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.:)