PVC's and LVH

[Chris508]

Hi, I have been diagnosed with PVC's about 1 year ago. After holter monitoring, echo, and stress echo, the cardiologist says they are benign. (heart function normal other than pvc's)

I am 37 yrs old, 6'7" and 240 pounds. Not overweight, played sports all through high school and basketball in college. Currently, most of my exercise comes from lifting weights 2 - 4 times a week and softball. I drink alcohol on most weekends and chew tobacco daily. Stopped drinking and chewing for a few weeks, but didn't seem to have any effect on my pvc frequency.

My pvc's seem to become more frequent with exercise, walking up stairs, running etc. ...or with some sudden movements, such as bending over and standing up quickly.

My echo results showed concentric left ventricular hypertrophy septum measurement of 13 mm. The cardiologist says that he wouldn't even consider 13 mm enlarged in a person my size, and he encouraged exercise with no restrictions. I understand that pvc's in the setting of a structurally normal heart are benign, but...
1. Wouldn't the LVH qualify as NOT structurally normal? ...or is it so minor that it is not a concern?

2. Do you agree that a LV septum measurement of 13 mm is not a concern in a person of my size?

3. If my PVC's are caused by the LVH, would they still be considered benign?

4. I have read that if pvc's increase with exercise that is not a good sign, is that true? ...and do you agree that I shouldn't have any exercise limitations?

I want stay as active as possible, but a little scared.
Thanks in advance...

[CCF-M.D.-MJM]

Hello,

1. Wouldn't the LVH qualify as NOT structurally normal? ...or is it so minor that it is not a concern?

I agree with your doctor.  13 mm is not LVH in someone your size.  

2. Do you agree that a LV septum measurement of 13 mm is not a concern in a person of my size?

Completely agree.

3. If my PVC's are caused by the LVH, would they still be considered benign?

You don't have LVH.  If you were 80 lbs, I would say yes, 13 mm is too thick.  At 6'7", 13 mm is not a concern.

4. I have read that if pvc's increase with exercise that is not a good sign, is that true? ...and do you agree that I shouldn't have any exercise limitations?

I agree that you should not have exercise limitations.  If you go back and look at the study you are referring to, I think you will find that it is a population that already has a cardiomyopathy and/or coronary artery disease.

Do your best to live with the symptoms.  From what you have told me, you are not at increased risk.

I hope this answers your questions.  Good luck and thanks for posting.

[mrbh]

The alcohol and tobacco must go immediately. Both substances are addictive as well as toxic to the body. Alcohol is notorious for irritating the heart, as well as interacting with many medications in a negative manner.

[tickertock]

Good Questions. I have occasional PVCs, they usually come in bad episodes in the 100s to 1000s daily every few years since 1992 and can last from weeks to months before disappearing. I have gone nearly 5 years without any epiosdes of PVCs besides the occasional one every now and then , sometime days before I feel even one. I do take medication atenolol, cozaar and HCTZ for the palps and mild HTN. I'm 5'9" and about 195 lbs. I'm about 30 lbs overweight.I also have a connective tissue disease AS,but its not life threatening. I myself have been diagnosed with LVH my interventricular septum, it is 14mm , all other measurements are normal, also my EF is normal and no valve abnormalities or leakages. The cardiologist has assured me that I don't have HCM and even with the mild LVH, the PVCs are still benign and despite the mild LVH I have a basically "normal heart". I had an ECG just over 2 weeks ago and it was not suggestive of LVH, it printed out completely normal so I don't know if it has regressed due to stict blood pressure control, usually it would print out minimal voltage criteria for LVH, this time it didn't, of course the echo is the gold standard for diagnosing LVH.It will be most interesting to see the docs reply.

[anacyde]

"Stopped drinking and chewing for a few weeks, but didn't seem to have any effect on my pvc frequency"

Sometimes to see a real effect it takes months, at least in my case it did.  I quit smoking 3 1/2 years ago and didn't really notice a change for the better in my PAC/PVC frequency until about 4-5 months later.

I had an enlarged heart following my recent pregnancy.  Though it was only .1 cm out of normal, it was 50% bigger than MY normal, as I'm pretty small and we had a comparison.  I asked the same exact question...Did this mean I was no longer structurally normal?  My cardiologist said no, that I would still be considered within normal limits, so in light of what your doctor told you I would assume the same.

My heart enlargement was not hypertrophic, it was dilated, which is typically more worrisome.  I too was encouraged to continue exercising, so I did, and within 7 months my heart returned completely to normal.  Exercise is definitely beneficial for anyone, particularly when you've got the go ahead from your doctor.  Don't let worrying stop you from staying active.

[West Chester Mike]

I've been suffering with PVC's for 18 years and the last 4 have been the worst. I've been in and out of the hopital 5-6 times because of these annoying life altering thuds. I will share some history of occurrences & symptoms.

1. Active weightlifter/power-lifter for 35 years. I may have 4-5 PVC's during a 45 min session. Cardio makes them go away. So, needless to say I run 2 miles in 4 feet of water everyday. ( I have bad Knees)
2. When my stomach is bothering me, so do the PVC's.
3. I feel them mostly in my stomach and esophagus.
4. If I turn my head to quickly I get 1 or 2. Which may be related to my stomach
5. Doctors (Cardiologists) told me that the stomach has nothing to do with the PVC's. But, EVERYONE I talk to about this has a hiatal hernia or GIRD.
6. I was part of a support group ( Via Instant Messenger) which had 1500 members at one time and EVERYONE had stomach issues.
7. I take Toprol.
8. No Alcohol for 9 years. No smoking ever. It was tough quitting coffee. If your from the Philadelphia area you will understand when I say, Wawa coffee is GOOOD! No more.
9. It has gotten more painful, not bad pain, but like someone is touching the inside of you stomach with there finger.
10. I'm 5'11" 250lbs 49 years old and I am still capable of lifting great amounts of weight (Even after both shoulders being surgically repaired) as well as a descent amount of extreme cardio.
11. I am losing my mind with this even though I know it is not going to be the death of me.

all and any comments are wanted

[woodruff]

"I am losing my mind with this even though I know it is not going to be the death of me."

Mike, I gather from the tone of your post, and particularly from the sentence I quoted, that your heart has been tested and found healthy, and that you understand that you are not going to die because of your PVCs.  If so, that's the good part.

The crummy part is that you understand this, but that knowledge alone doesn't remove your anxiety, and the anxiety makes you miserable.  Have you tried going to counseling for some cognitive therapy to deal with the fear caused by the PVCs, or have you had any sessions with a good shrink to discuss medications like SSRIs to quiet down your internal alarm systems for at least a few months?

[West Chester Mike]

I only get this way when it's 10-12 PVC's a minute and it only lasts about 5-6 hours. I do not let it stop me from doing anything. It's just frustrating. The last line was intended to be humorous, which is a way for me to deal with the annoyance. But you bring up a great point. I'm sure we have all at one time or another gone through or will go through periods where we need a little emmotional coaching or even medication. I will use that option if the" trigger finger get itchy". Just a Joke, but maybe not SO extreme for some people.

Do you have any stomach problems that make your PVC's symptomatic.
I am assuming you have PVC's.

[KathyE]

I have been experiencing PVC's for the past 2 years.  Last year I went to the ER because the pain was intense.  At that time they ran EKG, stress test, etc.  I have been back to the doctor several times and he (heart specialist) tells me the same all your doctors are telling you.  It is not life threatening you just deal with it.  I too exercise everyday to help my beats stay in rhythm.  I was given Atenonal but after a few months realized they didn't seem to help.  Asked my doctor about it and he said "won't hurt to take it but probably won't help if you do".  So....I quit taking them.  The pain I experience is a heaviness or tightness in my chest along with pain on the left side of my chest.  I also experience the back of my lower front teeth hurting.  I agree that stress aggrivates it.  It has been very frustrating because you know something is not right and your heart is beating off rhythm and you are fatigued yet they tell you "you don't have to worry just live with it".  I would like to hear from others who are experiencing the same.  I'm 50, 5'3" about 140 lbs.  Don't drink or smoke.  If you have found anything that help, please let me know.

Thanks,

[chriso1960]

I have been experiencing PVC's steadily for the last five days.
Every time I move too quickly it seems like someone in kicking me in the chest and I feel an intense need to cough.

I am 46 years old and I work out on a regular basis-cardio with weight training.  I am about 35 pounds overweight but I do not drink alcohol or smoke.  I gave up all caffeine hoping it would help but it hasn't.  Now I'm even afraid to work out.

Can someone offer some advice.  At this point it's beyond annoying, it's scary.

Thanks.