My heart has been skipping for about 4 years now. I am 33 yr male in good health. Two years ago I had a 24 hour holter, echo, elecrto cardio, thyroid test and chest xray. According to my doc. no problems present. I was however diag. with GAD and was given Zanax for about two months. Took myself off with docs approval and started natural therapy for GAD. I seem to get heart skips (beats normal, pause, big beat, normal again) when under stress or just whenever. It usually catches me off guard and is very upsetting. To the point where I become anxious and or very depressed. I have been researching the possibility of a gastro connection though not convinced. I do suffer from occasional reflux usually from wrong foods. I am 6'2 and 235 lbs. Heart pulse resting 72 and BP is 130/82 I thought a lower weight may help. I have also begun exercising more vigorously, seems to eleviate the symptoms for short periods of time. I live in a northern Ontario Canadian community and my family doc has moved to another city. Like most other people in this community now have to resort to a walk in clinic for med help. I find this frustrating as you nget a different doc. every time. Please write back with any suggestions.
Sorry to hear about your symptoms. Without specific information on the results of your holter monitor test I can only speculate on the problem. Premature atrial contractions (PAC), can result in a pause such as the one you describe. It is also possible for premature ventricular contractions (PVCs) to be contributing to what you are experiencing. If possible I would recommend seeing a cardiologist for another holter monitor test along with obtaining the results from your previous test. I think a specific rhythm problem should be identified first. There may be treatment available to decrease your symptoms, even if the problem itself has no long term effects.
Lastly, I would recommend regular exercise and weight loss may also help your symptoms.
One thing is certain after following these posting for years, heart skips (pac's pvc's) are common for many people, including you. I understand your frustration. I have looked for patterns, tried many diffent things, but there seems to be no way to predict or supress them. Sometimes I am sleep deprived, drinking coffee, and doing all the wrong things, but I only get 1 or 2 in a day. I then go through periods when I try to eat really healthy, get enough sleep, but I get hundreds a day for weeks on end. It is worse than predicting the weather.
I stopped my exercise program because I got tired of the several hours afterwards when they were out of control. I had all the tests a couple years ago, and I was told everything was normal. Well, something is a little off because I don't think these miss fires are how the heart is suppose to work. Do I keep going back for more tests? I don't think so. I have just decided to accept them, and if I drop dead then I guess the pvc's and pac's will no longer be a problem.
What I am saying is if you have all the tests, and nothing bad is found, then what else can you do? It also seems like the how many is too many, and when you treat them, changes from year to year and doctor to doctor. The only thing that remains unchanged is that they are a mystery and millions of people have them. Good luck.
Could anybody clear up a question I have on this same subject. Is there a difference between PVC's/PAC's and heart skips caused by anxiety? I've read previous postings by people such as Arthur that refer to Foci and a build up of heart tissue that indicate that premature beats are somewhat unavoidable. Anxiety on the other hand would be a physical reaction to adrenaline, so would I be right in assuming that this is a different mechanism?
Radioguy, I know how you feel about these skips, they can scare you. Maybe it makes you feel better if I tell you I have them as long as I can remember, and I'm a 73 year old female. Sometimes I go for days without any skips, other days I get a whole bunch of them. I was checked out by a cardiologist, had all kinds of tests, my heart is okay. Was told not to worry about them. And here I am, doing lots of walking and biking and just ignore them. Ever since I had all these tests I do not get scared anymore, feel it is just a symptom I have to put up with, like my bad back etc. I also get short episodes of a racing heartbeat, now these episodes do worry me a little, but was also told they are benign.
First, try to give a answer to Squims. The difference between PVC and PAC is that, although both are permature contractions not originated by the sinus mode (were the electric impulse for the contractions should be normaly originated), PAC's have origin in the atrias and PVC has origin in the ventriloques. For what I have read, and as I also have experienced, PAC/PVC are more frequent (or we notice them more) when we are anxious, so, yes, anxiety plays a big role on it.
Now, since I'm also new in having frequent PVC, here is some question to the more experienced (unfortunately) people in this forum. Is it normal to a person that as none or very sporadical PVC a day (less than 5 PVC/day) can start one day to have about 500-600 PVC/day for a period of days or weeks. This is happening to me since 3 days ago. Had a Holter a month ago that was normal (only 2 PVC) and a stress test 2 weeks ago also normal (only 1 PVC in the begining of recovery period). Also, very detailed blood and urine analyses ok. 2 years ago had a normal echocardiogram and Dr. didn't ask for another now.
Radioguy, I am sorry to hear about your concerns. I just wanted to mention this to you because you said you have GAD. I'm sure your Dr. has covered this but you never know and any little bit of info might help. About 8 months ago I was diagnozed with Hyperthyroidism (overactive). I was getting what I though were heart palps about 4 times a day. Sometimes they were so bad I was convinced I was about to have a heart attack. I was told it was because of an increased heart rate due to my my thyroid condition. I was put on 50 mg of atenolol and for a while I felt better. After some months they had continued to the point where I was getting quite scared that I had a heart condition. I had 4 (yes 4)! EKG's an Echo and 3 different Dr.s listened to my heart and lungs. All tests came back normal. My problems continued and my family Dr. sent me to an internal medicine specialist who did a Gastroscopy as he discovered that a lot of my complaints were of a gastrointestinal nature rather than a heart one. The test came back showing that I had H-Pylori bacteria in my stomach and that was what was causing all of my problems. The increased acid in my stomach was causing heartburn and reflux and what I thought were heart palps turned out to be esopheogal spasms.
I just wanted to let you know as I know how scary this can feel. I was told the spasms can feel very similar to heart palps and that is often why people are misdiagnozed. Good luck with everything.
Arythmia ia a troublesome problem, that many people have and it is reasuring to hear from others with this problem and the comments given by others as to how they deal with it. I have a very long post that I could make, explaning my own personal problem with it, including the actual stopage and restart of my heart beat, due to arythmia and just how it all started.
Just where does one post this kind of info and or ask questions related to arythmia ?
I didn't mean to imply that you should not get a second opinion. I've had several cardiologists (due to health insurance changes) and they all concur. I would always recommend a second opinion or even a third, but I wouldn't spend my life's energy looking for something to be really wrong with me.
My cardiologist explained to me that what felt like a skipped beat was actually the result of a premature beat and the pause that followed was either the chamber filling up or something along those lines--point being that there really is no absent beat but a premature beat that causes the sensation. I liked this explanation better than thinking that my heart was for some reason failing to beat!
I used to really freak about PVC's but when I had all the tests including a stress-echo and was told that things were fine (even with some trace MR and TR and even some PI), I had a choice either to accept those findings or continue through life in a state of constant agitation--no fun by itself but especially bad for someone experiencing PVC's as anxiety only exacerbates the condition.
So now when I experience a PVC (not nearly as frequently anymore which I am sure is due to decreased anxiety) I just decide to ignore them. Sometimes, if the PVC is a particularly forceful beat or if I have more than one in a row (like 3 with a few normal beats in between) I have to consciously decide to forget about it. But I do it; I make that decision. Then before you know it, I really have forgotten about it and I'm fine. In the past, I would begin to worry, sometimes for the whole day, maybe experiencing a few more and really freaking out--taking my pulse and blood pressure, etc. Just a vicious cycle.
Everynow and then I come to the board for reassurance. I admit it. It's a hard thing to completely let go of. But if you can get yourself mentally in a good place about these things, you can really effect the quality of you life.
i have been having pvcs for about 10 years and the drs all say they are no biggie. the thing i am concerned with is that the other night i was feeling the pvc flutter and i checked my pulse and noticed there was no pause. it was like instead of flub dub it sounded like flub dub dub. i have a stethescope so i listened. i never get any other symptoms and its always when im at rest or eating. anyone else ever notice this?
What is the secret to getting you questioned posted? I notice you have several questions posted. I never am able to ask a question (always full). Thank goodness you and others like you have similar concerns as myself.
Anyway, I was just curious.
I am slowly recovering from bulimia. I notice that my heart skips a beat every so often. It feels like a flutter and when I feel my pulse, I can actually feel it pause and start again. It makes me nervous. I mentioned my bulimia because I read about electolytes, and how a lack of them can result in serious heart problems. I am terrified because I did this to myself. I am wondering if I can actually fix this by taking supplements or if it will be ok as I am beginning to eat better and retaining a normal diet again? Is it too late? Please let me know.
My symptoms are very similar to yours. I also get the heart skip where I feel a pause and then an big beat and then normal again. I also have been under quite a bit of stress. I had terrible problem with heartburn and my doctor prescribed nexium. It has really worked great.
I had all of the various tests performed. My holter monitor showed 911 extra atrial beats within a 24-hour period. I also went to a cardiologist at a top hospital in Chicago and he told me that there is nothing I can do except take a beta blocker (Toprol). I have decided not to take it because, it only affects the symptom and not the cause.
Doctor said that in extreme cases, they could locate the renegade cells that are causing the extra beats and stop them from doing so. I told him that I would rather live with this than go through such a procedure that has many side effects and risks.
The one thing that I want to add to this discussion is that while I have felt this condition most of my life to a very minimal extent, my problems started last year when I had one of the most stressful days of my life. From that day on, the fluttering has not stopped. While I have periods where it does not happen for week or two at a time, I experience it almost every day.
Do other people have the same experience? It seems like doctors discount the anxiety part of the equation.
Also, I notice that if I do not eat right, the condition is more prevalent..e.g. if I skip lunch. Also, caffeine makes the condition worse so I have stopped drinking coffee.
Finally, the condition is worse at night -- especially when I go to bed.
Four years ago I had a particularly bad bout of PAC/PVCs and went to my Cardiologist. After the usual tests he informed me that they were nothing to worry about. My home and company doctors said the same. Becoming less anxious the frequency decreased. I still got them but just ignored them. Recently I have experienced a significant increase and started to become anxious again. I'm quite sure that indeed anxiety is a contributing factor to increases in frequency. However, I have also discovered something else and I'm interested to know if anyone else has made the same connection. Spending a great deal of time in front of a PC both at work and at home I believe that I have developed a kind of RSI (Repetitive Strain Injury) which affects my upper torso front and back. I have noticed that my body posture, especially when seated, can significantly increase the number of PAC/PVCs I get. This is also noticeable when seated at meal times or when driving the car (i.e. shoulders haunched, arms stretched out). Has anyone else experienced the same?
This site has saved my sanity!! I am a 49 year old Australian woman. I first started noticing extreme thumping in my heart when I was planning my daughter's 21st, about 6 months ago. In the past, I had had occasionally moments of palpitations, but nothing more than a few minutes here and there when I was under stress. However, like mxg3 said, the internal tapdance started at that point and has never let up since, not for a day. I have done all the stuff you folk have done - been to the doctor, had a stress test, worn a holter monitor which did pick up the ectopic beats. And, like all your doctors, mine said that I was healthy and that there was nothing to worry about. Easy to say. As well as the fandango rhythm, I also get a sort of fluttering sensation in my throat. I am not so much worried about heart attacks as just being irritated by the sensation. Sometimes I even get to thumping my chest area just to see if I can make it stop for a while. I find it particularly evident when I'm driving.
Yes, I am a perfcetionistic person and I do get anxious - but no more than at other times in my life. And I have long periods when everything is fine and I'm not anxious, but the thumping continues. I too went on a course of Beta-blockers, which minimised it somewhat, but I could still feel them. I didn't like the tiredness that went with it. I am fit and not overweight and I do not smoke, drink very little and have only moderate caffein intake. I also do not eat meat - only fish, dairy produce & vegetables.
I am particularly interested in the comment made by someone (sorry, can't remember who) that it may be connected to gastrointestinal problems. I sometimes suspect that my stomach is not too comfortable. I'll follow up on that. Thanks so much for just showing me that I'm not alone. It drives me crazy at times.
In some positions working in the computer I also trend to have more PVC's. As well, when I have more PVC's I also trend to feel a gas sensation, over my upper gastrointestinal parts, coming up. I don't know if it's the nervous that PVC origin or there is a gastro reflux that induct the PVC. I suspect of the both and this leeds to the subject anxxiety. I also feel much more PVC when I'm anxious.
I truly believe that the battle over PVC's has to be won in your mind. I first starting getting them last April after a particularly stessful period in my life. I didn't go see a Dr. for three weeks, instead I laid in bed night after night counting skipped beats and sleeping less and less. The GP only did an EKG, then prescribed beta-blockers, which did not help a bit and make me even more exhausted. Another four weeks went by (no sleep)and I saw a specialist. I found out everything was normal an then ended up going off beta-blockers and on anti-depressants and sleep aids. I had worried myself sick!
After researching PVC's and trying every remedy in the book, I finally conceded that I was powerless over them and I better accept them. Being a chronic worrier it took some work, but I am finally to the point where they are insignificant to me. I can even fall asleep easily, even when I am experiencing them. I weaned myself off of all prescribed drugs also. Mind over matter. If you don't mind, they won't matter. Good luck everyone!
I'm new to this forum I recently been having a irregular heartbeat. I have seen my doc he gave me a EKG said everything looks normal had a holter monitor test done now he says
I need to see a cardiologest but everything if fine no need to worry. Well I'm SCARED OUT OF MY MIND I'm 25 no family history
of heart problems. I have been to the ER already thinking I'm having a heart attack. They said I had a panic attack and gave me
some Zanax. that kinda took the edge of the worry. this forum and website has really helped to get my mind off this problem
my mom is a nurse and my wife is almost done with nursing school they keep telling me to relax but I just can't.
I have been trying to post a ? for the docs but it always
says its full.
could this be just REAL bad anxiety????
Speaking about PVC, I found, in the link after referred, a medical text about them, which also include some history about their investigation and medical theories, regarding to it's serious or treatment, in the past and present. I think its interesting. The Web page is http://heartdisease.about.com/library/weekly/aa011501a.htm
Hi Duck_Rider. As you will have noticed in this and other forums this so-called irregular heart beat is very common. You should, however, undergo all the tests just to be sure that there is no other underlying problem. If the docs say all is OK then believe them. Yes I know, easy to say! The problem with PACs/PVCs is that they do tend to get worse if you think and worry about them. Just get on with your life and ignore them, they will eventually fade into the background. You might feel the odd one from time to time but just let it go. I just went through a bad phase which lasted about 10 days. Then suddenly they went just as quickly as they had come. That is to say that I still get them but just the odd one here and there which doesn't bother me. One thing is for sure, as already said by many, even though they are of no threat (unless you get literally many thousands a day) they are a nuisance. It's a great pity that there isn't more research being done into this problem.
I need help. I am a 29 y/o female with anxiety..no other health problems. I am on my ninth day of heart flutters occuring singly and with no other side effects. All I feel is a hollow vibration in my chest, a butterfly feeling in my chest. The only time I don't feel them is when I'm asleep and in between the irregular beats. I feel my pulse when it happens, and it pauses then has a strong beat, a accelerated rate momentarily and then slows down again. Seen by IM Doc. Holter monitor showed lots of artifact so not real accurate, Echo normal, cut out caffeine and nutrisweet 5 days ago. (the doc blows off the nutrisweet theory although its the only new thing I'm doing..caffeine intake has stayed the same for many, many years.) I put myself on the heart monitor at work and shows early beats occuring singly. I am having so much trouble getting answers and someone to care as much as I do. I am suffering so much. Even when I feel calm, I'm still feeling them continuously. He wants me to see a cardiologist. I am worried something is wrong with the electroconductivity of my heart since it is structurally normal. I can't think of anything else. How come stress never caused them before? I have always been a worry wort type. Can anyone help? Please? thank you .
I suffer from anxiety and when I have an uncontrollable bout of pvc's I can usually bring them to a halt with a single Xanax pill, I only do this when I am totally overwhelmed by them as I try not to become too dependant on Xanax. I'm very sensitive to stress and although I have lived with stress throughout my life the pvc's only started at age 38. The best advice is to avoid anything that will stimulate the heart such as caffeine, and nutrasweet has been known to cause a rapid heartbeat, simple carbohydrates (sugar, white bread, pasta) in sensitve individuals can cause anxiety and rapid heartbeat, and exercise that boosts adrenaline such as weightlifting. Try not to focus on the skips as this will increase anxiety, and do some form of exercise that is not too strenuous such as walking.
You have it a similar point of me. In fact, I'm 37, going to 38, and the PVC are starting now - It's a similar age when your problem started. Is this a problem also linked to middle age ? - My life now is not with more stress than before, although, because some tachycardia episodes, I started to be much more concerned about my heart rhythm.
I have PAC's and PVC's (but more of the 'stop thump' ones) I call them the "skippies." I notice that I have them more if I wear tight clothes (which is much more often now if you know what I mean) or have really bad heatburn and "backup" with lots of belching. I have had numerous test....holter...echo and stress echo..blood and pee test. Everything showed normal. I must admit they bother me now more than ever due to the fact my 38 year old brother died last april of sudden cardiac death due to family history of atherosclerosis(sp?) I have been told since I am a woman I have avoiding that gene and it runs in the men in my family. My older brother who is 45 now went for test right after the funeral and ended up with two stents and test showed he had a previous heart attack. Thing is....neither of them ever complained about "skippes". Any insights welcome as I am in the same boat with most of you that can't get a message posted for the docs.
I recently experienced 7 skipped heartbeats in one minute when I donated blood at the Red Cross. (If you have 10 or more they won't accept your donation). RC nurse advised mentioning this to my family doctor on my next visit. This was the first time I donated blood. I'm a 74 year old male, a daily exerciser, a competitive racewalker and a marathoner. Are skipped heartbeats likely to end my aggressive physical activity? My next doctor appointment is late next week. (I'm trying not to worry).
I too would like to find out what effect exercise has on PVC's. I have always heard and read that exercise will help to minimize heartbeat irregularities but in my own case it seems just the opposite. As my heartbeat increases so do the PVC's. Funny thing is that it didn't do that on my stress test a couple months ago. Can things change that fast or is it just a phase I'm going through? Has any one else "worked through" the increased PVC's to where they got better as the result of an exercise program?
Clarification: my problem concerns IRREGULAR heart beats, not SKIPPED ones. (My normal resting pulse is 57). The problem disappeared shortly after my visit to the Red Cross where I was quite anxious about giving blood. To my knowledge, this has never happened while exercising, even when I'm racing under full power. I've had EMS people at a couple of races check my blood pressure right after I crossed the finish line. Nothing irregular was noted. I'll share my doctor's opinion for the benefit of anybody else who is concerned about robust exercise and heart health.
I too was told that exercise would decrease the pvc's but instead increased them. I have noticed that if I use the treadmill I will feel very few if any pvc's, but if I use the cross-trainer machine which utilizes arm movement the pvc's are even worse, and lifting weights causes a serious amount of pvc's. My doctor told me that the reason for this is the increased amount of blood adrenaline with certain exercise. Try different exercise and see if it makes a difference, and please report this back to this forum so that it will help me as well as others to better understand this problem.
I am planning to start out walking for my exercise. I have a treadmill at home but find that it's too easy to focus on the heart. The more I think about how my heart is doing the better the nerve pathways from my heart to the worry center of my brain work. I have noticed that the less I think about it the harder it is to feel any beat irregularities. I know they're still going on but they're harder to detect.
I also think walking or biking in nature will give me something positive to think about outside my body instead of always looking inward. I will start this new program as soon as I'm over the flu and report back my progress.
I have found that a hard cough will usually settle my fluttering and heart skips for quite a long period - long enough for me to forget about them anyway. I've noticed this particularly while I am resting or am driving in the car. It gets to the point where it's driving me mad, I take a deep breath and do a couple of very hard coughs - and they disappear. Sometimes my heart feels a bit "wobbly" for a few seconds (I don't know how else to describe it, a bit like it's trying to get its breath) - but then it all just settles down. Can anyone explain why this should be? It's like the sharp movement of my lungs jolts my heart muscle out of its irregularity.
Wow! There are a lot of us! I recently had a cathetar ablation done last week. Unfortunately, since it was thought to be uni-focal, the EP said that this would most likey work. It ended up being multi-focal.
I am very discouraged. I do NOT tolerate the meds. And now I'm on them again.
Two days after the procedure, my husband took me to the ER. Now I have pac's! About 3,000 per minute. The meds give me about 3-4 hours of relief per day, but the rest of the time I'm feeling these. Will go back to EP doc tomorrow for yet another holter to see if they are still pac's or pvc's.
I have been experiencing this problem for a few years now. I had EKG's and holter monitor. I was told my condition was PVC's. I had something like 1000 extra beats in one day. I was given 25Mg of Atenolol. It seemed to help for awhile, but now it's back. My only question is this: Does anyone else feel like their breath is taken away (briefly) during the bout of "skippies"? I am going to talk to the doc about giving up the atenolol as it doesn't appear to do any good! I just hate the feeling that my breath is taken away.... Does anyone else experience this?
The breathless thing seems to be very common. I have it myself at times and have read it many times here on the forum. The two explanations I've heard are:
1- Valves in the heart opened at the right time for the mis-timed beat to force blood back into the lungs.
2- The "second fear" or adrenalin generated by your body in response to the fear of the mis-timed beat.
In either case it seems to be of no interest to doctors. I have been told by a cardiologist that it doesn't mean anything and not to worry about it. He was not interested enough to even ask questions about the feelings I felt.
How is the excercise-program that you planned developing?
You must be over the flu now ;-), so tell me, do you go walking and biking now in nature?
Does it do you good?
I'm thinking of the same strategy.
I have a home-trainer, but outside, you are right, it's different; much more distraction; but scary too, you know: WHAT IF.....
How are you doing, and what did you do about food and supplements? Did you change, left out or add some things.
Bey, greetings from Holland.
- ***Ianna*** -
Yes, I am over the flu. It only lasted about a week or so. I have started exercising again and it makes a big difference being outside. When I was using the treadmill all I could think about was my chest and what might be going on inside. When I'm outside my brain is occupied with all that is around me. I have not increased my workouts up to where I would like them yet. It's more from a lack of time than anything else. I need to make the time since Spring has begun to arrive where I live (Southern California).
I have also noticed that my heart is not bothering me nearly as much as it used to. I can still tell that there are PVC's happening but not as often. They are also harder to feel. The less I think about them the fewer I have, (or at least the less I can feel them). I think that the nerve pathways that connect my heart to the worry center of my brain are getting out of practice.
The other thing I am doing to improve my health is the pulse test for allergies. It makes a very big difference with my heart when I work to avoid the foods that make it speed up. I have been putting off getting serious with the self testing but now I realize just what the benifits will be and I'm setting aside the time this week. The book didn't take much time to read. I have already read it for the second time including underlining the important parts. I will let you know the results.
Thanks for the answer back.
I'm glad you feel so well now.
I too have periods of time in which I feel a lot better.
Just this week was a lesser good time.
Don't know why.... maybe the full moon.... heavy solar flares....after all we are children of the cosmos----oh well...
Will you let me know the title of the book you are talking about? I think you are right about food related palps. I allready noticed that many times.
Then I have to find out if the book is ever translated into the Dutch language and is sold here somewhere; or else I have to order it at Amazon and read it in English (which is harder for me; picture me sitting here with my two dictionary's: Dutch-English and English-Dutch writing to you...haha...)
Stay well Steve, bey ***Ianna***
The name of the book is "The Pulse Test" by Arthur F. Coca, MD
Ik vond niet het boek dat in het Nederlands wordt geschreven. Het boek zou moeilijk kunnen zijn te lezen. Het boek gebruikt medische woorden en vijftig jaar geleden geschreven. Ik denk u met goede gezondheid zal worden beloond als u het boek kunt
(I did not find the book written in Dutch. The book could be difficult to read. The book uses medical words and was written fifty years ago. I think you will be rewarded with good health if you are able to read the book.)
As you can see, language can be a problem for all of us. Good luck.
This has been so helpful. I recently had a stress test and cardiac catheterization. Stress test showed PVC's, catheterization "looked good", no blockages. But at end of test I had " vaso vegal?" response. Pretty scary. Any comments on that? I am encouraged to hear that some people feel better with mild exercise. I love to walk and have stopped because of shortness of breath and extra beats. This discussion is helping me think through the questions I want to ask and possible solutions.
Thanks to everyone who shares.
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.