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Heart Disease  (Expert Forum)
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Ectopic heartbeats
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Ectopic heartbeats

by Colonelsandi, Nov 17, 2003 12:00AM
I am a 63 yr old female, smoker. 4 yrs ago I had an attack of atril fibrillation brought on by over-stressing in cold weather. I have been on two 25 mg atenolol a day and .25 lanoxin. I have had many check-ups, ekg's etc (read by a heart specialist sentfrom my physician, but no stress tests. But still have "flutters" - the extra or premature heartbeats. Never at the doctor's office! He doesn't seem to think it's anything to worry about. Somedays barely any, sometimes 4-5 a minute. BP runs in the high 120's to mid 130's over a diastolic of mid to high 60's with a pulse rate of 60-68.

Should I pursue further - I have no insurance and every appt is expensive! I am not faint, have no chest pain, the atenolol has slowed me down a lot. Seldom short of breath or anything.

Thanks - the Colonel

by CCF-M.D.-RCJ, Nov 17, 2003 12:00AM
Colonel,

Thanks for the post.

If the "flutters" are only 4-5 per minute, then most likely the "flutters" are just PACs or PVCs.  It is always possible that you could have afib, with different symptoms than the previous episode 4 years ago, but this is less likely.

The only way to definitively know what are these flutters is to have an event monitor, which will cost you $200-300, and probably is not worth it but for peace of mind.  Or to get off of the atenolol...

Hope that helps.

Member Comments (23)

by Colonelsandi, Nov 17, 2003 12:00AM
Thank you so much for your prompty reply! That makes me feel a lot better. The monitor is out of the question for now (retired with little to fall back on thanks to circumstances beyond my control). If they increase, I will seek local medical attention. I had wondered about the atenolol as I know they can cause that which they're supposed to solve, I'm uncertain why I am still on them. They also give me false cholesterol readings, false highs which the physician won't accept. I never have had high cholesterol or trigs but since being on these I have. My last test showed a total cholesterol of 214 - I need to have another full test without taking the atenolol prior to the test and after a fast. I am not overweight (5-10 at 160 lbs), my life is a little sedenmentary right now but I try to walk each day to make up for it.

I won't stop the atenolol without permission of my physician, think one has to be weaned off of it. In closing, the atril fib attack was corrected in the ER by something in an IV, the rate was only 120 but irregular. The Colonel

Thank you again!

by GRAMMYH, Nov 17, 2003 12:00AM
PLEASE SOMEONE ANSWER THIS. Would hope the doctor would give me a little information. I am a "young" 75 year old who is very active mentally and physically but do not feel I will be very long if some light cannot be shed on  these PVCs. I am a survivor but having trouble convincing myself I can handle this. I have recently been (June of this year) through the nuclear stress test, echo, holter and not for this but for definitive answers to  some chest pain and ischemic ekg. ( I have had the same ekg tracing without change since around 1980 when it converted from a "normal" tracing. I have been bothered by some periodic PVCs many years but not feeling them that much and frankly just a few. I was diagnosed in 1996 with Graves Disease and had radioactive iodine treatment 6 months later. Am on 100 mcgs. synthroid. That diagnosis was made on an ER visit with atrial fib. To make a long story short, I was sent to cardiac rehab at a hospital here in FT. Worth because of the chest pain on exertion. However the cardiologist said my heart structure etc. was all normal. At cardiac rehab on the monitor the PVCs have been very frequent but they do better (as the stress test shows)after I get the heart rate up. Due to atenelol the resting rate stays around 47-51 so I do not get the rate up too much. Am I getting too low heart rate and does that cause PVC to be worse? I hardly ever sit down and rest because they are so frequent at rest. Feels like runs at times and average 6-15/minute. Do not get the "Thump" feeling just the fluttery feeling. I am now seeing an EP and he gave me a good lecture (very kind) that I do not have heart disease. However I am now using an event monitor as of last wednesday. I would be constantly pushing the recorder if I recorded every feeling of the palpitations so am trying to just record ones with light head. etc. I do the treadmill now at grade 3 and 3mph and feel well when I get off. I am no longer on the monitor but check in with heart rate and BP at cardiac rehab. Please tell me if this low HR(goes up when I fo to the doctor to the 60's)is causing this very frequent pvc to have started or could another Beta Blocker help. I really feel helpless and want to enjoy these years. I do appreciate the conservative approach but find it hard to believe this is not leading up to some catastrophic event because of my age. Most of you are young . Does this make a difference. The EP and regular cardiologist never tell me my age is involved. Only that the test show normal heart. I had angiogram in 1999 . Was only showing 10% blockage in insignificant artery. Please tell me why the "nonspecific ST changes" on the EKG read ischemia if everything is normal. Please respond to this long letter but I am really between a rock and hard place dealing with these. Thanks and don't ignore because of age, PLease. Grammy

by GRAMMYH, Nov 18, 2003 12:00AM
To: Hankstar
Thank you so much for your kind response. You know many people (including docs) write you off when you pass a certain age. I bowl a pretty good game and love it(takes my mind off these PVCs awful feeling or I do not feel them at the time). I too question that synthroid. Had a TSH and T3 and T4 done last friday. It is early tuesday mmorning so have not heard yet. I wish the cardiologist/EP would know about these things but they have me go back to the internist for those tests. I think maybe if I were put on the low end of the replacement that would help but if you fall in the normal range on theTSH they say it is normal. I am afraid to make any adjustments myself. I am a long time survivor of breast cancer and had various experiences in life but these PVCs have their "bluff" in on me for sure.Thanks again for the reassuring information. The times I am not "on the go" and wold enjoy sitting down and "relaxing" I feel them so constantly I cannot enjoy the so called relaxation. God Bless all of you as you understand and help others. Grammy

by Ianna, Nov 19, 2003 12:00AM
To: Hankstar
Hello Hankstar,
-
I am a healthy female (Dutch) - 58 - menopausal.
Since you know alot about these PVC's and arrythmia's, I'd like to 'consult' you about my 'flutters'.
These things that last for 6 to 8-10 sec. and make you feel like you're going to pass out or die on the spot.
The single PVC's I've had for many years, but these 'rolling fluttery marbles' are different. It's like your heart stops, turns around a few times (the 6-8 sec. marbles), and then when you feel like you will not make it this time the heart 'starts' again with a bump. These come out of nowhere. Sometimes once a week, sometimes once a month. Leaving you a bit breathless and feeling like there's a brick inside your stomach that maybe will go away if you could burp...
They scare the h.ll out of me!
Then almost always a hot-flash follows and often leaving a sore spot on my upper spinal column. (I have a bad back)
I have no stomach problems that I know of, but I've always had a 'nervous' heart. In fact, I am a nervous sensitive person.
Sometimes I hyperventilate slightly.  
I've been checked and my heart was normal.
My bp is a bit high, and I take propanolol.
I watch what I eat and don't smoke.
I don't sleep well and enough.
What do you think....?
-
Love - *Ianna*

by reedsgr1, Nov 19, 2003 12:00AM
To: HANKSTAR
Hello Hankstar-
I am submitting this question to you because the forum is not accecpting any more questions.

VERY LONG STORY SHORT...
I am 35 years old, and in 1987 I had my first experience of palpitations and thought I was having a heart attack.  When I went into the emergency room, they found inverted T waves, and they freaked a bit...over the next couple of months I had an echo done and a stress echo.  They determined that my EKG was a normal variant for me.
In 1997 I had more anxiety, and went in for a Thallium stress test, and they come up with the same conclusion, so I started to relax.  I just saw the written report for the THallium and while he said he thought everything was normal, he ended the report with "Conceivably he could have a congenitally abnormal circulation of the heart, but this is EXTREMELY rare, and due to his anxiety I didn't mention this to him.

SO...I have freaked out yet again and I am seeing another cardiologist in my new town, and he asked me to have an resting echo.  I had it this morning, and when I asked the tech if everything looked "normal" she said that the doctor would go over it all with me tomorrow.  This has not helped me to relax at all.  My question is this....I noticed that I had an ejection fraction of 65% which looks good.  Does this figure also indicate that I don't have any abnormal heart wall function?
Very curious.
Thanks!

by kate38, Nov 19, 2003 12:00AM
To: Hankstar


Hellooo,

With all the questions you get ask on this forum maybe you should have one of your own.:)(just kidding)

Can you believe were already half way through Nov,Thanksgiving is right around the corner.WOW!!!
And if your teenagers are like mine you might want to bake an extra Turkey.

Hey,I was just wondering if you happen to know anything about the drug crestor,it's a new cholestorol medication.  
I can't seem to find anything about it on the internet.

May u and ur family have a wonderful Thanksgiving.
Kate :)

by kate38, Nov 19, 2003 12:00AM
To: Hankstar




Hankstar,

Thank you very much.



Kate  :)

by Ianna, Nov 20, 2003 12:00AM
To: Hankstar
Dear Hankstar,
-
Dank je wel!!!!
That's -thanks very much- in Dutch!
It's just like you described and your answer eased my nerves.
-
God bless - *Ianna*

by lak, Nov 20, 2003 12:00AM
Hank,
I am always reading on the forum and I realize your not a doctor.  But do you know anything about the muscle weakness being associated with pvc's are maybe the medication for them.
I take atenol 50, and blood pressure med hyzzar 50.  I cannot hardly climb stairs, hurts so bad I have to stop and rest.  I am on a 30 day monitor now.  My ejection fraction is 47% and I have been trying to feel my pulse to see if there are any significant runs. Mine are usually in 3's and 7,s.  It feels like there is a long pause after 3 beats pause 3 beats pause 3 beats pause then starts normal.  Is this anything to worry about.  I really appreciate your imput on this forum.
Thanks Lisa

by lak, Nov 20, 2003 12:00AM
Hank,
Do you know how they would tell if your heart muscles were damaged.  Is the only way an MRI.  That is the only test I have not done yet?

by lak, Nov 20, 2003 12:00AM
No, not really anxiety....but I just never feel well, tired, and I have these frequent cases of like sweats like a fever breaking 6-8 times a day. The last 24 hour holter I had 18,000 PVC'S in a 24 hour period.  Went to sleep clinic and he said the longest I went without having a PVC was 30 seconds.  I am sorry but I just don't see how these cannot be effecting my quality of life. When they say just egnore them it makes me crazy.  I have changed doctor and he wants to send me to new group of Cardiologist's in Columbus Ohio.

by lak, Nov 20, 2003 12:00AM
Hank,
Had all the test for connective tissue diseases, thank god all of those came back normal.  Just called the doctor and all blood test came back fine including my tyroid.  My ANA is a little elevated and that is why they send me to rhuematologist.  I thing our next step will be the electro study again.  I have had this done but when they put the adrenline in the doctor said it made horrified me so he did not continue.  I do not remember though........ that was in February.  Since then I really think things have gotten worse.  The other day coming up a flight of stairs at work heart rate went up to 261.  I did go to the emergency room and they said my potassium level off a little but no big deal !!!! I am really sick of all of this.  But, do not feel the same I did a couple years ago.  I used to work all day on the yard and still be able to function now after 2 hours I have to lay down because if I get tired, nausea, and muscle weekness.  Thanks for listening..... it really helps.  Frustrated Lisa

by lak, Nov 20, 2003 12:00AM
One more question?? When you have a PVC would it cause the heart monitor to bump up that high?????  261, 243, and then slowly go back to 80's.  Mine runs around 80-90 all the time.  But, I have sat with no excertion and watched it go to 161 the 260's were climbing the stairs.  I'll let ya go, thanks for replys.
Lisa

by lak, Nov 20, 2003 12:00AM
THANKS.......

by Ianna, Nov 20, 2003 12:00AM
To: Hankstar
So what if you were...
Silly people..
Just let them Hank, you're a real BIG help to many of us.
-
Love  - *Ianna* -

by lak, Nov 20, 2003 12:00AM
Hank,
Whats POTS or DYAUTONOMIA??????????

by lak, Nov 20, 2003 12:00AM
That's ok about the spelling, I mean.  I really enjoy talking to you and I will go to the web now to see what I can find.......Thanks Again

by GRAMMYH, Nov 20, 2003 12:00AM
To: Everyone and Hankstar
Hi! I am that 75 y.o. who  wrote the other day re: these many PVCs and Hank you so graciously did not write me off because of my age and again thank you  for your reply. I wanted to report that I got a call from my internist office early yesterday morning that I was over medicated with the Synthroid. You suggested that this might be the cause. They have ordered a lower dose. I have Graves Disease and even though the thyroid has been radiated I still have some functioning. Graves Disease being an auto immune disease is still there. Well do you think the thyroid is causeing this 6-15 pvcs/minute along with episodes of bigeminy etc. I know it will take a few days to get it back down but it has given me some comfort just knowing this may be a cause. I also have had hives on back and neck for a week or two and it itches terribly. I looked it up in a book and saw where hives can happen with hyperthyroidism. My event monitor is giving lots of information but I want to know what is causing this. Like many others I am tired of hearing "Don't worry", My earlier post is on this thread so if amy of you would want to know about all these symptoms that go with Graves I am the expert. One of the most overlooked diseases in the elderly because of the beta blockers etc. many symptoms are not evident as the arrythmias etc are treated and not the cause. I just need some encouragement from some one that a synthroid dose can get to be too much even though it was ok for some time. I hate to have to wait several weeks to see if this will make the palpitations better. My resting HR is around 47-51 because of the atenelol. I understand all of your anxities and mine is nearing the panic stage because of this constant thing and I am beginning to feel sick and losing my desire to even leave the house. I usually am going somewhere all the time before all this began. Worry about sudden death and things like that which is taking the joy out of my time I hope to have left. Being alone does not help so hope I get to feeling better than yesterday and today. Thanks for all your helps. Grammy

by GRAMMYH, Nov 20, 2003 12:00AM
To: Everyone and Hankstar
Hi! I am that 75 y.o. who  wrote the other day re: these many PVCs and Hank you so graciously did not write me off because of my age and again thank you  for your reply. I wanted to report that I got a call from my internist office early yesterday morning that I was over medicated with the Synthroid. You suggested that this might be the cause. They have ordered a lower dose. I have Graves Disease and even though the thyroid has been radiated I still have some functioning. Graves Disease being an auto immune disease is still there. Well do you think the thyroid is causeing this 6-15 pvcs/minute along with episodes of bigeminy etc. I know it will take a few days to get it back down but it has given me some comfort just knowing this may be a cause. I also have had hives on back and neck for a week or two and it itches terribly. I looked it up in a book and saw where hives can happen with hyperthyroidism. My event monitor is giving lots of information but I want to know what is causing this. Like many others I am tired of hearing "Don't worry", My earlier post is on this thread so if amy of you would want to know about all these symptoms that go with Graves I am the expert. One of the most overlooked diseases in the elderly because of the beta blockers etc. many symptoms are not evident as the arrythmias etc are treated and not the cause. I just need some encouragement from some one that a synthroid dose can get to be too much even though it was ok for some time. I hate to have to wait several weeks to see if this will make the palpitations better. My resting HR is around 47-51 because of the atenelol. I understand all of your anxities and mine is nearing the panic stage because of this constant thing and I am beginning to feel sick and losing my desire to even leave the house. I usually am going somewhere all the time before all this began. Worry about sudden death and things like that which is taking the joy out of my time I hope to have left. Being alone does not help so hope I get to feeling better than yesterday and today. Thanks for all your helps. Grammy

by GRAMMYH, Nov 21, 2003 12:00AM
To: Hankstar
Thanks for the encouraging words. When night gets here and the old anxiety sets in the pvcs are worse (of course)so I hit the computer. It is helpful to read of other similar problems and feelings and hear from those who understand. God Bless You Grammy

by Skipsaplenty, Dec 01, 2003 12:00AM
Somebody please help me. I am a 32 year old mother of an 8 month old and I am at the end of my rope.  I have had PACs and PVCs for about 7 years now, but they were about 2-6 a day.  Suddenly in the past 7 days they are constant (PACs).  I have been to the emergency room 4 times.  They all see them and say they are nothing, but this is not baseline for me.  I can't eat because they bother me, I can't sleep well.  They are about every 4-5 beats and they let up occasionally for an hour or so.  I have had an echocardiogram, enough ECGs for an 80 year old with congestive heart failure and even had a stress test.  I also wore an event and Holter monitor that documented alot of PACs.  I cannot deal with these.  I take 25 mg of metoprolol (Lopressor) b.i.d. and 75 mg of Zoloft.  It does not seem to be helping.  I have some Xanax that I take occasionally, but it only numbs things.  Does this mean I am getting an acute heart problem?  Every doctor and my cardiologist says no, but honestly, if they don't quit I don't see my quality of life being anything but horrible.  It makes me angry and depressed.  No take no caffeine for stimulants.  Somebody please talk to me who can relate.  I have always been athletic and I don't know how I will ever live with this.

by LynnSB, Dec 16, 2003 12:00AM
To: skipsaplenty
Are you breastfeeding? Even if you aren't, you might be low in magnesium . Some doctors pooh-pooh that low mag could cause palps,some would recommend  trying it. Ask you doctor. It couldn't hurt! You might do a search on the internet about arrhythmia and magnesium deficiency.. just make sure , if you take magnesium, that you find one that doesn't upset your stomach and is well absorbed. Magnesium glycinate is one such form. Slo Mag is a form often prescribed by docs because it is supposedly easy on the tummy but it kept me in the bathroom.. ugh.
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