Getting constant, but asymptomatic PVC's - is it worth seeing a doctor?

[KatieBu]

Hi there and thanks very much for taking my question. I am a 36-year-old woman. For the best part of the last year I have been suffering constant and frequent skipped heartbeats. It all seemed to start when I decided it was time I started to take regular exercise. Prior to that I used to get a very big PVC only once every two months or so. But now I seem to get around two to four a minute. They are stronger at the end of the day. They are very typical of other people's PVC's: an uncomfortable and annoying feeling of something flipping over in my chest. I don't get breathless or feel pain or anything like that, but sometimes there is a bit of a "rush". My father has hypertrophic cardiomyopathy. I had a scan for HCM about ten years ago and was told I was clear, though a small murmur was detected. I really don't want to give up exercise: I can't believe that it's bad for me... I don't have any particular stress in my life and haven't drunk caffeine for over a year. Also I drink alcohol in extreme moderation.

I keep thinking I ought to go and see my physician and get myself checked out, but haven't quite got around to it yet - mostly because everything I read seems to point to asymptomatic PVC's not being dangerous in most cases. Is it worth getting myself checked out? The PVC's are annoying, but I don't want to take any drugs if I can help it. I would rather just live with it.

Also, I'm interested in getting a cosmetic surgery procedure done which would necessitate a general anesthetic. Would the PVC's present any problem?

Thanks so much

Kate

[CCF-M.D.-MJM]

Hi Kate,

Your concerns are very reasonable.

You are correct that PVCs in the setting of a structurally normal heart do not impose a greater risk than the general populations.  It then comes to the question of whether you want to try to take medications to try to decrease their frequency or intensity.  If you don't want to take medications, benign PVCs do no change your risk and your approach is reasonable.

With your family history of HCM, it is reasnable to have your heart checked for structrural abnormalities and a holter monitor to quantify the PVCs and make sure they are only PVCs.

If you have a normal heart, the PVCs do not increase your risk of general anesthesia.

I hope this helps and good luck.

[hankstar]

Hi,

  I would think that if your father has hypertrophic cardiomyopathy and it being a famalial disease, and your echo/scan was 10 years ago, another echocardiogram would be a reasonable approach at this time to rule out any structural abnormality, on the other hand it could be your every run of the mil day PVCs.

Take care,
       hank

[Guss]

If any of you could shed a light on my situation, it will be highly appreciated.  I am 43 years only and currently have frequent PVC's which started just about month or so ago.  I have good days and bad days.   When the PVC’s start, they really are uncomfortable. My cardiologist said that they are stress related.

I had an echocardiogram 3 weeks ago which I passed with flying colors.  I smoked 1 or 2 cigarettes a day for about 20 years rarely going over that.  I quit smoking.  I gave up caffeine.  I now eat health and exercise.  By the way, I have resting PVC's as I do not feel them when I am doing cardio excises.  But when I lift weight, I feel them.  

I also have a slight apnea problem.  So, I had a sleep test to find out if the PVCs are related to lack of sleep.  You sleep at a facility and they monitor your brain wave and your heart.  To my surprise, the technician said that I did not have any PVC’s during my sleep.  Is this common???   Why do I only have PVC’s during the day?  Are they stress related?  I do not feel stressed out.  

Any comment you can provide will be highly appreciated.  

[hankstar]

I am not a medical doctor, but worked in the medical profession for over 18 years.Being you had no PVCs during your sleep study this does not necessarily means that stress directly triggers your PVCs but could have an indirect trigger. It sounds as though your PVCs are related to high adrenalin levels or adrenalin "rushes", maybe you have some autonomic dysfunction and or have a change autonomic tone and have developed some form dysautonomia. I don't konw if you are on medications, but for these type of PVCs , usually beta blockers are quite effective in suppressing them, you might wish to talk this over with your doctor.

If this is causing you severe anxiety, an anti anxiety medication might be prescribed with the beta blocker or even a low dose of paxil or zoloft might help a great deal in this case.

Always trust your cardiologist or internist for the best guidance and treatment with your symptoms and never take comments posted here on the forum over the advice of your trusted doctor, but you might find information here that might help enlighten you and also your doctor(if you ask the right questions to him) as to get the root cause of your symptoms and maybe your treatment options.

Best wishes and let us know what happens.

[KatieBu]

Many thanks to the doctor, hankstar and anacyde for your comments. Much appreciated. I will book a doctor's appointment next week! Anacyde, I hope you find some relief from your PVC's too. They're enough to make a saint swear aren't they? Good luck also to Guss in getting the bottom of your PVC's.

Kate

[Guss]

My PVC’s are about 10 to 20 per minute when I get an episode.  The episodes last for about 10 to 20 minutes every 4 hours or so.  I have learned to ignore them.  But they are frustrating and you feel less than what you were before.  Depressed at time, but not all the time.  So I am managing the situation OK I think.

Hankstar, what you said makes a lot of sense.  I think my problem is triggered by either one of two situations: 1) dysautonomia as you stated caused by stress; or 2) dysfunction of the electrical impulses between the brain and the heart.  I am hoping it is the former.  Everywhere you read about PVC’s, they state that if you have a good hear structurally, that the PVC is an effect not a cause.  So we have to find the cause.  

Another test I did recently (you guys are going think I am nuts) is a total scan of the body and they found that my visceral fat was too much.  This is the fat that surrounds your organs, not the subcutaneous fat that is under your skin.  I did not have much under the skin.  The doctor that conducted the exam thought that my PVC’s are caused by temporaneous elevation in my blood pressure which goes against the dysautonomia theory (I think).

Thank you Katie Bu and Anacyde. Best wishes to everyone.  Please give me your feedback.

[Schurrthing]

I don't think you're nuts about the body scan at all.  Can you tell me what it was like and if you had to pay for it.  I remember seeing it on GMA.
Thx, Roxanne

[SouthJ]

Guss, you sound like me. I'm 37 and have PVC's also but they seem to be the worst when I do sudden exertions, like running up the stairs, lifting weights, sex, etc. I don't feel them at all when I do aerobic exercises or run. I can do intense aerobics for an hour and feel nothing but will feel them if I climb up a flight of stairs quickly from a resting state. It's pretty weird but I've passed every test my doctor has given me, including the echocardiogram (resting/exertion) stress test. They found singles, doubles, triples, and quadigeminy with me but still say I'm fine. No leakages or blockages and a strong EF reading of 68 I think.

I think the best advice is to eat healthy, avoid caffeine and alcohol, get lots of rest, and exercise. Also, reduce stress. That's very important.

[SouthJ]

By the way, I would stay away from medications like Toprol XL. These will reduce the intensity of your PVCs but will make you feel sluggish and tired. I was placed on it by my doctor and I had to come off of it. Toprol is a beta blocker and research has shown that you are more likely to suffer sudden cardiac arrest on a beta blocker than someone who takes nothing at all for their PVCs. This led me to believe it's better to live healthy and tolerate them without the meds.

[hankstar]

Hi,

   I am sorry to hear of your PVCs, being an episodic off and on again pvc sufferer myself for over 12 years, aggravating by some of the same triggers as yourself.

   I was wondering if you could point to what suggest that beta blockers can make one suffer from sudden cardiac arrest while on beta blockers more likely rather than not taking anything at all. I am on atenolol 100mg daily in divided doses and would be curious to know.

   Beta blockers are classII drugs fror arrhythmias are not associated with any proarrhythmic effects, only sotalol(betapace) would fall into that line of drugs.  Tambocor(flecainide) is an exapmle of a proarrhthmic drug, but it is not a beta blocker. Beta blocker to my knowledge are not proarrhythmic drugs and is the one line of frugs that has shown to reduce the mortality rates among person who have heart disease, suffered heart attacks and now even heart failure.

   I know there has been some debate lately of atenolol and its efffective use in hypertension, other than that beta blockers are safe and effective drugs, though they are not for everyone. If you have read or received any latest information or studies concerning beta blockers and PVC involving SCD, I would like to know. Thanks in advance, hope the PVCs give you a break.

Best wishes.

[Guss]

Thank you SouthJ.  I am very hesitant to take medications too.  Funny that I didn’t think much of it when I took a bunch of advils during my power lifting days.  Now at age 43, I am trying to stay away from any medication.  About Toprol, my internist gave me a sample, which did slow down the PVC’s.  The cardiologist at the ER that I went to when the PVC’s were 30 per minute told me to be careful of Toprol as well.  But did not say why.  I am staying away from them.  I believe your asymptomatic PVC’s are a warning because of something not quite right in your body.  To try to mask it is inherently wrong.  I agree with you SouthJ.  I think we need to treat the source not the symptom.  Now, if you have a structural problem with your heart and the PVC’s could kill you, that’s another matter.

This is a great forum.  I truly thank all those who have lent me support during my confused times and all the others whose comments, though not addressed to me, help me understand this weird thing called PVC.  You’re all wonderful people.  Hankstar, thank you for your advice.  I do appreciate it.

Warmest Regards,

Guss

[Guss]

www.healthwisecenter.com

This is the information about the place where I had my body scan SouthJ


Guss

[jennifer79]

Reading these posts about pvc's sometimes I often wonder is that what I really have?? I am 25 yrs. old,female. Have been having them for 9 years. They come out of nowhere,when im relaxed,eating,etc... mine feel like flutters. They last only a sec or two and then it is gone. I get them about once,maybe twice a week.I read that alot of you say yours last minutes to hours. and you can have 5-10 a minute..mine never last that long. Is that a good thing or is what im experiencing possibly something else?? Ive been to 2 dr.s, a cardiologist just a month ago..he ordered a echo,did a ekg,bloodwork..and 24 hr. holter monitor.everything came back perfectly normal except the 24 hr. holter showed a few extra beats. but while wearing the holter I didnt feel one single flutter! the cardiologist said that was fine and nothing to worry about.I have read on here that if you dont feel the flutter while wearing it then they can not properly diagnose you? he said thats true but since i am on toprol,young,and they happen rarely not to worry???? someone please help i need answers...Thanks

[Guss]

Hi Jennifer.  I am new at this as I started having mine out of the blue only 4-5 weeks ago.  But I did a ton of reading on this topic to try to understand what is happening to me. From what I read: 1) PVC's are uncomfortable and are either harmless, if your heart is structurally good, or dangerous if your if you have an underlying heart disease; 2) the frequency does not matter.  Actually, you are lucky that you only have them once a week.  Imagine having 100 in one hour, even though they may be benign; and 3) PVC's are triggered by something in your body that is not right, e.g. blood pressure, stress, having consumed stimuli like caffeine and cigarettes, medication.  They will come and go in cycles.  Some people become symptomatic with PVC as they feel dizzy and nauseous.  For those that have symptoms, the Dr. prescribes beta blockers to try to lessen the frequency and the symptoms.  Others whose just feel the uncomfortable feeling of a pause and thump in the chest and the neck without symptoms, the Dr. just say: try to find out what is causing them and eliminate it.  

I tell you I freaked out when I first got mine, but I found that my blood pressure was elevated and I was few pounds over weight plus my job was stressful.  So now I am exercising and the severity of my PVC’s are decreasing.  This forum has been awesome as there is a lot of support from others.  

Hope this helps.  Best of luck.

[jennifer79]

Guss, Thank you so much for replying. You are right, I am lucky that mine only happen once a week. I couldnt imagine having these things all the time. My heart goes out to those who do. What you said made me feel better. Thanks again

[freedancer]

I've had PVC's for quite a while.  They used to be very few and far between.  Now, I have them constantly.  I went for a whole week non-stop.  I was at the ER twice and the DR told me there was nothing he could do.  They ran an EKG both short and 12 lead and stated that my heart was fine, no sign of disease.  However, these PVC's are beganning to ruin my life.  I have periods where they won't stop and the more I have them, the more worried I get that I am just going to drop dead at any moment.  Sometimes I get light headed, breathless and fatigued.  I have told the DR this but he still insists that I am fine and won't die.  I have noticed that they come alot after I eat dinner or just when I am sitting in my chair at night after a long day at work (I am an intensive case manager for a mental health center).  I have literaly cut off any caffene, cut out chocklet(sp), tea and anything else that I can possibly think is causing it.  Can anyone help me?  I do admit that I have a terrible fear of death and often worry about it.  I have tried quite a few of the anti-anxiety meds but some of them made me feel worse.  If you have any suggestions on how I can get the DR to do more testing, please let me know.  I have had a treadmill test, holter monitor and cardiac workup with no results except to show I have 10 PVC's or more a minute.  I am getting very tired and exhausted from all of this.  I feel embarrased about going to therapy because I work with mental health but I should add that two years ago I was attacked violently by a mental health patient so could some of this be PTSD symptoms?  Thanks very much.  Most sincerely, freedancer.

[caramich]

Are you sure that the PVC's aren't a symptom or side effect of something else?

Do you mind if I ask you a couple questions? (and hope I can find my way back to this thread).  I'm not a doctor by the way...just feel like one sometimes.  But you caught my eye.

How old are you?

Overachiever?

How is your sleep?

Do you have back pain? Arthritis?  Stomach problems?

Do you have odd pain or medical issues that pop up out of nowhere and come and go..... seems like it's "always something"?

Do you have bursts of energy where you go like crazy and then other periods where you are so fatigued that you can barely get out of bed?

Headaches?  Jaw pain?

Let me know.  Just yes/no, don't give a lot of personal details on the site, it's never a good idea.

[hankstar]

Good questions , I have ankylosing spondylitis,along with chronic fatigue syndrome and fibromyalgia syndrome  secondary to the disease, PVCs and tachycardia are a complaint with certain connective diseases. Also this problem can cause depression and mood swings. Any chronic illness can.

Very good questions.

[SouthJ]

I can't remember where I read it but there is documented research that those people with PVCs who took the beta blocker drugs suffered a higher degree of mortality than those who simply tolerated the PVCs and took no medicine. With all the problems caused by modern medication, I tend to shy away from medication that plays with the mind, heart, or stomach. This is one of the reasons I got the hell off PPIs (aciphex, prevacid, nexium) and began treating my acid reflux naturally with licorice root and better eating, weight loss, etc. Now I save $120 a month in prescription spending and have less trouble with my stomach than when I was taking those medications. It was also announced last month that medications for GERD increase your chances of getting serious illnesses like pnemonia (pneumonia) because they decrease the stomach acid which kills the bacteria. We already know about Vioxx and what it has done.

I feel natural is the way to go in most circumstances. Healthy eating, exercise, and lots of rest are the best way to treat PVCs as long as you have a healthy heart. It's always best to be screened just in case, however. If you have PVCs and haven't been looked at by a cardiologist, you need to get to the doctor to rule out other problems.

[caramich]

Hank/Freedancer:

Good questions because Freedancer jumped out at me like a neon sign.  Obviously you too..........  

I also have FM & CFS. Multiple health issues. Have been through the mill with the medical profession.  

I wonder how many people are taking medications or VITAMINS/SUPPLEMENTS that are causing PVC's?  I don't see that mentioned much but it definitely should be.  That's really one of the FIRST places I'd start quite honestly.  

Stress......someone said stress on another post and stress definitely aggravates mine but mine is pretty much 24/7 and that's not stress related. I'm high maintenance but even at my most relaxed I have the PVC's now.  I've been stressed and this is nothing.

I wonder for some of us if it's physical stress.  I do find it worrysome that some posters are blowing off all people who ask about PVC's because definitely it could be masking or signaling an underlying condition and anyone who has a medical symptom that is scaring or worrying them should get it checked out.  

Now there are the ones who are tested up and down and then still worry, post and panic.........  that's a different story.  Check it out, CYA, then if docs tell you it's ok, let it go!

[freedancer]

I appreciate your interest.  I am 49, will be 50 in March.  I get between 5 and 6 hours of sleep a night.  I have severe headaches, diagnoised as migraines, probably caused most likely by the sever blow to my head two years ago April by an attack from a mental health patient.  I do have other aches and pains, hip pain, lower back and tail bone.  Neck, shoulder pain as well.  Most of the time, I can get out of bed fine but I am often tired, sometimes due to fatigue caused by a migraine the day before as they really take thier toll on my health.  Only complaints I have had to the doc have been the heart PVC's, migraines and hip pain.  I am in therapy for the hip at this time, possible bursitis but may need a shot.  I do fall a lot.  Just be walking along and down I go, someone saw me fall a few days ago and said my ankle twists in, not sure if it is a complication from the head injury.  I do take vitamins E, fish oil, and a liquid vitamin that has a lot of different things in it.  I also take some prescription meds.  That is all I can give you so far.  Thanks,  freedancer.

[chaswriter]

I'm so glad I found this forum. I hate that anyone has PVCs, but at least we aren't alone.

I was diagnosed with PVCs about 8 months ago in the ER. The doctors and nurses assured me that's what was happening and there was nothing to worry about. What brought me to the ER was the frequency of the PVCs. I was having about 6-8 per minute and that really scared me. After I was told not to worry, I went on with my life, still having the PVCs on a daily basis, mostly when in a resting position, and especially if I lay on my left side or back.

Three days ago I was back in the ER. The PVCs were coming on strong and I was feeling light-headed and slightly disoriented. (I'm not sure if that was because of the PVCs or just general panic because I feared I was dying.) They hooked me up to the heart monitor, said it all looked fine. I wasn't happy with that so the doctor set me up to wear a holter monitor, which I did, for 24 hours.

Today I got the results. They said I was having "ventricular ectopy." Now that sounded scary, so when I got home I started to research it and, if I'm not mistaken, this is just another way to say PVC. When speaking with the nurse on the phone, she said I should see a doctor about the problem, but she in no way indicated a sense of high urgency.

I am going to check on this further, of course, but I would love to read some opinions from those of you who know a lot about this subject.

Thank you, and best of luck to everyone suffering from this.
Jeff

[hankstar]

Usually once one starts to have frequent PVCs, they usually start between the ages of 20-40, then tend to occur in this pattern, they wax and wane , go away for months or even years, each time seeming to return with a greater vengence and longer duration, at least this is the way that my PVC started, even though I remember having the occasional one all my life, my first prolonged episode was in 1992 at age 27, I just turn 40, 3 weeks ago.  I haven't had any prolonged episodes in about 3 years.

Ventricular ectopic beats and PVC are one and the seem. They are usually referred to as ventricular ectopics.

Be assured you are not alone in this problem with PVCs and the anxiety that manifest itself due to feeling them.

  Hope you feel better soon.

[Barbarella]

I know your concern.  I had the PVC's from hell, and I mean that literally.  First let me tell you I've been having them for over 40 yrs off and on and I'm still alive. But in my late 40's I went through a VERY stressful time period in my life, and I had PVC's day and night, it was so bad that they came every other beat for a very long time, and real bad after a meal.  I had all kind of tests done, everything, including heart ALL came out o.k. I was put on beta blockers for the PVC's they helped some, but made me very sluggish at work and completely washed out at home, I had no energy at all. The cardiologist took me off the meds, and told me this:  "There is nothing wrong with your heart or anything else in your body (he had the report from my Internist).  The more you worry about your PVC's the more they will come and the longer they will stay.  Try to get enough rest, less stress, watch your caffeine and alcohol intake".  No need for follow up he told me, and it was up to me now to get this under control (he did not say that about being up to me) but I knew it was.

Then I read an article in a magazine either written by a doctor or somebody in the medical field I don't remember.  The article said that you can get sudden death if you have PVC's during exercise.  Well, I walk real fast every day for 3 miles, and sometimes I have PVC's while walking.  Again, I went back to the cardiologist unfortunately WITHOUT the article, but I told him what I read, and he said "do you believe everything you read in magazines"?  Kind of ticked off that I even brought that up.  He said some people have PVC's during exercise, after exercise, during a meal, after a meal, during sex, after sex, and the list goes on".

This is what confuses me:  These medical articles which are written mostly by doctors why don't the doctors we see acknowledge what it says, or why have they not heard of it?  This is very confusing.  The doctor I believe he was a doctor in the article said that PVC's during exercise can be life threatening and my cardiologist kind of rolled his eyes, and gave me a lesson when and how PVC's can occur and that there is nothing to worry about.

Bottom line for me, I still get them but a lot less since I stopped worrying about them.  I do admit though that when they get pretty frequent at times during my exercise I slow down or go home which my cardiologist said NOT to do, but this is easier said than done.  Even knowing that these PVC's are harmless when they occur while exercising this is still frightening to me.

[caramich]

Sorry for the disappear.......caught the flu.

Freedancer - get evaluated for Fibromyalgia.  Your symptoms sound TERRIBLY familiar.  You're female?  Male doesn't rule out FM but female gives you a much higher chance. So does type "A" personality. So does a high stress lifestyle or prior injury, history of chronic health issues, history of abuse/child abuse(you being the child).

Primary symptoms that make me send someone to a doc for FM evaluation are :  Sleep problems, chronic pain issues including back pain, headaches/migraines,  pain that comes & goes.  Things like yeast infections, irritable bowel are also a concern. TMJ is a biggie. Chronic fatigue is another dead giveaway.

There is a site that lists the best FM docs in the country, referred by patients.  Am I allowed to post it?  Not a site that is advertising, it's strictly a doctor referral.  Or you can try to get in touch w/me if I am allowed to post my info.(will try to add it to my profile......) .   This is a 'throwaway' email addy anyway.

[caramich]

Ps. just in case anyone is worried that this is going 'off topic', the PVC's and heart problems can definitely be linked in to Fibro.  Many of these symptoms and illnesses go hand in hand and it's important for us not to overlook one illness in favor of another!   ;0)

[freedancer]

Thanks for the update carmich(sp).  I too have been fighting mr flu and I was given the shot!  I have never been evaluated for FM but I will as my VA doctor as soon as I can see him.  I have a lot of those things going on with me.  PVC's have let up some.  I noticed that they come on strong when I eat anything with sugar or honey in it.  Does anyone else have these when they eat meals and what sort of foods cause you to have them?

[whoozit]

I find the diagnose of PVCs to not be completely reassuring, and here's why.  The heart is supposed to beat normally.  It is designed to beat normally.  If the engine of the car is not running normally, it seems to me that sooner or later it would have problems.  It just seems like common sense to me.  Then again, I am not a doctor and am a little freaked out about the PVCs that started a couple months ago.  I, too, experience them during sex, during exercise, during rest, standing suddenly, after eating, etc ad infinitum.  sometimes I have runs of a dozen in a row.  But the docs say "no problem".

Then I go and read this article from the New England Journal of Medicine.

http://preventdisease.com/news/articles/rethinking_treadmill_test.shtml

And once again, I wonder.  Does anyone REALLY know what is going on?  I guess what it comes down to is not living in fear... realizing that our lives are not really in our own hands, and that when it is our time, it's our time.

As for me, I have an appointment with a cardio in a few weeks.  I am going to grab him by the ears and say "LISTEN TO ME!" and make sure he understands exactly what I am experiencing and feeling.  PVCs are pain in the behind.