EP Study--Please advise

[smiley]

Two years ago I was diagnosed with a "classic" MVP after having symptoms of fatigue, shortness of breathe, irregular heartbeat, mental fogginess, and palpitations which began mildly a short time after having a dental procedure done which resulted in a severe abscess.  Over the course of many weeks, my symptoms became very severe, actually debilitating.  At the same time, I was being treated very aggressively for a severe sinus infection which was related to this same dental procedure.
     Over the course of the past two years, you could say my family and I have been through the wringer. I have been to specialist after specialist.  After my most recent echo, my treating cardiologist has stated that there is moderate mitral leaflet prolapse, moderate leaflet thickening suggesting prior inflammation with scarring; fused chordae tendinae, and inter- mittent mild mitral regurgitation-especially after PVC's.  I was then sent to another cardiologist in hopes of an EP study, as I have been on Rythmol and Clonidine for a year with some relief, yet, poor control of my PVC's and symptoms. (I have been unable to tolerate many other meds.  Atenolol ineffective, Betapace ineffective, Norpace-blurred vision.  Rythmol and Clonidine are tolerated in small doses).
     I have been told by the electrophysiologist that my symptoms are unrelated to my PVC's.  I often have a palpable pulse in the low 40's and this is usually accompanied by severe fatigue and SOB.  My halter monitor revealed 38,000 PVC's in 24 hours.  I have a normally low blood pressure--usually 90's over high 50's or 60's, which has never presented a problem.  That's just been me!
     It has just been suggested that I may be suffering from POTS-Postural Orthostatic Tachycardic Syndrome.  I had a Tilt Test 18 months ago that was negative.  I do not pass out, and very seldom feel any dizziness at all.  I was put on Florinef, and after only two doses I'm feeling as poorly as when I was first diagnosed with MVP.
     I am now 45 years old and have no prior history of any cardiac problems. I was unaware of my MVP until just two years ago.  The Registered Nurse part of me truly believes that I unknowingly suffered from a subactute endocarditis which brought on all of these problems.
     I have lived this...and I am 100% positive that my symptoms
ARE directly related to my PVC's. I'm sorry to say, that, it seems that many doctors are unwilling to hear or believe what their patients are relating to them.  
     Do you feel that an EP study may possibly prove to be beneficial?  I don't have to tell anyone who suffers from these symptoms how terribly frustrated I am, and how very debilitating they can be.  I just can't understand how I can be told there's not a relation between my PVC's and symptoms when so many other people are describing the same things that I am experiencing. Tell me, are all PVC patients being told the same thing???  Am I
to give up on this thing and settle for feeling crummy for the rest of my life???  I just need to feel better!!!
     I sincerely thank you for your input!        Smiley

[Gary to Smiley]

Actually I suffered the same situation -I had an abcessed tooth
bacterial tests negative,I now have mitral and tricuspid reguritation.Also one of my echos revealed small degree prolapse of the mitral valve after over 2 years of guessing...
I kept on walking with an abcess tooth(teeth) for 2 years and developed sinus problems as well.The only things that where helping where extended release antibiotics and aspirin.Went through a coronary angiogram which showed no blockages in my coronaries.
I do honestly believe that your symptoms are related to an infection -over 90 percent of cardiac problems are initiated by bacteria !!!!The only thing ---for someone to tell that you
had endocarditis or subacute endocarditis will be a problem
Doctors are relying on indirect measures(echo has a with  resolution of 1-2 mm -not good enough to see tiny tiny spots )small bacterial colonies are invisible....unless the heart is seen directly during surgery.Of course regurgitation itself
is caused mostly by subacute endocarditis.I was trying to ask this question which might be quite important to people with
valve /coronary symptoms:WHAT EKG CHANGES ARE PECULIAR FOR
REGURGITATED MITRAL OR TRICUSPID VALVE VERSUS THOSE THAT
DENOTE CORONARY DISEASE (BLOCKAGE).st-t segment depression is peculiar for coronary blockage what about regurgitation
peculiarities how doea a EKG of a heart with a regurgitated valve look like ??anyone knows the answer ???????????????

[VTBen]

I would have to say that when I am getting thousands of PVC's, in Bigeminy and such, fatigue and shortness of breath do occur with me.  Maybe it's part anxiety and frustration, but I do get those physical symtoms very much.

[CCF CARDIO MD - DLB]

You could seek another opinion from an EP doctor. EP studies can very rarely be useful for certain types of PVCs, but a review of your Holter monitor tracing would need to be done to see if this applies to you. You could also discuss the possibility of trying flecanaide with your EP doctor for the PVCs. I do not think an undiagnosed endocarditis is related to your current symptoms, but PVCs can cause certain people a great deal of symptoms, though fatigue and shortness of breath are unlikely to be due to PVCs.