PVC and other Symptoms 2nd opinion

[Jon1234]

Firstly,This is a wonderful service that you offer.

I am 30yr Male. Family history significant only for MVP. My BP varies from 114/72 to 145/80 w/ stress. I first had symptoms of butterflies in my chest ~4 years ago. I stopped the caffeine and they went away completely. I then started noticing what were identified as PVC's on a 24hour holter. I think I had 8 total captured. Echo two years ago was normal (no mvp). I have been “living” with the skips, but have more recently been getting a vibration sensation (like a muscle twitch or phlem feeling) in my chest on the left side. This occurs every few days and comes and goes for several minutes to an hour. I'm not aware of other symptoms with it, just anxiety. It is definitely not a muscle twitch outside of the rib cage. I get those and they feel very different. Also it doesn't feel like the butterflies as those felt like I was on a rollercoaster when they occurred. I also have to sleep on my back as I get weird chest sensations and an elevated heart rate when I sleep on my side now. I had a 48 hour holter recently, which was normal except for some PVC's. Of course I did not feel the vibration sensation in my chest during the entire 48 hours. My doc has not recommended a followup echo as he believes it will be normal since the first one "was done so recently." He tells me the vibrations are PVC's and put me on Toprol-xl 25mg.
Questions:
1. What might these symptoms (vibrations and strange sensations when lying on my side) be? They don't sound like PVC's...
2. Could this be something serious? Like AF?
3. Repeat echo?

[CCF-M.D.-MJM]

Hi Jon,

The only way to prove they are PVCS is to see them on monitor, although you could try to correlate a skipped beat with your pulse and this sensation. I have several patients that complain of strange feelings in their chest when they lay on their side, especially their left side.  When you lay on your left side, your heart is closer to your chest wall and makes it easier to feel the beats.  If you had an echo that recently, your physician is probably right.  Even if they are PVCs, PVCs with a structurally normal heart are more of a nuisance than a medical concern (I know, easy enough for me to say, right?)

You will need a holter or event to show that it is AF.  My guess is it is not, but a monitor will answer your question.

I probably would not repeat an echo if you have one in the last several years and you don't have shortness of breath, swelling in your legs, waking up short of breath at night or other significant changes in symptoms.

I hope this helps answer some of your questions.  Good luck.

[Jon1234]

Fogot to add blood work all normal.
Thank you for your time.

[I'mallheart]

today i was taking a shower and i could start to feel my heart pounding out of my chest and got alittle "dizzy" and just shacky like something bad was happening..before the shower i did feel some "hard, clicking like pounding from my heart area..i then took my atenolol and went to take my shower about 10-15 minutes later,,,once i got out of the shower i used my at hime blood preasure machine that said 140-95 and a pulse in the 140,s// i then just tried to relax and stay calm..well about 10 minutes later pulse and blood preasure went back to "normal" i guess the atenolol "kicked" in... should i be concerned? i was about to call 911, but last time i had something like this i took the atenolol and was fine 20-30 minutes later... any feedback, suggestions..i am labeled by the doc's as tachy and pvc's with "anxiety" after the event and holter monitor and echo and ekg about 15 months ago..and was then given atenolol...is there something there missing..i have an anxiety book and know alot of it is, but could it be something worse? i had a job interview lined up and had to cancel, baecuse of this..resecheduled for tomrrow..i have no insurance and wont until March..but if i need to go to the Hospital of course would..i have also prior to this episode..been having more PVC AND palpiations..and like posted the other day a low pulse in the middle of the night..i am just sick of this happening, like just as i start to feel good again, BOOM back at it.. its frustrating my wife cause havent been able to get a good stable job and we have a nine month old boy..
ANY ADVICE FROM ALL WOULD BE APPRECITATED..
THANKS
Blessings
Dave

[Momto3]

Hi Dave,

Sorry to hear that you are not feeling all that well. Have you tried calling your doctor? Is he/she an EP?  FWIW, when I was taking Inderal for pvcs on an as-needed basis, it took about 20 minutes before I realized the effect. Maybe it's the same with you and the atenolol.

Since your last holter was 15 months ago, maybe your doctor would consider a follow-up holter or event monitor. An event monitor could capture the heart's rhythm while you are having the symptoms. You mentioned that you don't currently have medical insurance, do you think your doctor would talk to you over the phone?  That way, you could hold off on any tests until your insurance resumes.  

Maybe your doctor will be willing to talk to you over the phone and give you some suggestions on what you can do until your insurance kicks back in and you can see him/her. Explain to the nurse/secretary what you have been experiencing, and tell them that you are not currently insured.  They can help you dedide if it is something that needs attention, or if you can wait till March.  It may give you peace of mind to make the call.

Sorry about the job interview.  Good luck tomorrow!  
Congrats on the baby!!

Connie

[mrbh]

Almost sounds like a panic episode with palps. I have had a bunch of them like that. In my experience, the PVC's sometimes trigger some sinus tach which generally fades along with the panic.

I agree about the onset time for beta blockers. My Inderal takes roughly 15-20 minutes to kick in. That can be the longest 15 minutes in the world when you are having a problem.

Call your doctor if you still feel poorly or are overly concerned about what happened.

As always, I'm NOT a health professional of any kind, so your mileage may vary. Good Luck!

[garberville]

When my PVCs act up they tend to be brought on even further by taking a hot shower.  I realize that you had symptoms prior to the shower but the hot water may have increased them.  I found that taking a colder shower really limits the shower induced PVCs.  I'm personally aware of one other person who is also PVC/tachycardia sensitive to fast skin temperature increases.

[Medboy]

First off great message board and interesting commentary. Well it appears there are many PVC sufferers and me included.  I am curious given what I am reading how many Dr.'s are prescribing Atenenol/beta blockers on a as needed basis to treat mainly PVC's or sinus tachycardia?

2. Are the mjority of people getting PVC's triggered by sinus tach first and then they degrade into PVC's?

3. How long does the PVC episodes last when they begin?

4. How many PVC's are typical per day on this board?

5. What are the common triggers for them?

6. How many of the people on the board have benign PVC's (stress, echos' etc are normal so Dr. says PVC's are benign)

7. How many people rank the anxiety as the main problem?

I dont want to take away from the gentlemans concerns on the post - frankly I suffer the same issues as he does and I am at a loss to deal with them too. I see my cardiologist on thursday afternoon and want to raise some good questions hoping I can share some insights to the forum.

The only thing my cardio says "they keep good company" meaning PVC's in a normal heart without disease are considered nothing more than a nuisance.

Finally, I too take Atenenol on a as need basis and sometimes I wonder whether its even appropriate taken this way? ie. is it safe and or effective?

Thanks-

[Medboy]

BTW- my PVC's/Palpitations started exactly the same time yours did I presume at 30 given your age you identify and after our first born child. I am 39 now and have had them off and on since 30 often getting episodes as little as once per yr to at least 12x per year typically none for months and then bang and whole slew of episodes one after the other. The only thing I can say is: if you have had all the typical workup, stress, echo, etc ... and all normal then they will say live with them because there is no treatment for them.  My cardio now 65 has them too so he is more sympathetic and he just ignores them but its hard to do when you are not in the med profession.  I typically take the atenenol too 12,5 mg of it I split a 25 mg tablet in half and take when required too but not sure whether this is even effective anymore? Mine starts with sinus tach and then degrades further into PVC's which then leads to ruining my day/evening whatever time of day. Yes, coping is everything but not sure how and what other people do to cope as well. Its a tough one really. If you have no symptoms - mainly fainting then dont worry about them so they tell me.  I am at a loss too... I will say one thing anxiety seems to be a key trigger and sometimes they come without warning and when you are not anxious and just feeling good. Other times extreme weather causes them to appear. I live in Toronto, Canada so weather here is cold like NYC weather - lousy most times. Extreme heat also triggers them too. I often get them in the shower too so u are not alone. Its hard to pinpoint but again they say dont worry but hard to do.

How long are your episodes anyway? How many times per yr do you get them and how do they last each time? How many skipped beats do u get per episode?  Getting 8 skipped beats is considered noneventful (absolutely nothing) although I feel for you because I get them this way too and often freak out in the process,

Take care and they only thing I can offer is try to relax in whatever way you know how. I am convinced of one thing. PVC triggers are more about an unbalanced body chemistry than about the heart itself.  I just havent figured out how to remain in a stable body chemical state!!

Stay well my friend you are not alone - read the archives they help in some ways but dont read too much because it will make you crazy.

[lmroswell]

I don't know if Atenolol is in the same family with Toprol, but I was told by my doc to take the Toprol at the same time everyday, and not to stop taking it cold turkey because it could induce something called 'reverse tachycardia'.  Hot showers usually increase a normal heart rate.  Had you been late in taking your meds?

[Christie2004]

I did read your link.

All I can say is that traditional, standard, drug company saluting, everyday medical society did NOT want me treated for hypertension.  There was no kick back being offered to get me onto the evil Ace inhibitors--if anything, I was told that I DIDN'T require any meds.

It wasn't until that brain MRI that the insidious damage was shown.  And it wasn't discovered by a doctor who would be the one to prescribe "drugs" to keep my BP down.  He had no interest in profiting from referring me back to my reluctant internist for treatment.  My internist still wouldn't put me on something until tests showed narrowing of the renal vasculature, and until the 24 hour BP monitoring showed such variation.  

It all boils down to the fact that there are all sorts of extremes in medical opinions. The extremists invariably justify their position by attacks on drug companies and their influence on medicine today.  Easy target that everyone can hate!

I go down the middle of the road.  Less chance of going over the edge.

Peace, ok?  I don't often comment unless I see something of interest to me.  You are intelligent and articulate and I like your posts.

[pms_barbie]

Well my echo shows mvp but they say the pvcs are still benign.  I was having over 10000 pvcs a day until my ablation.  I was having bigeminy.  Thats a pvc after every normal heart beat.  My bigeminy is gone however I still have pvc's.  Not nearly as bad as they were but never the less they are still there.  I have read,  so take it with a grain of salt.  That a healthy heart can have 50000 of them a day and they are still benign.  However at rates that high I would be worried about cardiomypathy.

[Medboy]

I can only say wow, if I had 5000 pvc's per day I would be in for treatment with a psychiatrist/psychologist for sure. I commend your strength and fortitude in dealing with these PVC's... I have a tough time dealing with 100-200 or so on a bad day and then having none for weeks on end.  How do you deal with them without going crazy? How did you deal with the bigenemy and did your docs tell you they were benign? I am more curious with the "how" you deal than the PVc's themselves although I am interested in the frequency of your PVC's.  

Do you take beta blockers now? I am curious who did the ablation? and would you say it was successful. Not sure if you mentioned that you get 5000 per day every day (PVC's)

Incredible !!

Looking forward to your post. Thanks

[Barbarella]

Peace?  I did not know that we were at war :) JUST KIDDING.

I'm glad that they caught your problem in time.  I'm just so frustrated when one doctor says this, another doctor says that, and an article again says something totally different.  I was not talking about your case when I said that there is a lot of hype out there.  If I'd take high BP lightly I'd not take my meds.  I personally think mine is just when visiting the doctors, but the Cardiologist I had to see because of a leaking heart valve felt that my BP was NOT only white coat anymore.  As you can see I do not want to gamble with high BP and therefore I went ahead and took/take my BP meds.  I just wish all doctors could come to a common agreement when it comes to any illness.

[BlondieCO]

My doc told me that she really thinks anxiety intensifies PVCs.  I just got my scan results yesterday and I have no heart disease or blockages.  I am reassured now that I will not drop dead, but will be bothered for two weeks out of the month.  My doc told me to continue Atenolol and be grateful that I have no heart disease.  She told me that she thinks men have hormonal dips as well that may cause benign PVCs that are not linked to heart disease - sort of like thyroid problems in women.  Maybe it would shed more light on why we all get them.  But I am reassured that they are benign and unfortunately I,like many others can feel them, the lucky ones who don't feel them still get them daily as well. The beta blockers do help lessen the contractions in the heart, and I personally have had fewer.  It's good to get some answers.

[pms_barbie]

I wore a holter about two months ago that said I was having 900 pvcs a day.  They have seemed to drop down a lot more since then.  However I have been told by several people that sometimes it takes a while after an ablation for things to really settle down.  The bigeminy I didnt deal with well at all.  I stayed in bed most of the time which wasnt good.  My nerves were totally shot.  The ablation was done at the Cleveland clinic by Dr. Burkhardt.  Omg it helped me so much like I said I was having over ten thousand of those critters a day.  In all honesty from what I have gathered and read 200 pvcs can be very normal.  My ep dr says he has them and doesnt feel his.  Most people have them and dont feel them.  Just us lucky ones do....lol  I do so much more now than I did.  I told my boyfriend the other night if it hadnt been for the ablation I probably would have ended up in a mental ward.  I had a theory and that was .....maybe it depended  where in your heart pvcs occur as to wheter you felt them or not.  Try not to stress hun because I know thats what made mine worse.  My aunt stays in bigeminy and she never feels it at all which totally amazes me.  I am taking toporol I know thats not cutting the pvcs down but it does make them less noticeable.  I have this bad habit about feeling pulse a lot.  This is how I know my pvcs are cutting down since my last holter.  Now sometimes since I am on the bb I can feel a pause in my pulse but I cant tell it in my chest like I use to.  However please note that unless you have a lot of pvcs most drs wont even consider an ablation.

[pms_barbie]

Yes several drs said they were benign.  I forgot to mention that.  I also sometimes a 4 or 5 beat runs of vtach that were benign.  My understanding is in a stuctually normal heart most pvc are benign.  So I would recommend anyone having pvcs to seek a dr just to make sure that the heart is structually normal.  Now my pvc's are so scattered I handle them really well.  After having that bigeminy so bad this is a walk in the park for me.....Hang in there hun and try and stay stress free.  A lot of things can trigger pvc's so trying to avoid those triggers may help a lot.  If you would like to email me I can give you a link for a pvc support group that you may find very useful.  My email is pms_barbie41096***@****

[Sam R]

Anybody hear from Arthur lately?  The guy knows more about PVCs and  PACs  than most docs.

[Momto3]

Medboy,
Hi and welcome aboard!

I was also have thousands of pvcs per day and they were "benign." Had them for many years and one day I finally just accepted that my heart beats to a different drummer.  That took a LONG time and a very compassionate and thorough doctor.  I was in bigeminy so often that it was pretty much normal for me and still "benign."  

That being said, in late 2002 I was diagnosed with cardiomyopathy (ejection fraction dropped to 40%) as a result of persistent, and very frequent pvcs. I was multifocal and had the pvcs ablated in 2003. My ejection fraction returned to normal very shortly thereafter and has remained good since...Thank goodness.  

As far as anxiety, I think it's like the chicken and the egg thing. Not sure which one comes first -- but, anxiety can certainly play a role.  Hope you are feeling better.  

Barbie,

Not sure about the 50,000 beats since mine never got that high (at least that I know of).  I remember reading somewhere something about 10% ectopics can cause a problem.  Sounds like you are enjoying your new heartbeat.  Boy, I can relate to that! It actually took me awhile to adjust to having a normal rhythm.  Did you experience that too?  Did you say that you had your ablation in Cleveland?  Do you live near Cleveland?  I am from Northeast Ohio and also had my procedures done in Cleveland. I have a cardio at CCF, but my EP is at another Cleveland hospital.  Glad to hear you are doing well.

connie

[pms_barbie]

It felt so nice to have my heart beating normal.  It was weird feeling at first but I love it.  I still get some pvc's but they are nothing like that bigeminy.  I live in Ky so I had about 5 or 6 hours of driving.  However it was worth every mile and then some....lol

[Momto3]

You are right, it does feel great...I keep waiting for the other shoe to drop, but it has been over a year since the second ablation and (shhhh), I'm still enjoying wayyy fewer pvcs.

Have a great day!

[LilVaChic]

I have had PVC's since I was 16 y/o. Sometimes they would wake me up in the middle of the night.I have MVP with middle to late systolic click...non ejection. I am 46 y/o now and 3 months ago I went to the ER because of them. Had an EKG and was monitored for a few hours. The dr. said I was fine and sent me home. I have been taking Tenormin for at least 20 yrs and it seems to help for the most part. A month ago I went to a new dr. and he did an EKG and said that I had an old anterior infarct...abnormal EKG. The next day I had to go to the hospital to get a follow up EKG and it said borderline...consider anterior infarct...if this was true...how could a previous EKG read abnormal and a later EKG read borderline? I got my records from my visit to the ER a few months ago and EKG read abnormal...old anterior infarct...when the dr. told me the EKG was fine...whats up with the an abnormal EKG being fine? Can someone please enlighten me on this? Have to say I am concerned...Thanks for all your help.

[LilVaChic]

A few years ago I had reconstructive breast surgery due to benign tumors...saline implants...Could the implants cause a false anterior infarct to show on my EKG?

[pms_barbie]

Im sure thats possible.  I had an ekg once that said possible infarct. I have never had an infarct.  That why your dr has to look at the ekg himself.  Since you had breast implants I would think it might influence the ekg reading.

[DOORKICKER]

I am a 30 year old male social drinker, non smoker.  1 week ago, while i was off from work for the holiday, I was folding laundry and my 2 yr old daughter knocked over the clothes tree I just put the laundry on and I yelled at her. Then my heart fluttered.  My heart skipped a beat when I felt the flutter.  I calmed down and the fluttering stopped.  However, since then I have been worried  sick.  I am on atenolol 50mg. once a day for high blood pressure.  My heart really hasn't fluttered since but its more like a butterfly sensation sometimes in the chest some times right above the abdomen.  Also, in my throat it feels like a sinus cough.  I have no shortness of breath, chest pain, etc.  I've been reading a lot about PVC's on here and it sounds like what was happening.  Most of the day, I'm fine, but other times I get the feeling.  I spoke w/ my doctor and he attributed the heart flutter to no taking by atenolol on time.  I think I'm crazy and it may be anxiety.  also, I've started walking everyday and feel great when I walk.  please help.