PVCs and Pain

[Leeblan]

First, a little background.  About 8 months ago, I felt a fluttering in my chest.  It lasted for a minute or two, and during this time I felt light headed (anxiety?)  After this, I became more aware of palps(PVCs?) that I have been having most of my life.  Had some pain on upper and lower left side and shoulder.  Mostly 2" above nipple and maybe 1" toward center.  Doctor took an ekg, which was normal(showed slight anbormal sinus rhythym...tach, I think).  A week or two later, felt "pressure" and pain, ER took X-ray and ekg....normal.  Finally, GP ordered 24 hour monitor and echo.  The tech that did the echo said my heart looked "great" and that I had "great flow"  During visits with two Drs, they reviewed echo and monitor reports.  Both said that there was nothing abnormal or "life threatening" Was prescribed .5mg Xanax (I am under a HUGE amount of stress) Since then, palps come and go. Never more than 3/day One really hard beat that feels like my heart is coming out of my chest, then all is fine.  The problem is now I am having these pains again.  I have been really gassy lately (stress?) and when I drink something cold, I feel the cold go through the spots where I am having pains.  My question is, could they be stress induced gastric probs, muscular tension, or should I get more tests on my heart?  I should note that I do quite a bit of strenuous work with little or no shortness of breath, and no increase in pains or PVCs.  Also, when not thinking about pain or doing something fun, I rarely if ever feel it.  HR usally around 80, never more than 120.  BP averages 125/75

[Mar285]

A related discussion, PVC's was started.

[Niki9682]

I have the fluttering that you describe as PVCs, but I also have tightness and shortness of breath.  I'm at a loss as to what to do because I have no medical insurance.  I don't know where to go to have this checked out.  Is the tightness and shortness of breath common with PVCs?

[debigriffs]

I am a 46 year old female with a history of fibromyalgia (since 96)but otherwise, fit and in good health, B/P 110/70. In June of 2002, I became sick with a mysterious illness (later determined to be a virus) which had the major symptom of orthostatic hypotension as well as other maladies. After a week I was only able to crawl on my hands and knees due to fainting/weakness. I was sent to Stanford Medical Center where I spent 10 days. I had an echo cardiogram, blood tests, tilt table testing, etc. Their diagnosis: Orthostatic hypotension and gave me proamitine. The proamitine made me sick and I kept trying to tell them it wasn't helping. THey sent me home and two days later my GP at home took me off the Proamitine as he believed it was a virus. After 9 long weeks I started to get better - no more symptoms - just time to build my body and life back.

In March of 03, I started to feel bad - tightness in my chest, squeezing in my left arm. I went to the ER. My B/P was 160/100 and my pulse was 160. EKG showed no abnormalities. I was given an Ativan and refered to a cardiologist. I went on a Holter monitor and had a stress echo. Holter monitor showed several instances of 148 BPM while showering, or just sitting and several PAC & PVC's some coming every other beat. Stress echo showed several PAC's & PVC's that lessened with exercise - a good sign they told me. After reviewing the Stress Echo & Holter info, I was told I have PVC's & PAC's and they are benign and to just deal with them unless I can't then they can give me beta-blockers (which I don't want). When I asked why all of a sudden would I start having these uncomfortable and very persistant PAC's & PVC's they said they didn't know. WHen I asked if they would go away as quietly as they came they said no.

Can someone tell me why these all of a sudden crop up, and what can be done about them? I have one - usually more per minute and they are uncomfortable. I can't belive they are really as benign as I am being told. Organs just don't start acting up for no reason - do they? Thank for any assistance!

[CCF-M.D.-KE]

Dear Leeblan,

Sorry to hear about your palpitations. Have you been diagnosed with PVCs? The echocardiogram report you mentioned suggests that you have a structurally normal heart. In this setting PVCs have no impact on long term outcome. If you are experiencing PVCs beta blockers would be reasonable first therapy to improve symptoms. You report being very active and in great shape. Given your level of fitness your doctors should also consider other sources for you pain such as the chest wall,
GI (gastrointestinal) tract or anxiety.

An exercise stress test would not be unreasonable to evaluated your functional capacity. However, from what you have mentioned thus far you are likely in low risk population and probably would do well without a stress test.

Thanks for your question,


CCF-MD-KE