P.V.C.'S

    
      Re: Re: Re: P.V.C.'S
    


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Posted by CCF CARDIO MD - DLB on July 20, 1998 at 10:20:40:

In Reply to: Re: Re: P.V.C.'S posted by KEN RODRIGUES on July 18, 1998 at 10:59:27:

: FOLLOW UP QUESTIONS:
  1.  WHAT IS THE HEART DOING DURING A PVC?
  2.  WHY IS IT THAT I CAN FEEL ONE COMING ON JUST BEFORE IT HAPPENS?
  3.  IS IT A RUSH OF ADDRELINAN?
  4.  WHAT BRAND OF BETABLOCKERS?
  THANKS
  KEN
  
  : : I AM 50 YEARS OLD AND IN GOOD HEALTH EXCEPT FOR THESE PVC'S ALL THE TIME.
  : : FOR THE LAST 3 YEARS I HAVE BEEN HAVING PVC'S, SOMETIMES
  : : UP TO 300 TO 700 A DAY, OTHER TIMES ONLY 1 OR 2 A DAY.  I DO NOT FEEL THEM WHILE WORKING OR EXERCISING ONLY WHEN AT REST.
  : : DOCTOR HAS BEEN TREATING ME FOR HIGH BLOOD PRESSURE AND HYPERTENTION FOR THE SAME 3 YEARS.
  : : TAKING 20 MG OF LOTENSEN AND 5 MG OF NOVACK.
  : : HE HAD ME ON 10 MG OF PAXIL WITH 1 MG OF LOREZEPAM FOR HYPERTENTION AND PVC'S, WHICH SEEM TO WORK BUT I DIDN'T LIKE THE SIDE AFFECTS OF PAXIL AND STOPPED TAKING IT AROUND3 MONTHS AGO AND ONLY TAKE LOREZEPAM WHEN I CAN'T SLEEP.
  : : HAD ECOCARDIOGRAM, DYE INJECTIONS AT ACTIVITY AND REST, AND AN ANGIOGRAM THAT ALL SHOWNED NEGATIVE.  BOTH DOCTORS TOLD ME TO LOOK FOR ANOTHER JOB THAT WASN'T SO HIGH STRESS.
  : : I DON'T UNDERSTAND WHAT BRINGS THEM ON SINCE I DON'T DRINK, SMOKE, OR USE CAFFEINE PRODUCTS AND TOOK EARLY RETIREMENT LAST YEAR..
  : : IT SEEMS LIKE I CAN BRING THEM ON BY MYSELF JUST THINKING ABOUT A PROJECT OR STRESS SITUATION.  ALSO, LIKE THE OTHER GUY HAVE 2 OR 3 AT A TIME AND CAN FEEL THEM COME ON JUST A SECOND OR TWO BEFOE THEY ACTUALLY HAPPEN.
  : : THE WORST PART IS THAT I FEEL MOST OF THEM AT NIGHT WHEN I AM TRYING TO GET TO SLEEP.
  : : USUALLY TAKES ME 1-2 HOURS TO GET TO SLEEP AND I WAKE UP IN THE MIDDLE OF THE NIGHT WITH PVC'S.
  : : APPRECIATE ANY HELP THAT YOU CAN OFFER.
  : : KEN
  : ---------------------------------------------------------------------------------------------------
  : Dear Ken:
  : The extensive tests done on your heart indicate that it is normal.  This makes the PVCs benign - they are unlikely to cause you any harm.  However, they obviously bother you.  Just so you are clear, Paxil is an antidepressant and lorazepam is an anti-anxiety medication.  They do not eliminate PVCs per se; these medicines just make you less anxious.  This is certainly a reasonable approach if your doctors feel that your main problem is psychological and/or stress related. A class of medications called beta-blockers can be useful to actually decrease the number of PVCs you have, though it will not eliminate them; however, these medicines can worsen depression, if that is part of what is going on. There are other medicines that can help suppress PVCs, but they all have side effects and are difficult to take; these medicines are best prescribed by a cardiologist who specializes in heart rhythm problems.
  : I hope this is useful. Good luck. Feel free to write back with further questions.
  : Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.
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Dear Ken:
PVCs are premature ventricular contractions. That means they are abnormal beats that originate from the heart's pumping chambers (the ventricles) before the normal heart beat can occur.
It is often the pause after a PVC and the subsequent normal beat that are experienced by a patient as "feeling funny." Thus you may be aware of the PVC, but "bothered" by the subsequent pause and normal beat. It is this sensation of "skipped beats" that can make PVCs annoying.
Adrenaline can cause and contribute to PVCs.
It would be up to your doctor to decide if beta-blockers are even appropriate for you, and if so, which brand. I prescribe atenolol and metoprolol.
I wish you the best of luck. Feel free to write back with further questions.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.