Good

[NurseKagome]

Hello,
I am a 23 year old woman who has been having PVC's since I was 16 years old. I was only lucky enough to have them recorded and diagnosed as of last August 2005. I have had a echo, holter monitor, 2 stress tests, blood work and ekg, all results normal except for PVC's. I have elevated cholesterol since it is heridatary on my fathers side but it is just above borderline right now, I am thin and eat very healthy. I have had 4 spurts of unrecorded events that felt like PVC's and tachycardia together (hr at 180+ during the events). This has me concerned. Also I have lately found a coorelation of PVC's with exercise, though I can get them at any time during the day, it just seems to happen with exercise lately. I also tend to have chest pain that can be a sharp pain right in the apex area of the left side of my chest or hard in the centre and feels like it spreads to the right and left sides of my chest. I also get intense upper back pain. My questions are:
1.)should it be a concern to me about the pvc's on exercise so much lately? could a pvc at that rate stop my heart or somthing worse?
2.)What do you think of my chest pain? It can be pretty intense and last 5-10 mins other times it's only for a second.
3.)during the very fast hr spurts (not diagnosed) where it feels like my heart is just going crazy and it feels like pvc's at the same time, is this symptoms typical of those who end up with v-fib?What is happening if it is just "normal"?
4.)I have seen a cardiologist and I am wondering is it nessacary or important that I see an electrophysiologist?

Thank You!!:)

[CCF-M.D.-BJ]

Nurse,


1.)should it be a concern to me about the pvc's on exercise so much lately? could a pvc at that rate stop my heart or somthing worse?

No. I dont want to be too succint or dismissive, bur you have a normal cardiac evaluation and palpitations. You should continue to live a healthy active lifestyle.

2.)What do you think of my chest pain? It can be pretty intense and last 5-10 mins other times it's only for a second.

I would have to believe it is due to a noncardiac source. The quality, timing as well as your risk profile would make the likelyhood of a cardiac source low. Occult asthma, muscle pain, or GERD can sometimes also cause chest pain.

3.)during the very fast hr spurts (not diagnosed) where it feels like my heart is just going crazy and it feels like pvc's at the same time, is this symptoms typical of those who end up with v-fib?What is happening if it is just "normal"?

People that end up with vfib drop dead as their symptom. If anything rhythm related, it sounds more 'SVTish'. An event monitor would help discern the rhythm.

4.)I have seen a cardiologist and I am wondering is it nessacary or important that I see an electrophysiologist?

A good cardiologist should be able to handle your case just fine.  

good luck

[em1981]

As for your short spurts of tach, I'm not a doc and you should definitely get it diagnosed, but I've had runs of PVC's caught on a holter at a rate of 180 - it's just considered nsvt (non-sustained ventricular tach) - and as long as your heart is healthy with a normal echo, there's not really any chance of that turning into sustained vtach which might cause vfib.

I get PVC's, PAC's, psvt, and nsvt and the docs haven't yet thought that there's anything they need to do for me, even when I was getting them during exercise. I'm 25 years old. I've also had episodes of chest pain that can go on and off for months that were only ever diagnosed as chest wall pain.

Long story short I wouldn't worry too much if you have a normal echo, but you'll probably want to keep trying with holters and event monitors to try to get the rhythm diagnosed if it hasn't been caught yet.

Hope the upcoming doc's response will help you!

[NurseKagome]

Hey there!

Your 25? Awe, so nice to hear from a fellow pvc suffer who is my age...do you ever get frustrated and think "I would like to be like everyone else my age, no worries about health, exercise without probs and go into the middle of nowhere and be panic free"? I do.

So you have pvc's during exercise too? I don't know alot of ppl who do. How do you feel, heart feeling and physical feeling, when they happen at 150+ beats per min? I know that I like jump off the treadmill and walk around for like 15 mins or longer when it goes back to normal. It really angers me though, since it happens usually 15-20 mins into the exercise cutting my exercise short. I just feel so anxious when it happens during exercise. It really bothers me when I swim.

The four times the "heart attack" as I call it (pvc's and sudden onset of 150+ hr) I was awake, working or at home. It scared the s**t outta me good. I was alone at home too when it happened the very first time...thought I was a gonner!! :(

I had normal results from blood work, echo, ekg, holter (48hrs) numerous times, stress test and x-rays. What exams have you had done? My heart is perfectly healthy as of my last checkup May '05. I just did another 24hr holter where I caught the pvc's during exercise on it too!! scary! I tried to stur them to see if it would happen, and it did, more than I had barganed for actually that whole night after.

Wow, this was long, sorry! Hope to hear from ya soon!

Nurse Kagome

[NurseKagome]

In regards to the "symptom of v-fib" I meant what happens before the attack...I know what happens after. Thank-you for your answer and time.

The Nurse

[NurseKagome]

Isn't svt the precursor to vfib?? I think I read about three types or two maybe? It's not a good thing anyway and I thought I read something once that said ppl who get svt shouldn't exercise intensly cause it can trigger sustained vtach and lead to vfib. Both pretty serious. Oh, boy...arg. This cycle of stuff to think of never ends...when will I get to relax about all this stuff?? boo.

Nurse Kagome

[Angie O Plasty]

I'm pretty sure it's v-tach, not SVT, that can be a precursor to v-fib.

[NurseKagome]

Well, that is comforting...NOT.

[NurseKagome]

vtach has a couple different forms...I am assuming I had NSVT since I could feel my pulse, and besides for great fear, no symptoms at the time. no passing out and such.

angio o plasty do you mean svt as in sustained ventri tach or sinus ventri tach?

[dmil241]

It is my understanding that SVT means supraventricular tachycardia meaning "above the ventricles" originating either in the atria or the AV Node. NSVT is non-sustained ventricular tachycardia meaning 3 or more PVC's IN A ROW for under 30 seconds. In a structurally normal heart, it is still benign. GOOD NEWS!!

[NurseKagome]

yup, my doctor thinks thats what i have too. svt. she said it's ok and not to worry about it and that i am perfectly healthy. thank you for explaining it to me:)

nurse kagome

[Bromley]

Hi.  My understanding:

-NSVT is non-sustained ventricular tachicardia.  It is not necessarily benign, and can warrant some "due care". You may want to see an EP, an interventionalist, or a general cardiologist if you have nsvt.

- I dont think I have heard of any criteria for determining whether a heart is structurally normal.  I should think it would have to involve an echo, and an angio, as a minimum, especially if you have NSVT. Talk to your doc.

- From what I read, either svt or vt can be associated with sudden death, but the correlation between svt and sudden death in the population as a whole is lower.

- There are some types of svt that are quite dangerous. For instance afib associated with foward conducting accessory pathway, a condition that can be fairly common in people with WPW.

- I can feel my pulse very well when I have svt.  I can also feel my pulse very well when I have nsvt. My experience says that the strength of your pulse, and how the tachycardia feels, totally depends on your condition.

Sorry for all of this --- i know its a difficult subject; I just saw your post and wanted to help.

[Bromley]

Oopps. I just realized what I said above is totally over blown in regards to the original discussion topic. I am not a doctor, and what the doctor said up top there looks about right, even to me. It would be good to get those strings recorded though.

[NurseKagome]

I have seen a cardiologist and my gp and both said to not try and over analyse my case, I am healthy, my heart is ok and my percentage chance of going into v-fib (in their expert opinion) is nil. So with that preached to me today for 45 mins, Yes almost for an hour straight I asked all kinds of questions and got informative answers...some medical advice contradicting things I have read and others like things I have read or talked to others about, I believe them the doctors. They are the experts, not us, we need to start trusting them which I am starting today. When palps are viewed by a person who is not under stress TRUE symptoms related to the palps will be found not the ones we CREATE with our minds (at times, probably most times:). I am choosing today to stop torturing myself and to live my life like others I have been envying out of my fear of heart probs. everyone only lives once and we could all get hit by a car tomorrow, hit by lightening, get diagnosed with terminal cancer, choke, or spontaneiously combust but you know what? I'm not waiting for death anymore, because thats what I felt like I was doing. I am going to live. I wish you all the same!! Thanks so much for your kind help and support, I know you all try your best to comfort eachother. Keep posting, keep reading :)

Take care all!
Nurse Kagome

[woodruff]

Congratulations to you, NurseKagome!  I agree:  At a certain point--having had our tests done, and realizing that we can go about our normal lives in spite of our funky beats--we have to believe that the docs who give us our stress tests and read our lab work, our echos, and our EKGs actually have been to med school and are generally trained to recognize dangerous conditions when they see them.

Most of us have not even taken anatomy and physiology classes (though most of us could, since they're taught at junior colleges), and it is not sensible to keep challenging a benign diagnosis without the education to back up the challenge--particularly when our symptoms just do not indicate physical illness.  Being uncomfortable with strange sensations, or being frightened (even panicked) is quite different from simply being unable to do physical work.  A worried patient should ask him/herself:  "Can I do the things I usually do?"  If so, there is almost certainly no grave illness involved.

I'm speaking generally here, of course.  I don't mean that patients should not question their diagnoses.  Of course they should ask questions!  But as to being misdiagnosed:  Occasionally, dangerous symptoms are missed or misunderstood by doctors, but I have seen this only a couple of times in my life.

[Bromley]

Hi. I just want to make it clear that my lengthy comment above was meant as a general explanation, perhaps to dispell a misconception. It really doesn't apply to the original post that well.

Dr BJ did suggest though that an event monitor would help to identify the arrhythmia (i.e. the bursts that are not recorded yet) referred to in the original post.  If you successfully follow doctor's orders for something like that, I have found that it's much much better to let EP's analyze the test results. You are most certainly correct --- an individual needs to have a very good education for that.

best of luck and kind regards,

Bromley

[NurseKagome]

thanks, i know you were only tring to figure it out, as we all do haha! believe me i have come to some frightening conclusions about my own health in the past that were totally unsupported by my medical tests. there just comes a point when we have to trust their years of medical knowledge to our (most times unsupported) opinions or crazy diagnosis. i know i have done it. but i'm choosing to stop looking for and chasing a "problem". i am healthy, i'm ok, theres probably a better chance of me gettin hit by lightening then scd and that goes for just about everyone on this site (probably) minus a few more serious cases where structural heart disease and such are involved. don't feel concerned about your tring to figure it out, it only shows you tried to help :)

thanks!

Nurse Kagome