my recent surgery. But I did have thyroditis with my first pregnancy - it resolved about 3 months after she was born.  From what my doc says and what I have read there is a definite hormonal link at times - and then again it could be a few cells out of thousands in the heart that can misfire for no reason at all.  What I wish is that we all could find is a doctor who specializes in these benign cases - there has to be some research out there that makes more sense.  And then maybe there are answers too as to why some of us are sympathetic to feeling them, and others have them daily without being aware of them, the bottom line is "if we couldn't feel them, we wouldn't stress and worry that are heart is just going to stop."  We need better answers:)

[mom2six]

Hi,

I just wanted to let you know that pvc's can began durring pregnancy. I am now 37 and gave birt to my 6th child on 01/06/04. I never had any problems with my others just a little high blood pressure at the end of one pregnancy. I did have full blown toxiemia with my first but, I was only 16 at the time. As soon as I became pregnant with my sixth I began having pvc's. I thought at firts I was dying. I wore a 24hour holter monitor before I even knew for sure I was pregnant. The darn things continued through my whole pregnancy. They did decrease for a while after the baby but, have not gone away. I have found that around ovulation or right before my period they are worse. They also seem worse after eating a large or high fat meal. This week has been really bad. I know I don't have alot compared to some people I estimate 30 to 100 a day. But, I feel each and everyone and they scare me now as bad as they did when they first started. My doctor said I didn't need further testing as my heart sounds good and the holter was great. I don't know whether to push for more tests or just relax. My stress level is high especially with these combined with kids. I just need some reassurance. I am not getting enough rest I have a three year old who gets in my bed everynight and kicks me all night long. Should I push for more tests or just relax? I feel great other than these darn things.

Theresa

[BlondieCO]

I think we just have to relax.  I have had O today, and I am not sure why.  My cycle ended Wed. maybe it's hormonal - guess I won't know until the end of this month.:)  But the .25 mg of Xanax has helped a lot.  I did not want to take ANY medication, and the doc said with this low dose I can take only when I need it (I've only had 2 doses).  My doc did tell me that stress can cause us to feel them, but it doesn't have to be the cause - that is the mystery.  But stress and the adrenaline that accompanies it through your body could also give you more - like feeding them.:)  I will knock on wood today, and if I get them during the next cycle, then I know that is my cause - and then a doctor might be able to help me better manage it, whether it be through hormones or some other type of management.  Hang in there - if your heart is sound, it's just an unknown phenomenon.

[BlondieCO]

I have a question about Xanax?  I have taken two doses, I only have the .25 mg tablets.  Then I read that stopping them abruptly is bad?  Seizures?  My doc said they are really low dosage so I can take them when needed, just make sure there's an 8 hour lag between?  I haven't had any PVCs today, so I haven't taken a pill, and hadn't planned to.  Can you take them as needed?
Thanks

[Erik36]

I have been taking Xanax for 12 years now. It works wonderfully to relieve stress caused by these darn PVC's. A dosage of .25 mg
is the lowest dose you can take. If you only take it when the PVC's are bothering you and not every day, you can take them as needed. If you end up taking them at least once every day then you would would need to taper under your doctor's supervision to prevent problems. It would be extremely rare for you to get a seizure from even stopping .25mg once a day but you should always follow your doctor's advice. Xanax has worked wonders for me and I hope it helps you too. Once you take Xanax and feel how it works you may be able to get by just knowing you have it in case you need it. Good luck.


Erik

[Momto3]

Yep, I also take them as needed.  I've been taking them for a few years now, and I would bet I have not taken more than 20 of them.  I also have the .25 dosage.  At one point, my internest prescribed the .25 tablets 1-2 times per day.  He wanted me to try that for a month.  Because I am so concerned about taking RX (especially when I am not sure I need them), I started out cuttin the .25's in half!!  After two weeks of taking 1/2 to 1 per day, I noticed that it no longer provided the same relief.  That made me a bit nervous, so I decided to take them only as needed.  I agree with eric, knowing that I have them is often enough "medicine" for me.  I always carry them - just like American Express - never leave home without 'em : )

I find that if I have them with me, I am much less likely to need/want to take them.  Anxiety seems to go hand in hand with pvcs, that's for sure.  Like the chicken and the egg for many people. Although my GP said I could take the xanax, my EP was not too thrilled with the idea.  She said that the xanax will not treat the pvcs, it simply makes it so the person taking it does not care.  TRUE!  After several years, she now knows me well enough to know I only take it when I need it, and she is fine with it.  If you are finding relief with it, use it as needed (never heard of the seizure side effect) and try to put it out of your mind.  That's not always easy, but it can work wonders for the psyche.  Hope you're having a great day!!

connie

[wmac]

I am a pvc, pac, aivr,racing heart and nonsustained ventricular tachycardia suffer. I have been through all the test. When I was told that I had non sustained vtach at which time I only had three pvcs in a row, I totally freaked. Now I have had 10 in a row which really made me freak even more. So my cario who is also an ep doctor sent me to the University of Utah for another opinion. Which they did even more test. They tested me for ARVD, now that was really scarey. But everything came back fine. So in all I have spoken to 10 doctors about this problem and all of them say that my nsvt is not life threating. Hahaha easy for them to not worry right. Well I do feel alittle better about it but I do for sure have my moments of freaking out still. I now have a implanted loop recorded to capture my racing heart they think it could be a sustained vtach, but then again it feels differant so it could also be a svt. who knows! I have a healthy normal heart ef of 70% a little mvp, inwhich they believe that could be causing the nsvt. But yes in the setting of a normal healthy heart they all say there is nothing to worry about. So I hope this helps.
wmac

[cabonna]

Thank you sooooo much everyone for getting back to me with your stories.  I don't feel like such a freak now!

I know that anxiety doesn't help the pvcs but I guess it's a bit hard to not be anxious when I am scheduled for a c-section in just under 3 weeks.  I had an emergency c-section with my first child so I know what to expect, but that doesn't make it any less stressful.  I also didn't have any pvcs with my first pregnancy which has made this all very terrrifying with this time.  

I'm still getting about 3-5 pvcs a minute and this is every day.  If I'm lucky I might have a few hours where I don't get any or at least I don't seem to notice them but it's hard to cope with on a day to day basis.  I guess I'm hoping they will go away once the baby is here, but then as I've read from so of you that might not necessarily be so.  If that's the case I will ask for medication.  Being pregnant I can't take anything so I just have to try and put up with it all.  I have good days and bad days which I guess most of us do.  Some days I have far less pvcs than others but right now it seems like every day is a bad day!

Here's hoping that one day we won't have to live with these horrible things anymore.  I bet if it were a cardio that expereienced these things as much as us they'd soon find a cure!

Thanks again everyone for your reassurance.

Donna

[Cashiers]

I too am a very sytomatic person to the extreme, had ablation in april for re-entry loop for the fast tach.  Still taching, now looking at another ablation at Duke this time.  

Went thru all tests(echo, stress, cath and all monitors) I have strong heart no blockages just out of all over the place with rate and rythem. I read all these posts tonight, so many us, it's scarey! Someone should figure this out. I try hard to just go about the day but there are few days where it is not affecting me hard.  

I have the pain and pressure, feeling weak and dazed and confused at time.  Not fun when one is in mid sentence with client......  

I hope this guy can help  Dr Bahnson at Duke Univ Med Center.  Anyone have experience with this Center?  

I am going to ask for some xanax as well, that could make life abit easier now and then understand the grip it can do.  

I should here tomorrow on date of procedure.

Sorry so long

L

[Guss]

Thank you Blondie for the thoughtful and encouraging comment.  I do appreciate it.  This a question to all:  is any of you experiecing frequent pvc like I am.  At times, especially when before sleeping, I could count 30 or more in a minute.  This is kind of scary, but I feel fine.  It is just the nuisance with the big "thumps" that you feel with these things.  Like I said, I am very new at this.  I just felt my first PVC only 3 weeks ago.  

Thanks to all and God Bless.

Gus

[Lexicon154]

Just a note of caution about Paxil, Xanax, and other anti-depressants.  Do not take any of them if you are currently taking Rythmol.  I don't know about other antiarrhythmics, but my cardiologist warned me that any of these ADs can make Rythmol stronger.