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PVC's and Vagus Nerve
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PVC's and Vagus Nerve

I've had chest pains and PVC's for 7 months now.  Good news is I'm finally more or less convinced I don't have cardiovascular disease.  I suppose at 35 yrs old, having passed Thallium and Stress echo's, combined with acknowledgement that I do have PVC's but I am able to exercise at 85-90% of my max HR without chest pain is enough to get me 90% of the way to "thinking normal rational thoughts".  It has been difficult for sure as I do have a lot of jaw and left arm pain, but I now believe that has a nerve/muscular cause as those symptoms are getting worse, but are easier to pinpoint now.  That said, a few questions.

1.  My PVC's generally get worse as the day goes on or after I exercise.  I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal?  Any reason for this?

2.  During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120.  Cardiologist said this was normal?

3.  Is it possible that a vagus nerve problem can cause PVC's?

4.  The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this?  Or does it have a mech of action?

I want to thank you and everyone here for their time/posts.  This has been a difficult 8 months, and while I'm not back to normal yet, I'm no longer convinced I'm going to die, I still have thoughts that concern me but I'm at least 85-90% better mentally.
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Hi PED,

1. My PVC's generally get worse as the day goes on or after I exercise. I can wake up and feel normal and have very few PVC's, but later in the day they get worse, and sometimes after exercise. Normal? Any reason for this?

PVCs present diffently in different people.  There is still no clear explanation for when they decide to show their face.  Some people can recognize triggers like coffee, soda, sugar, exercise, etc.


2. During my stress echo, as my HR went above 120, they completely went away during my stress echo, only to return as my HR dropped below 120. Cardiologist said this was normal?

This is normal.  Faster heart rates tend to suppress PVCs.


3. Is it possible that a vagus nerve problem can cause PVC's?

There is no data that I know of to suggest this.

4. The doc said a low dose beta blocker might be useful (toprol XL), besides side effects, it doesn't make sense to me as my PVC's seem to go away when my HR rises, wouldn't a beta blocker prevent this? Or does it have a mech of action?

beta blockers decrease PVCs in some people and not others.  Beta blockers do decrease the sensation of PVCs.  These are the reasons we use them.   If you think the beta blocker makes them worse, there is no harm in not taking them any longer.

I hope this helps.  Thanks for posting.
23 Comments
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Hi. I have had the same problem recently. I have palpitations and PVC ( prematural ventricular contractions ). I am a little overwieght and i suffer anxiety problems / my most fear is that i am going to die becuse of this. I have being checked by a doctor and he did an electro and he said it is ok, I have PVC but it is nothing to worried about. I also have chest pain, and pain in my jaws, arms and shoulders ( That scares me a lot cause I think  I am going to have a heart attack ) Are you taking any medication? I am taking Atenolol 50 mg a day for the PVC and Clonazepan for the anxiety. I feel quite better but the PVCS are very bothering. I know how you feel.
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Only meds I'm currently on are Altace for BP and Zetia for Cholestorol along with a baby asprin.

Yup, they wanted to load me up on Xanax also for "Anxiety" which seems to be the cop out these days.  I tried it, it did nothing other than get me all wound up after trying to ween off of it.

My anxiety, if I had it was over potential heart problems.  Chicken or the egg.

It was nice when I finally got a cardiologist (3rd I went to) to finally listen and talk a bit.  I could tell he also felt it was a bit of anxiety, but at least took the time.

Young people get short changed when it comes to cardiology.  I'll bet many additional appointments could be avoided by an extra 5 minutes during a first.
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I have had PVC's for 7 months. Started out of nowhere. The feeling was so undescribable, terrifying and could happen at any time for any reason. For months I went to the doctor(s), pulmonary, cardio, internists...had every test done. They scratched it up to anxiety when I started to break down in their offices when all the tests were coming back normal and they said there was nothing wrong with me. I knew there was. I was anxious now, on top of frustrated and depressed cause these things weren't going away and I had no clue what they were, where they were coming from and what triggered them. The feeling was in my throat, neck and chest. Sometimes felt like little electric shocks, sometimes felt like spasmsm, but the bad ones felt like I was falling down a hill, like a pit in the stomache type feeling, even (for the ladies) almost like a menstrual cramp right in the chest. Scared the hell out of me. After doing some research on my own, I found my symptoms could be heart related so asked my doctors to do a holter. Said I didnt need one cause of all the negative tests. Said it was anxiety. I persisted and got one. Showed some PVC and PAC but they didnt match up my diary to the holter (cause i think they just entertained me with the holter and still said it was anxiety). Found myself and electrophysiologist who agreed to a two week holter just last month. Half the times I hit the record button it showed I was getting PVC, PAC or Sinus Tach. So I FINALLY GOT AN THE ANSWER. Although I am still frustrated as to why these things started at all. What wasnt captured on the holter and has me a little concerned is the BIG ONES, the ones that feel like the going down the hill feeling...I calmed myself enough to feel my pulse the other day when I got one and I could feel the pause in my beat several times in a row. I wonder if these are just RUNS of PAC/PVC or something else. I told my ep and he said he didnt thinkt it was anything to be concerned about. I asked what could be done to help the feelings they bring and he said IGNORE THEM. I got upset with that. NO WAY I CAN IGNORE THEM. He told me to try LEXAPRO for a month to see if the "calming" helped. I asked about beta blockers and he said they could be worse than the PAC/PVC and plus I have nothing wrong with my heart so no need for beta blocker.

It took me MONTHS to figure out what was going on...feeling was so bad...thought I was dying. Once I found out it was these beats and found this forum...I was relieved to see it is somewhat common  but still worried SOMETTHING WAS WRONG WITH MY HEART AND THEY JUST DIDNT FIND IT YET. I am trying to find a way to cope with this the best I can. I can handle the little ones, bu the BIG ONES, I still panic. I just can't help it.
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Avatar_n_tn
Hey,

Believe me I know how you feel to a T! It's totally normal for someone to feel the way you do considering the terrifying feeling associated with these darn palps. I have a routine check up tomorrow with my cardiologist and I am really looking forward to another conversation and the chance to ask some more new questions I have regarding PVC's since...you can't learn enough about them before you hear something else new! haha.

I hope that you are able to put the past scary and difficult 8mths behind you and that you can move on step by step into a worry free or at least very low stress life style. And everyone is different so don't compare yourself to anyone else, just listen to your cardio, trust them ok? Once a 3rd opinion comes around good, trust it, believe in it, your ok. A 1st opinion from a good cardiologist is great too.

I wish you the best and keep reading this forum, the archives on palps are a great place to start! :)

Take care,

Nurse Kagome :)
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I have found that atenolol total of a 100mg daily in divided doses, plus 25mg of cozaar twice daily combined have reduced my PVCs to almost 0, but I think for some reason it is the combination of the beta blocker with the ARB and not just the beta blocker alone, I take it for optimal B/P control, also for PVC and tachycardia episodes. I'm lucky not suffer from any of the dreaded side effects of beta blockers. I know just how horrible those PVC can make one feel , especially the bigeminy epiosdes.Hope everyone gets relief soon.
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Talylor, have you read any literature, on the internet or in a book on heart disorders at the bookstore, about what is happening in your heart when you have a pvc?  The heart's chambers are elastic; they receive and pump out basically as much or as little blood as comes into them from other parts of your body.

When you have a premature or early beat (that's the one you will probably NOT feel), there will next be a pause in the regular rhythm, until the next scheduled beat.  This pause or delay is not long enough to be dangerous, but it is likely the cause of the weird, sinking, or 'going down the hill" feeling you describe.  Some people are more sensitive to it than others, but I feel this one, too.  Anyhow, during this pause, when you don't feel a pulse, your ventricle has time to get a little more full with returning blood than usual.  Since the ventricle is elastic, it easily expands to receive any extra blood.  

Of course, the ventricle also has to pump OUT the blood it receives.  It's a muscle, and a strong one, so it contracts HARD, like a fist, to pump out what has come in.  That's probably the "BIG ONE" you feel.  It's scary, but's it's almost certainly a perfectly normal response to a small delay in the heartbeat.

These feelings are almost impossible to ignore once you are sensitized to them.  As the doctor here has said, beta blockers may or may not reduce the frequency of these funny beats--but they seem to change the way we perceive them.  You might want to ask your doc for a try.  These drugs are usually not dangerous, but they can make you tired, among other things.

You say you are still worried that something is wrong with your heart, and that the doctors just haven't found it yet.  This is something you simply must get over, because it is not helpful in any way.  Believe it or not, docs do learn very difficult stuff in medical school. and we all  understand that--otherwise we'd all go to medical school, right?

Doctors learn how to recognize dangerous conditions, and they have no interest whatsoever in missing a diagnosis or having a patient die on them.  That hurts their pride, for one thing.  You have been checked out very thoroughly, and have been told that your heart is healthy.  You have undoubtedly noticed by now that you can do your usual, daily activities, right?  This means that you are healthy, in spite of the irregular beats.

It is not difficult to get an understanding of how the heart works, how the beat starts, how it spreads through the heart, and what kinds of things can cause changes in the rhythm.  If you cannot accept what your doctors tell you, I suggest you take an anatomy and physiology class at your local junior college.  The fees are usually quite low, and anyone, really anyone, can learn this stuff--provided he or she is willing to study hard.

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Avatar_n_tn
I have a similar situation where my pvc's get worse as the day goes on, and speaking of the vagus nerve, they seem to get worse after I eat. Not so bad if I have just protein and complex carbs, but if I have any simple carbs; bread, pasta, rice, sugar... they come on like gangbusters. I have noticed something interesting recently. I am taking antibiotics for Lyme disease right now and I have not had one pvc since starting the course (even after eating a chocolate eclair AND a raspberry cheese danish today!) I also noticed last year when I was on antibiotics for three months (Lyme again), I had no pvcs. Anyone else ever notice a decrease while taking antibiotics? antibiotics are supposed to have an antimflammatory  effect and I'm wondering if that has something to do with it.
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Some physicians are better listeners than others too.  Read alot of the posts in here and see if they sound like you, that may help you. I know I am still not convinced either so I understand. I don't read aboout people having all the symptoms I get with mine, so that makes me feel like they are missing something. Its hard to believe you are 100% when you feel something is wrong. I don't think you were trying to be insulting to the docs, you are simply scared.  I have news, I am a nurse, and I have had anatomy and physiology and I was on the deans list also......and I still have questions about my pvc's, so just keep digging for info and read in here. I hope you feel better soon..........sometimes they just go away after awhile too. I wish that for you. God Bless
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I feel all your pain as I had these PVC's a few months back.  Scared the you-know-what out of me...

I had all the test at the Cardio..EKG, Holter, Stress-Echo, and all came back fine.

What finally made my PVCs go 99% away was starting a daily supplement of Magnesium Citrate.  I take 400 mgs a day (one am, one before bed), and maybe once every few weeks, I'll have one or two PVCs.  If I still have them more often, I'm definitely not feeling them, and that's good enough for me.

Just wanted to offer the magnesium suggestion...

God Bless,
Mike
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Al Dente...My cardiologists, who I was seeing first, after the 24 hour holter said I was getting rare PAC/PVC with NSR and that I could try a betablocker if I wanted. Gave me a RX for Toprol 25mg. However, he said TAKE IT ONLY IF YOU CANT DEAL WITH THE FEELINGS and still wasnt quite sure I was actually feeling these beats or just having anxiety. He said EVERYONE would get these beats showing up on their holter. So I was hesitant to take a heart medication until I knew for sure. That's what sent me to the EP. He was the one who did the 14 day monitor and told me he thought, although I was getting these beats, I more so had GAD (General Anxiety Disorder). Of course I told him that was SECONDARY but he told me I needed to compromise with him and try the Lexapro for a month or two and see if it makes any difference, if not, he would try something else and do other testing (CARDIO/PULMONARY STRESS and another ECHO) because I also have been having chest tightness, been SOB and just generally feel weak and odd on the left side of my body since this all started.

I don't know what MRUI's are. SSRI would be Lexapro, correct? I read that could cause palpitations but and a fast HR and I was concerned about that but he told me I need to stop worrying about all these things and listen to him. I told him my cardio mentioned the betablocker. (oh yeah...went to an EP who didnt even check my pulse or run an EKG in his office or look at all my test results and just wrote me a RX for a calcium channel blocker (Verapamil)but I was hesitant to follow that. This second EP said no to both. In your post, you said you think Lexapro WONT work? and a beta will???

NurseKagome...I find myself having questions all the time. I truly go thru stages where I think I can handle it, think they are going away and then BAM I get one and I fall two steps back again. I get different feelings:

1. Quick shock like feeling.
2. Little/Big thumps.
3. Feeling of fullness or "pull" in the neck (lasts a second)
4. The SINKING feeling (that I now know the BIG ONES come from the runs of these beats and they always feel like its never going to stop. Terrifying)
5. Quick "push" or "pressure" in throat

I was convinced for so long that all these feelings must be DIFFERENT things causing this and wanted to wear a monito til I caught all of them. Again, doc's say "YOU ARE FINE". I told them "but i didnt have a BIG ONE being monitored...what if that is something dangerous?"...his answer...TRY THE LEXAPRO!

Woodruff...I believe you were one of the ones I corresponded with on this forum when I first came here (about two months ago). THank you for all your knowledge and advice. Believe it or not, I have done alot of research trying to figure out what exactly is happening in my body when these things come on. Also, alot of my knowledge has come from reading posts on this forum. I can't believe how much rings true to how I feel and what my concerns are. I truly thought I was losing it for quite some time there until I discovered this wasnt something all in my head or something I was taking way too over the top. THESE FEELINGS CAN TRULY SCARE PEOPLE. I tried and still try to this day to have my family and friends listen to this aspect, cause all they say is THE DOCS ALL SAY YOU ARE FINE SO I DONT KNOW WHAT YOUR PROBLEM IS NOW. They just have no idea.

Because I have SOB, chest tightness, sometimes heat feeling, sometimes numbness in left arm and hand, I STILL have a WHAT IF? that I cant let go of. But I am tryng.
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Avatar_n_tn
Hell to all, Taylor, I know all to well the way you feel. I myself can handle the PVC'S that don't make the hard thump. But the ones that cause that sinking, adrenalin like feeling in my thoart and begining of my chest drives me out of my mind!!!!
I am vacationing in France right now, the other night started getting PVC'S with the really hard THUMPS, I am thinking how can this be "normal" went to a hospital in Paris, what a nightmare!, nobody spoke a word of english, got an EKG. All they could say is no heart attack. I am counting the minutes to get the hell out of France and go back to San Diego to see my Cardio. Those beats I was having the other night were not normal, and they didn't even hook me up to a monitor to watch the rhythm, so none of these beats were recorded.
Best wishes
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I know that the very same PVCs can feel different, some light, some strong, some like a double rollover and then a hard thump, some like a sinking feeling that takes your breath away.

I had them documented during an exercise stress while having a bad episode of them , nearly every PVC I had during the test felt different, yet everyone was a unifocal PVC originating from the very same spot, probably had a total of about 10-12 PVC during the entire stress test at just about every heartrate maximum beats achieved was 171 bpm which was about 93% of the max predicted heartrate, I was just about to turn 37, so the max predicted heartrate was 183bpm. I was told I just needed to get my heartrate up to 155 bpm which would have been 85% of max predicted heartrate as far as i was told that was the percentage you need to achieve for the test to be rated as fairly accurate. I'm just trying to say that the very same PVCs can feel quite different at times, I really don't know why but that's just the way it is. I think this is reason why so many patients think that their doctor/cardio/Ep must have missed something, 99.9% of the time nothing is missed of course nothing in life is 100%.
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I guess I do question and wonder and panic when the feelings are different. And I guess for my doctors to tell me YOU ARE FINE without catching one on the monitor I need to focus on that. But it can be hard at times. The other day, when I felt one coming (I can sense the strong ones coming on sometimes)...I calmed down enough to check my pulse and to feel that pause over and over (runs?) was so overwhelming. It passed of course, and I am still here today...but God how I wish I never had them at all and never will have them again. Doc says I have a RARE ones...only a few a day was caught on the holters. I know people get hundreds and thousands so I sometimes feel WHO AM I TO COMPLAIN...but honestly...to get feelings that make you feel like you are going to die (even though you know you are not) a day here and there is simply hard to cope with.  

I also never know what will trigger them. Sometimes I can all day with one little one. Or a day with one BIG one or a day with alot of little ones and then a day with nothing. Sometimes a deep breath. Sometimes cleaning. Bending. Sometimes after exercise or going up a flight of stairs. What freaks me out is sometimes I can feel my left chest almost filling up, almost like it is enflating like a balloon and then one will come or...if I stop what I am doing...it will simply pass. I HATE THAT. Goes all the way up to my neck. I mention all this stuff to the docs and they still say YOU ARE FINE. Meanwhile, I think angina, an undiagnosed arrhythmia, a disease, a clogged this or that...yes...i ran and sometimes still run the gamet in my head.
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The EP gave me the Lexapro 10mg. I got upset and said I wasnt going to take them that I would rather take the Topral my cardio doc gave me. He said no that, at least no for now. I reluctanly took his Lexapro samples and on my own, cut them in half to start only on 5 mg (which I was told by my nurse friend was safe) cause I want to see if ANYTHING changes. If not...I want to wean off as easily and fast as possible. I am very mad about taking this but I felt at the time I had no choice. Been on it over a week now.

I live close to NY and had made an appointment with one of the top 10 best EP's in NY who works out of Mount Senai. Made this appointment weeks ago. My family thought I was nuts but I think I need someone who REALLY knows what he is doing. Not saying my other doctors are quacks or no good, not at all...I like them. But this anxiety diagnosis has me frustrated to no end. I know that is not the cause of my problems.
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Taylor, your posting is interesting to me, it sounds to a T what I am going thru. I do not want to take medication, my blood pressure runs80 over45 most of the time and my pulse dips into the low 40's. I understand all these drugs make these worse!!
I know when I will have a "bad" day of PVC'S. I know which ones will cause me the most grief. Anybody out there know of any good doctors in the San Diego or Los Angeles area?
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cupcake...my BP and HR, as my docs tell me, has always been normal. On the monitor, my highest HR was 155 and my lowest was 54.  I asked about this since it came up Tachycardia and Brachycardia on the results but the EP said it was "normal" and the high rate was due to anxiety most likely, even though I told him it was after exertion (exercise, climbing stairs, cleaning, etc...)...yes, very frustrating. Just got one quick THUMP in my throat as I was typing this. HATE IT!!!! Taking a deep breath, even swallowing sometimes brings them on. How is one supposed to IGNORE that???? Unbelievable!

I am upset I am taking the Lexapro but felt cornered into it almost. Hoping this doc in NY next month has more/better insight.
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Avatar_n_tn
Taylor, you are taking Lexapro, and is it working at all ?? I have never taken any meds, my doctor of eight yrs says it's not my palps that are the problem it is that they make my life a living nightmare. I myself am having some thumps going on, if I were back home in SD, I would go to the ER and have it checked out. I am soooo stressed right now being in Paris, the hospitals here are worthless unless you speak French. I am to the point were I will try meds, I just could not handle it , if it made my PAC'S worse than they are.
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"..I also never know what will trigger them."

Talylor, you will probably never be able to isolate a real trigger for these things.  Very few of us here have.  It's frustrating, but that's the way it is.

However, you say that you get them while cleaning, while going up stairs, and after exercise, but--please notice--you CAN clean, you can go up stairs, and you can exercise.  People with bad hearts cannot keep on doing these things.  They turn ashy-colored, they sweat profusely, they cannot breathe, and they cannot go on.  You do not have these signs of illness.

However, you are very, very of your physical symptoms now.  You even kind of "listen" for them, don't you?  And this is at the very same time that you can undoubtedly see that your body is functioning just fine, even when you feel one of the BIG ONES (which is probably just an unusually strong but healthy contraction of your ventricle).

I have experienced the same symptoms as you (over 4000 pvcs in a day, kiddo), and here is what I have learned:

A beta blocker reduces my awareness of these odd beats, even though it may not change how often they occur.  Beta blockers also make me, personally, too tired to function (though this does not happen to everyone).

However, in less than two weeks, the right SSRI not only reduces my awareness of my irregular hearbeats, but it takes away the habit of "listening" for them.  I mean, it flat takes it away, so that after four or five months on the right drug, I can taper off--and the fear stays away for a long time.  Oh, it may come back in a year or two or three (I get bouts of panic attacks at wide intervals), but in between, I am fine, even though I'm still having the PVCs.

I agree with al dente that a cardiologist is not trained in psychiatry.  Cardiologists do know when a heart is healthy and when it is not.  They do know that anxiety can make innocent symptoms seem worse, but they are not really familiar with psych drugs.

My shrink happens to be an specialist in the chemistry of this particular kind of medication, and we have gone through several SSRIs to find the right ones for me.  Everyone is different, so don't believe it when someone tells you that such-and-such is a "terrible" drug.  It may be bad for that person, but not another.  Speaking for myself, I have learned that Celexa and Zoloft work the best for me, while Lexapro made me very nervous--AND it made chocolate unappealing.  Definitely not the right drug for this person!

Interestingly, not one of the SSRIs made my PVCS worse, not even Lexapro.

Please think about consulting with a psychiatrist on this issue.  In a phone call, you can ask if the doctor specializes in drug or talk therapy.  
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I am second guessing startine the Lexapro now. I am on my 7th day weary to stop and weary to continue. I should have just started taking the Toprol that my cardio gave and left it at that but back then, there was second guessing as to what I was feeling so I and they (cardio and internist) were hesitant for me to start theM. Thats why I went to the EP to be sure and when i got the dx...i was sure he would put me on beta or calcium blocker. I don't help myself though. I get very emotional with the doctors. I get upset and frustrated so they see me break down and WHAM...i get labeled GAD. Believe me...I know I am anxious and emotional. I am on edge never knowing when these things will hit. Who wouldnt be? But I truly truly know that if these things would stop or lessen, I would be SO MUCH calmer. I have always been known as the rock to my friend and family. Always been the strong one, the level headed one, the one who could deal with ANYTHING. And I have had medical problems in the past, had tests and surgeries (nothing major) that everyone who knows me envy's that I could go thru and come out okay...BUT NEVER ONCE SUFFERED ANXIETY OR FEELINGS LIKE I DO NOW...THIS is my main arguement that what I am feeling is NOT caused by depression or anxiety. Something triggered this CONSTANT aching on my left side, hard to catch a deep breath, left sided numbness, SOB and most of all these PAC/PVC. I caved in to the Lexapro out of desperation.
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I wrote my last post before I read yours. Thank you for what you wrote and what you wrote is what the doc told me is the reason why he put me on it. I second guessed the Lexapro because I know I am not depressed or suffering from GAD. I thought this was a bad choice cause it didnt focus on the heart. I thought that was what I needed. I thought just calming me would only help me deal with them better and not deal with the actual problem. But maybe this IS a way of dealing with it. I am very lost. Willing to try anything at this point after months of not taking anything and/or not knowing what to take or even what the problem was. So the Lexapro was the rx I choose to take cause it came from the EP who was the rhythem specialist. I do go to counseling. For the past 3 months now...why? cause of these PAC/PVC. Definitely helps  me vent and talk about my worries, fears and feelings (since family and friends think normal tests results should be all I need to feel "okay").
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"But I truly truly know that if these things would stop or lessen, I would be SO MUCH calmer."

But the thing is, this IS the way your life is now.  This is the way your heart is behaving now.  You will probably never find a trigger.  You will probably never find anything that will make the PVCs go away.  However, accepting the damned things, and realizing--way down inside--that your ability to function physically is NOT affected, will enable you to live a normal and happy life.

"BUT NEVER ONCE SUFFERED ANXIETY OR FEELINGS LIKE I DO NOW...THIS is my main arguement that what I am feeling is NOT caused by depression or anxiety. Something triggered this CONSTANT aching on my left side, hard to catch a deep breath, left sided numbness, SOB and most of all these PAC/PVC. I caved in to the Lexapro out of desperation."

No, there was probably not any physical or emotional trigger that you will ever isolate. I can understand that you are desperate to find one, in the hope that the symptoms will go away, and your life will return to the way it was,  but it is probably never going to happen.

I can also hear your desperation, and since you are now trying to second-guess yourself on what drug to take--thus giving yourself even more pain--I urge you to call a psychiatrist right now.  I mean, get on the phone, and do it NOW.

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" I am very lost. Willing to try anything at this point after months of not taking anything and/or not knowing what to take or even what the problem was. So the Lexapro was the rx I choose to take cause it came from the EP who was the rhythem specialist. I do go to counseling. For the past 3 months now...why? cause of these PAC/PVC. Definitely helps me vent and talk about my worries, fears and feelings (since family and friends think normal tests results should be all I need to feel "okay")."

OK, I see you're in counseling.  That's good.  But after three months, you should be feeling better than you are.  My personal opinion is that you would profit from talking with a psychiatrist--if you are not doing so--because psychiatrists are MDs and can prescribe medications.  There's a lot to be said for choosing the right drug, believe me, and then having regular follow-up visits with your shrink to see how you're doing.
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Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
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3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank