33 year old female, non smoker, good BP. Started with PVCs about 2 years ago. Had an echo and 30 day event monitor showed PVCs and after taking a diet pill, a short run of NSVT (6 beats). Echo came back "within normal limits." Recently I decided to go back for a 2nd opinion to another EP for peace of mind. He is very kind and willing to take the time to explain things to me and told me how very common PVCs are. I did though express my on going concern and he offered to do tests that would make me feel better. I asked if we could do a cardiac MRI and he said we could be he did not think it was necessary. He also has offered to do an additional Holter, this time for 48 hours just to get an idea of the number of PVCs I am having on any given day (the average I feel on bad days are approx 200 +/-).
My question is, do you think a Cardiac MRI is something I should look into getting at this point? It is rather expensive and he is willing to do it simply for my peace of mind but I do not want to open any more doors then are necessary. The PVCs started out of the blue and have increased over the past 2 years (started as only 5 or so every few days to atleast 5 everyday).
A cardiac MRI is more so for heart disease am I correct? And would the echo have shown if I had heart disease and therefore would then possibly need a MRI?
Are there any additional tests you would recommend at this point? He has offered to see me annually and do an updated a Echo every few years just to make sure there are no changes.
My biggest goal is to make sure I am not missing anything, therefore feeling confident that these truly are benign. As you are aware mentally PVCs and NSVT can be very concerning and very hard to accept. But at the same time, I do not want to do a cardiac MRI and turn up something I was better off not knowing. Catch 22 I know.
Thank you for your time and input, it is very truly appreciated.
It's hard to answer this question without seeing you, but I'll give you some thoughts. You are correct in that many people, especially young women, can have a lot of PVCs. As long as there are no known structural issues with the heart (valves, function of the heart muscle, etc), it is usually more of a nuisance than something dangerous (at least based on what the current research shows). There are some cases in which the echocardiogram does not pick up subtle structural abnormalities that an MRI can pick up. There is also a type of MRI that can be done as a stress test. This would look at whether you have any heart disease (decreased blood flow to your heart during exercise, etc).
It doesn't sound as though your cardiologist has found anything concerning on your EKG or echocardiogram that would prompt him to look into this further. Patients who have long/frequent runs of VT or who have had severe symptoms (unexplained passing out, etc) are usually the patients who get more aggressive testing. You could consider doing the Holter again first. While you have it on, make sure you record what symptoms you are having (if any) and that way he can correlate it with what's happening on the monitor. He can then see if there is anything new/concerning since your last one, given it seems the number of your PVCs has increased. Then, you can discuss the MRI.
As a side note, there has been some suggestion that exercise can actually improve PVCs in young women. May be from stress reduction. If you're not very active, you may want to try some lifestyle adjustments to see if this helps (discuss this with your cardiologist). I would also try taking caffeine, chocolate, and stimulants (especially diet pills) out of your system to see if that helps. Also, make sure you have had your thyroid levels checked. We do use some drugs to curb the number of PVCs if they are really causing you symptoms, but that would be a last resort.
Thank you for the response. So really, it is not necessary as he said its for my peace of mind... They are so mentally upsetting though. I have no other symptoms other then I feel each palp. Very unsettling and I just feel I could handle them more if I knew my heart was strong. Nothing cake back on the echo which was nice but we just never know why they start. They can be so frustrating and depressing. I have been given the all clear and was told to have a nice life lol
Magnetic Resonance Imaging (MRI) is a process through which the imaging of internal parts is done. MRI helps in visualizing the internal structure of the body in detail. Nuclear magnetic resonance is used in order to find out the nuclei atoms of the body. Basically, it uses the magnetic field and radio waves to click pictures of the internal structure of the body.
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