PVC's PAC's and Supraventricular tachycardia

[dmbe70]

I am a 35 year old, 145 lb. woman with two small children.  No known health issues, generally pretty healthy. B/P usually 120/70.
Ever since I had my first daughter, I have had episodes of what they tell me are pvc's and pac's.  I will be standing making dinner, or sitting with my children and it will feel like this heavy sinking feeling in my chest (almost throat) area.  For the most part, it is quick, and if I brace for literally a few seconds, it's over.  Since this past August, I have had 5 different episodes where it feels as though it is fluttering and my rythym does not reset immediately; the longest one lasting close to 6 minutes.  It is a very strange feeling which starts like the sinking feeling I get from the premature beats but doesn't stop. It is difficult to catch my breath during the episode and it is very frightening.  I am not an anxious person, and am generally able to stand and ride it out, but there are times where it feels like it will not reset and it can make me a little nervous.  Only once, it made me very dizzy and short of breath, but that lasted less than 30 seconds.
I wore an event monitor for 30 days, where they were able to record the PVC, PAC activity.  I was also told that I was having a supraventricular tachycardia.
I am told by my cardiologist that she is "very confident" that it is nothing to worry about.  I had an echo/stress test and blood work and was thankfully told my heart is just fine, but these episodes are quite scary.  
What is a svt and can this really all be nothing to worry about? Should I get a second opinion?
Thank you!

[CCF-M.D.-MJM]

Hello,

It is common for women to have more PVC/PACs during and after pregnancy. It is also common for SVTs to manifest during or after pregnancy.  SVTs are almost never life threatening and most cardiologist will not miss the life threatening cases becauase they are straight forward (WPW with atrial fibrillation).  The key for you is capturing the arrhythmia -- the one that makes you very symptomatic -- while you are wearing a monitor.  Many of SVTs are treated successfully with medications.  If the medications do not work, they are often successfully treated with abaltions.  It depends on the type of SVT you have.  If  you trust your doctor and the symptoms are too dibilitating, I don't think you need a second opinion.  If the symptoms really bother, it wouldn't hurt to see an electrophysiologist for a second opinion.

I hope this helps.  Good luck and thanks for posting.

[andie3330]

In a healthy, structurally normal heart, svt is usually more of an annoyance and not dangerous. I'm sure your doctor has ruled out wpw syndrome by looking at your resting ekg. WPW is one type of svt that can be more worrisome due to an abnormal electic pathway in your heart, but wpw shows up as "pre-excitation" of the ventricals on a resting EKG, so you would know if you had it. Has your doctor recommended vagal manuvers to convert a svt episode back to normal sinus rhythem? Sometimes splashing cold water on your face or bearing down, as if having a BM, can convert your heart out of svt. I don't think any treatment is necessary for svt unless the symptoms are very bothersome and frequent for you, in which case there are meds that can reduce your symptoms (not because svt is dangerous but just to help you feel better). Also, svt can often be "cured" with an ablation procedure - but, of course the procedure has its own set of risks which must be weighed against how much the svt is bothering you.

This is only my best understanding of svt - I'll wait to see what the doc says for more info.

[andie3330]

Looking back over your question and my comment, I'm not sure I really addressed your basic question. SVT (not to be confused with NSVT which is something different) is just a faster than normal heart rhythm which originates from a signal in the atria other than the SA node.  It usually comes on suddenly and can last a few seconds or up to a few hours or more. Your heart then converts back to the normal rhythm just as suddenly. So, just for example, your pulse could be 70 beats per minute then suddenly be 200 beats per minute then back to 70. Vagal manuvers may help convert your rhythm back to normal sooner than it would spontaneously. I think it is a relatively common condition, in fact, I think the majority of the general population may experience at some point in their lives. I could be wrong about this point, but that's what I've heard. Hope that helps a little. Best wishes, Andie

[dmbe70]

Do you know what an SVT feels like, exactly?  I have never heard anyone explain it in the way that I feel it.  I would love it if someone can describe what it feels like to them.  It is so hard to describe, I know, but I would be thrilled if someone could try!  Do my symptoms sound like it could be something different?
Thanks!

[talylor]

I have been having a problem for the past 4 months. I have gone thru testing for cardio (ekg's, stress, echo) and lungs (chest xray, chest ct scan, pft test) and even gastro (barium swallow). You can read my post in the gastroenterology forum for more detail. Your post caught my eye because of your description. I havent been able to describe what I am feeling in my chest and throat (which sometimes radiates to the stomach). I have said butterly type feeling, hollow type feeling, sometimes, pressure, sometimes tight, I can go on and on. I even said it feels like a "pit" type feeling, like when going down a rollercoaster or a hill. I guess, your description of "sinking" feeling fits as well.  At rest or while active (walking, or simply doing chores around the house). Bending can bring them on, deep breathes as well. I get them literally for a few seconds and they are gone.But for those few seconds, I get very nervous and scared. I will stop in my tracks and do my rest to stay calm and let them pass. My docs have prescribed me antianxiety meds recently cause they are simply getting the best of me. I feel FINE all day. No other symptoms such as headaches or fever or nausea, other than constant soreness on my left side.

My docs said he is pretty sure based on all my tests he can rule out heart and lungs and sent me to a gastroenterologist but I am not completely convinced. He decideded to put me on a heart monitor (which I get on Wed). He thinks this should rule out heart once and for all.

[momto3girls]

Hi dmbe 70,

I too am suffering from SVT.  Mine is hereditary (my dad has really bad SVT which goes up to 250 and stays) and mine has gone up to 180 for no apparent reason.  I literally would just be sitting down and my heart would take off.  The best way to describe the svt is that for me, I feel very jittery like I've had too much caffeine and jumped on treadmill at the same time.  Other times my heart flutters, skips and pauses.  I have had a pretty decent cardio work-up with ekg, echo, stress test, stress echo and this Thursday I have a nuclear stress test.  From everything I've read and been told by my cardio doctors, SVT, Pac's and Pvc's are totally benign if your heart is structurally normal.  Now, that is so nice to hear but when these little buggers hit, sometimes that explanation goes right out the window!  If I start to get anxious when I feel them coming on (whether svt, pac or pvs) they get 10 times worse and last longer.  When I try to calmly ride them out and take deep breaths reassuring myself that it's nothing, they really do go away.  Weird, huh?  Just know that you are in good company, there are so many others out there who are experiencing the same symptoms and are just as worried about it.  Try to relax and tell yourself that in light of the good cardio work-up you've had, there just a nuisance, not life-threatening.  To make you feel better, my dad has had svt for over 20 years and it didn't damage his heart at all!  He just this past christmas opted for an ablation because his svt would go so high and stay high for hours and that meant he needed to go the ER to be converted.  Even then, he was fine, just annoyed!  He could even tell the ER doctors how fast his heart was going.  They got a kick out of that!  Take care and don't let this consume you (easier said than done, I know!)

[andie3330]

What you describe sounds to me like PVCs - which are totally benign - almost everyone has them occasionally. However, most people don't notice them much.  I never noticed PVCs till I was pregnant, but then I started having a lot of them and they felt like you describe - like the sinking feeling you get after going over a hill on a country road and the feeling radiates up to your neck. To confirm that you are having PVCs (non-technical, at home confirmation) feel your pulse when you think you are having them. If you just have one, isolated PVC then by the time you feel your pulse you won't feel anything abnormal - but my PVCs tend to cluster together - so if you are feeling your pulse before and during when you have a PVC, there will be a definite pause between beats and sometimes the next beat feels stronger than usual. Like: beat..beat..beat......BEAT..beat..beat..etc.
That's how I figured out that my symptoms were due to PVCs. Unless you are monitored with an ekg or holter when the PVCs actually occur, a standard cardiac workup won't show that you are experiencing them.  Again, PVCs are benign, but its hard to believe that fact when you can feel them so intensely.
Anyway, I may be way off base and your symptoms may have absolutely nothing to do with your heart - but your description struck a chord with me.

[Pickyrose]

I am 44 and have been dealing with this since 1997.  I too am post surgical menopausal and began having symptoms after having the flu. I noticed that I could not walk as far as some of the other people I was with, while in Boston, without being out of breath.  I then started having episodes wheere I could feel my heart racing at rest which would cause shortness of breath and for no apparent reason.

In the beginning I was told that it was anxiety - I didn't think so, since it came on without any events.  I was also told that it would pass, that women get this sometimes (without a diagnosis)and that I shouldn't worrry since I was not having a heart attack.

I believe I have had every test possible with the exception of a stool sample and had finally been given the diagnosis of IST.  From there it has been trials with beta blockers, calcium channel blockers and anti-depressants (for whatever reason, they are suppose to slow the hr).  

Since those have finally been exhustated, I have had three ablations.  The first was a disaster, to say the least, they accidently pierced my heart and I was in ICU for about three days.  Since I am so desperate to have this fixed, I tried again.  It was sucessful for three days and reverted back to rapidly beating, but what a wonderful three days it was.  I could actually walk upstairs to my bedroom without feeling as though I had run a mile.

I just had the third one done on 04/20/06 and still no luck.  I am now having more episodes and they seem to be worse.  My hr is as low as 50 and soars up into the 100's.  I feel the "fluttering" whenever I move and I am still short of breath.  The dizzy spells are more frequent (I look like I'm drunk).

While I understand that this is not life threatning - it is disabling and certainly leaves you out of a lot of actvities.  I'm 44 not 94.  I don't know what is left for me.  I've had some doctors say a pacemaker, but others say it would not help.

Is it just me or does this appear to affect mostly women?  I get the feeling that since this is not life threatning, it is put on the bottom of conditions to be researched.

Does anyone have any information on the benefits of a pacemaker with this condition?  If that is what it takes to stop having my life interrupted, I'm willing to do it.

[1beat2many]

hello. i have been reading this forum for a very long time but never posted. i am so furious that nothing is being done to aleviate these horrible symptoms we put up with.  i want to work but a little stress or too much movement gives me horrible skipped beats that last a long time and make me extremely light headed. i have put up with these for 15 years now.  they have progressively gotten worse and longer.  i was diagnosed with pac's , pvc's and atrial fibulation.  i know when the irregular beats are coming because i get a weird feeling in my chest.  the feeling is like the feeling you get when you are about to sneeze. i use to call it a pressure because i could think of no other way to describe it. does anyone else feel very light headed when these beats happen repeatedly? i am on atenolol which helps only with the atrial fib. anyone on anything that helps with the pvc's and pac's?
thanx
maryann

[talylor]

Thanks for your response. The throat feelings truly scare me. That is where I feel them the most. When I feel it in my chest its in the upper chest. Like right under the neck across the breastbone. Usually on the left side. But recently has also been on the right. If I feel it lower, it literally feels like it is coming from within my breast. It's never in the center of the chest. Never feel heartburn type pain. Never feel a palpitation or any type of fluttering. I sometimes feel a single strong heartbeat here and there when I check my pulse. My pulse rate is never TOO high. Resting rate in the morning is 65-75. During the day 75-85. At times. after some exertion it has risen to over 100 but comes down within minutes. When I say they these feelings last seconds. I literally mean SECONDS. Maybe even a single second. Its just a FLASH of a weird sensation. I can get dozens a day or get just a handful a day. But they have been every day and that is why I am hoping this heart monitor will pick SOMETHING up if it is indeed the heart.

Do you have a heart monitor? Are PVC's treatable? Do they tend to go away after awhile or is this something I am going to have to learn to live with? Do you know what causes them? Mine all started after antibiotics for a UTI infection but all doctors I have seen tell me that that's impossible. The medicine is long out of my system and even if I did have side effects from it, the side effects would go away once the medicine leaves the body.

[talylor]

Just a little background...37 yr old female. 5' 11". 165lbs. Hypothyroid for six years (had that checked out too to make sure my thyroid wasnt off and recent work up showed I was fine in that area).

[KAD]

Hi Pickyrose,
I had IST for about a year.  I am a 28 year old female.  I know IST is more common in young females, with a dissproportionate amount in the health care field.  I am a nurse.  I had consistently high heart rates in the 130-180's with my heart rate rarely below 130.  They treated me initially with beta blockers, calcium channel blockers and anti arrhythmics.  They were ineffective for me and I was not interested in staying on medication for the rest of my life.  The doctors were fairly aggresive (aggressive) with treating me, due to the fact that after a few years with my rapid heart rate they said I would definitley develop cardiomyopathy.  So they attempted several sinus node ablations.  The first two were inffective and after the third one they were able to lower my heart rate, but it ended up being lowered to much.  My heart rate was down in the 30-40's.  So they implanted a single chamber atrial pacemaker.  My quality of life is improved drastically.  But the trade off is now I am dependent on a pacemaker, which is not without its risks.  I have to go in and get it checked every 3-6months and will need it changed every appx. every 5 years.  My advise to you would be to exhaust all your options with medications and do not take putting in a permanent pacemaker lightly.  My device worries me occasionally.  Whenever they change the pacemaker, you have to watch for signs of infection because if you do get an infection in your pacemaker it is very, very serious.  But I am grateful to have this device to help me!  Good luck!
Did you ever try the drug Flecainide?  I did have some success with that medicine lowering my heart rate.

[woodruff]

"The throat feelings truly scare me. That is where I feel them the most."

I've had those sensations, and in my case, it turned out to be related to times when my blood pressure was pretty high (I have labile hypertension--usually low, but sometimes, when I'm anxious, way up there).  You might want to check your pressures when you have those feelings.  My throat sensations go away when my BP is down.

" When I say they these feelings last seconds. I literally mean SECONDS. Maybe even a single second. Its just a FLASH of a weird sensation."

I've also experienced that FLASH.  You put it very well.  Some of us are more sensitive to the feeling of a skipped beat, and I'm betting that "flash" is an instantaneous "alarm" response by our nervous system to a minor disturbance.  Same with the "hollow" or "dropping" sensation that some describe.

"Are PVC's treatable? Do they tend to go away after awhile or is this something I am going to have to learn to live with? Do you know what causes them?"

In my experience, pvcs are not very treatable.  They may go away for months or years, only to return without any obvous reason.  They may never go away.  There are some drugs that may, possibly, help minimize them.  The big thing is to understand that, if your tests show your heart is normal, these odd beats are pretty much harmless.  Your ATTITUDE towards the pvcs can be changed, and if they make you so anxious that your lifestyle is affected, then it's important to see a good shrink or counselor, because cognitive therapy or psych meds can be a real help.  

If you read a lot of posts here, or do a search using the term pvc, you will get a lot of information about the great number of people who have them and what their experiences are, with and without medication.

[talylor]

Thank you so much for taking the time to respond to my post. I am at such a loss as to what is happening to me. Found this site and have been reading through it very throroughly. First posted in gastroenterology forum cause that is where my internist sent me after he said my cardio work up (ekg, stress, echo) and lung workup (ct scan, xray, pft test) ruled out heart and lung. I was not convinced that it was gastro. I just posted in the respiratory forum trying to find an answer. I have been doing research and thought maybe medicine I took when this all started triggered all this. I am looking at any angle and any possible cause because I am at a loss. I know my docs are too but they need to figure this out and fast. I KNOW what I am feeling. Have become so anxious and so worried about what this is that my docs are now saying it may be anxiety. But I told them...yes...ANXIETY NOW...and I am doing something about it (aka counseling, and got prescription of xanax filled that my doc told me to take when needed but still havent taken one yet. trying to work thru it other ways). I KNOW I have anxiety now after all this time. And this effect on me mentally is probably not helping me physically. So I am trying my best to cope and calm myself down til they find the answer.

Do you think a heart monitor will find it if it IS the heart?
With all the other tests done that seems to say structurally my heart and lungs are fine...I guess it CAN'T be anything serious. But its so hard to believe feelings that are SO scary are not serious. Yet, I have read over and over on here that terrying feelings can very well be harmless. I am so hoping this heart monitor tomorrow helps. My breathing has been off sometimes and I am afraid to exercise like I used to. I need an answer is what this all boils down to. Right now, with no answer, my mind is wandering too much and I know thats not helping me any.

[CollegeGirl143]

I had really bad svt (AVNRT) for about 6 months.. it was common for me in an episode to feel pounding in my throat, like my heart was beating in my throat, and my doctor said this was common of SVT... my svt was so easily triggered just standing up would send me to 200+ beats per minute, eating too, so they recommended a cathater ablation and im cured :) you should look into this, its true medication can suppress it but the ablation cures it and its really not bad.

[andie3330]

The holter heart monitor will definitely tell you whether or not your symptoms are caused by PVCs, as long as you actually have the symptoms while you are wearing the monitor - and it sounds like you will, given the frequency of the feelings you report. I don't know about the one-sided aspect of your symptoms - I've never experienced that - but everyone is different. PVCs do not usually require treatment, but if they are bothersome your doc may suggest a beta blocker to reduce your discomfort. Like Woodruff said, PVCs are very unpredictable - can come and go with no obvious reason - but are often aggrevated by stress, caffine, lack of sleep, pregnancy etc.  Woodruff's point about blood pressure was interesting - might be worth picking up a home blood pressure monitor to see it your symptoms are related to BP changes. Its always difficult to truly assess BP based on the limited readings at the MDs office. Good luck tomorrow with the heart monitor. Andie

[talylor]

I have checked my pulse right after I have had the feelings. My pulse can be as low as 65 and sometimes as high as 90. I have never been checking it at the EXACT moment they happen cause they are so random. But as soon as I feel one..I check the pulse for the next minute or so. I can be at work, get one. Home  watching tv, totally relaxed. boom get one. Go from sitting to standing, boom get one. Change positions during intimacy and boom get one. There is no rhyme or reason to them. No common denominator that I can find.

I get put on this 24 hr holter monitor tomorrow. I pray there is ABSOLUTELY nothing wrong with the heart...BUT if these benign beats or whatever they are, are the cause...at least then I will know and we can take it from there. If the monitor comes back normal...I will be completely drained and lost as to where to turn next.

[andie3330]

Honestly, if I were you, I'd be very relieved to find out that my symptoms were just due to PVCs - really - everyone has them at times, they are a normal, totally benign finding. I know its tricky but you have to have your finger on your pulse before a pvc happens to notice the pause. By the time you register the symptoms, your pulse will be back to normal. At times, I'd have several PVCs a minute - so that was easy for me to do. But, when I first started feeling them, I remember holding my wrist for 10 or 15 minutes until I finally felt one happen. Like you, I was very anxious to figure out what was causing my very strange and worrisome symptoms. Not that I recommend this strategy - don't drive yourself crazy about it like I did. Your monitor will be definitive if you are in fact having PVCs. Take care, Andie

[Pickyrose]

Thank you for your response.  No, I have never tried Flecainide.  I'm not sure if that is a beta blocker or not.  I can only tolerate about 25 mg of a beta blocker.  Any more drops my bp and if I sneeze or cough I blackout.  

I have been told that antiarythmics will not help me.

Since my last ablation, my heart rate is all over the place and just feel awful.  If I move, I get winded.  I have not been back to work yet because of this.  I understand that there are risk with a pacemaker, however, I feel that I would rather enjoy five to ten years rather than suffer for another 20.

This disrupts my life both at work and at home.  Cleaning the house is like running a marathon - not to mention sex is next to impossible.

I'm ready to try the pacemaker.  I'm currently awaiting word from U of M hospital as to what the next step will be.  I just can't imagine that it would be nothing (what an awful thought).

I wonder if this affected more men if there would be more done about it?  I'm not male bashing either.  It just seems that many of the aflictions that occur to men are treated or cured.  I don't believe that women are treated the same when it comes to any problems with the heart.

Hopefully, there will be a resolution soon.

[mairey]

I have just been through the worst PVC phase of my life dating back to January when I got a very bad upper respiratory infection visiting family in the UK. It got so bad that they were constant and like electric shocks through my whole body making me feel nauseous and light headed. I was due to go on vacation to Cancun last week and was thinking of cancelling.( Iwent and had a great time - no PVC's despite doing all the "Wrong" things). 3 weeks ago I was having a friend over for dinner and hadn't eaten much all day. While we were waitng for the food to arrive I decided to open a bottle of red wine. I drank half a glass and immediately felt it go to my head. Ate heavy Italian food and drank more wine. Normally even the lightest food would set of the PVC's big time but the wine took over and I went to lie down and slept for about 2 hours. Woke up with my heart racing and pounding and thinking I am going to die. About an hour later heart rate was back to normal and I fell asleep again. Woke up the next morning with a bad headache but PVC's gone!  They have not come bck since although I know they will at some stage maybe tomorrow, next week, next year, who knows. I wouldn't advocate this but this is the second time that sending my heart into overdrive has worked. The last time I was rear ended after an 18 month run of worsening PVC's, my back was messed up but I din't care , no PVC's. I get angry when Dr's just dismiss this as benign and never listen. If they would listen and document all these expereinces that are posted here then maybe they could piece this puzzle together. Benign they are certainly NOT!

[KAD]

Flecainide is an antiarrthymic drug.  It's a fairly strong medication, but it did work for me.  It slows conduction thru the heart.  You do have to be hospitalized to be started on it.  I was usually hospitalized for about 3 days when they intiated it.  It may be worth looking into for you?  It does have some effect on BP, so I don't know if it will work for you.  You have to have a stucturally normal heart to be able to take this drug and you cannot have heart disease(if I remember correctly).  I agree with you in that men are treated differently when they present with cardiac problems.  They always seem to make excuses for womens heart problems, like it is anxiety(that's a classic!) or stress or something.  Well, I hope things work out for you.  Take care!

[mom4cem]

Dmb,

It is a scary feeling. You have received some great replies.

It is hard to believe that one is o.k. even with feeling these things. I know when it happens to me I still get upset every time. I receive reassurance that I am fine, then I am o.k. for a while then when it hits again I am back where I was before.

Hang in there.

[talylor]

So I had the 24hr heart monitor put on about 3 hours ago. I have already had a few of the "feelings". Not the strong ones that scare me and make me nervous, but the quick "flashlike" ones. Does anyone know...does it matter if they are strong or not? If it is indeed heart related causing these things, small or big, weak or strong...the monitor will pick it up, right? The nurse told me to go about my day as usual. Not to try to "bring them on". I told her I never know what is going to bring them on so that wasnt a problem. She also said it would take a few days to a week for the results. A little frustrated to hear that but I guess after 4 months, whats another week.

[jeff 67]

You're still here so that in itself implies they ARE benign, particularly if you have dealt with them for many years.

[mom4cem]

Hi,

I have worn them many times. May I ask why will it take that long for the results? Are you seeing a cardiologist or an internal medicine dr? I would think the cardio would have the results in a day and an internal would send out the reading to be read and dictated. A few weeks sounds like an awful long time.

Don't worry, if it happens while you are wearing it no matter how strong or light it will pick it up. Many times it picks up things that one may not have felt. It is a constant ekg.

[andie3330]

I hope your day is going ok with the monitor. I'm sorry - I shouldn't have told you or anyone how you should feel in that last post of mine - I just wanted you to know that PVCs are not physically harmful. I know that many people - myself included - have had a difficult time emotionally because PVCs can be very scary until you have the reassurance that they're not going to hurt you. Anyway, the monitor will pick up PVCs and PACs if they are occuring, whether you feel them very intensely or not.

[talylor]

I was told the results would be back in a few days to a week, not in a few weeks. I dont think I would have been able to wait THAT long. I am under the care of both an internist and a cardiologist at the moment. The cardiologist ruled out the heart over one month ago based on an echo, resting ekg and stress. But since my symptoms have not gone away since then, my internist wants to check for an arrythmia, extra beat, whatever he is looking for. The doctors are in the same practice/same building. The internist ordered the monitor and the cardiologist will read it.

The nurse who put it on me told me to write down every time I feel anything off/abnormal. Any of the symptoms. I feel like I have been writing all day. I have good days, bad days and VERY bad days where they seem to just keep coming and coming. Havent had the really strong ones that I get in the throat that make me panic...but if these little ones register on the monitor...thats fine with me. Believe me. I dont want to get a strong one.

[Tiara772]

A related discussion, can birth control affect SVT in any way doctor?? was started.