PVC's are now constant

[RNRita]

I have had PVCs, PATs,and Vtach leading to SVT since I was 20. I have been to several cardiologist with the same results. Benign. Lately, I had an attack of a few PVC's in a row followed by a tachy rate that I could not count. It lasted for about 5 minutes.  It happened again right before a trip to DisneyWorld. It ruined my trip). Again, EKG showed nothing.  I do try to eat pretty well, and take supplements.  Now I started a new job that I love, but I am TOTALLY exhausted all the time.  Plus my PVCs have started coming constantly, probably thousands a day, with couplets, FELT:(kick in chest, sharp pain, tightness for seconds, breathlessness at time of palp). No ignoring these. I had a holtor and an event monitor before the symptoms got too bad and of course only light PVCs showed on the test. My doctor told me everything is benign with a normal heart and that I don't have heart disease. How does he know?  My chol. is 240, my LDLs are 138 and my HDL's are low.  I have had no stress test or any other.  My mother has extensive cardiac disease.
I take 50 mg of atenelol, and .25 of Xanax daily.  It is like telling me to ignore a sharp pain. I have high anxiety.  Who wouldn't?  But I am really tired of being told that it is causing it. I had PVC's first. I wonder why money is spent fixing men who have problems with their sex lives, but I see no one trying to come up with any help for those of us who suffer with this.  Any help would be appreciated.

[Forum-M.D.-MJM]

Hello,

Sorry to hear about your struggles.  I think the obvious answer to your last rhetorical questions is the men with erectile dysfunction have a problem that can be fixed with a single pill taken when needed, there is no such magic bullet for people with PVCs because PVCs are a problem that we don't fully understand.

Without knowing what workup you have already had, it is difficult to suggest other directions.  A standard work up for PVCs could include depending on clinic circumstances:
EKG
ECHO
STRESS TEST
Holter monitor and if you don't exerpience your typical symptoms, try an event monitor where you will have to wear the monitor for a longer period of time and press a button when you have your typical symtpoms.

If there significant abnormalities on the above tests, if indicated, the work up may include
MRI to evaluate for structural heart disease and rule out less common conditions
EP study and possible ablation of monomorphic PVCs -- if there are too many shapes or morphologies the PVCs, an ablation will not help unless one of the morphologies is predominant.
Signal averaged EKG to evaluate for late potential suggestive of heart disease or scar

Again, these are not tests for everyone, only people that appear to need them.  Just because they are not ordered does not mean that your doctor doesn't believe your symptoms.

If the symptoms are severe, there are medications like flecainide that can suppress PVCs, but success does vary by the case.

I hope this answer the questions.  Good luck and thanks for posting.

[wmac]

Ok if you say that pvcs are not fully understood, then why is it day after day you doctors tell each and everyone of us that they are not life threatening? If you dont understand them then you really dont know.  I would say having these pvcs runs of nsvt and all the other palps  that we all get are the absoulte worse thing anyone can have. They control our lives give us anxiety, make us live in fear on a daily basis and all we hear is dont worry.  I have been going through this for many years now and yes im not dead yet, but sometimes I just think go ahead and kill me and get it over with.This nsvt has ruined my life in so many ways. Yes I have heard that there is no silver bullet but this just doesnt seem normal to have these nor to live like this forever. And yes if this somehow  someway affected a mans sex life I would bet you that there would be a magic bullet soon. Living this way is not living.

[RNRita]

I totally agree.  I am a cardiac nurse.  I have lived with these things for years.  I have studied, studied, studied...maybe trying to do what no one else will...figure SOMETHING out.  I know the feeling of, "Oh just kill me and get it over with."  I have started a new job and fear I will lose it.  How can I concentrate on what I'm being taught when I am getting "jolted" from inside a million times.  I'm not a stupid person by any standards, nor am I a hypochondriac, yet I am treated like one.  My cardiologist told me to "stop putting [yourself] on monitors.  I was astonished.  I am in the middle of feeling like dropping over and cannot get an appointment with a cardiologist.  They all tell me to go to an ED, if it is that bad.  There you mostly get treated like you're psycho.  I am at wits end.  And yes, if they are not fully understood, why aren't there new things being seen each day?  People are certainly working on cancer, heart disease, MS, DM....the list goes on.  There are a lot of us suffering and not able to live and it isn't because we're scared cowards.  I used to be content with reading other people are going through this.  That isn't enough anymore.  I want to LIVE!

[Momto3]

WOW!  You guys definitely struggle with pvcs more than I ever did.  Despite having thousands a day (all varieties) I was fortunate to not have them ruin my life.  Oh, that's not to say they didn't cause me tons of anxiety b/c they did!!! But, I've been to enough doctors are read enough medical literature to believe that even though the medical community doesn't have a full grasp on the ins and outs of pvcs, they do know that in most cases, they do not progress to anything serious.  

Now, if there were miracle cures for anxiety that would be great!  For me, it was more the anxiety than the actual pvcs.

Having seen people deal with cancer, advanced heart disease and other more serious conditions, I'm very happy to see more money spent on researching life threatening conditions.  More reserach into ectopics and potential treatments for debilitating symptoms would be great, but I'm much more afraid of the life threatening disorders.

I'm so sorry that you guys struggle so much with your ectopics.  I really and truly hope that you are able to find peace in learning to accept them as just one of your body's quirks.  I really do understand your anxiety...Hang in there and don't let these buggers get the best of you!  We're here for you!

[skippylu]

I agree!!!! I'm 36 and have experienced these for yrs. but recently after i was asked to do a treadmill test and jolted from the treadmill to the table for testing, no skippies happened.. of course not.. but later that night i had a bout with them which scared the living daylights out of me! i had pvc's for a solid fifteen minutes straight.. i was worried about croaking but didn't want to get up for an ambulance for fear i'd aggravate the situation.. i took and asprin and put my knees up, then 30 minutes later it happened again for the same length of time! i freaked and immediately removed all caffeine from my diet. i did a monitor and was told the are "benign" and given a patronizing grin  when asking if they could be fatal and could my nutrition be altered to help.. "no"..
screw this, i am looking into it s much as i can. I myself have ASD and supposedly MVP which i wonder if are connected. my cardiologist mentioned the Amplatzer device to close the ASD and i asked if it would make the PVC's stop but he had no clue.. what the heck? who's got the answers? who's doing the research? what's the solid data?
i wonder, with such an increase in thses things,is it related to something outside of the body physics such as environment.. what with the advent of Microwave ovens and cell phones.. do these things affect the electril wiring in our bodies? someone needs to think outside the box!

[pugfriend]

I am so sorry for your distress and in one way glad to hear someone is as frustrated as I am for the lack of understanding of this problem.  I have had heart palpitations of one kind or another for over 30 years. I have often hesitated to seek medical attention because they just look at me like I am crazy. I too was ( retired) a nurse and am not stupid.  I try to keep going when the PVC's are happening but it sure is hard sometimes. The worse is when I get a run of something that feels like my heart is turning flip-flops for several seconds. Really leaves me weak. I can't connect these episodes to anything such as anxiety. In fact, when things have been really stressful, like losing a loved one or starting a new job etc., I don't seem to have the problem. It is usually when I am just sitting around watching t.v. or reading. What a mystery! I wish someone, like the doctor on CNN, would do a story about this problem and give it the attention it deserves.  There are too many of us out here to ignore it any longer.    I know that having this for so many years and am still here is why doctors tend to ignore the symptoms.   One time I kept having severe sinus infections. All at once I got a large growth above my nose right between my eyes. One doctor said I needed surgery right away, one said it was just fat and the third did a biopsy, sent it to Mayo Clinic and as I suspected it was from the sinus infections and it eventually went away.  Ever wonder why they call it Practicing medicine?    The point being they don't know what causes PVC's and such in a structuraly normal heart. But is it really normal?  I don't think so. Otherwise it wouldn't feel so bad.

[jeff 67]

Hi wmac,

You asked why do the doctors continually tell us that PVC's in a structurally normal heart are not life threatening when in the same breath they tell us they don't really understand them.  The answer is STATISTICS.  You don't need to fully understand something to be able to assess risk.  By examining a large sample size of people who have "normal" hearts and then looking at mortality rates for those with and without PVC's are risk difference can be determined.

[frs87]

PVCs as a harmless symptom is disseminated because life experience shows that nothing bad happens with people who have them.

But I do get the feeling of frustration. The fear that they always going to turn into something worse. Fist they said my PACs were inoffensive until it turned into a SVT. Then into a AF. Then I was cured because I had an ablation, but PACs and PVCs continued. Now they turned into a STV AGAIN!! It is so frustrating. Now they are going to say it is benign and I won

[RNRita]

Well, it is nice that everyone is posting of their experiences, but please understand that some of us feel them more than others.  It isn't because we want to, or that we can't ignore them because we're weak, it is just the way our bodies are.  I am 50 and have had this since I'm 20.  That is 30 years.  It has NOT killed me, but has caused me much distress.  Although, when I am not having problems, it is amazingly easy to counsel others not to worry.  I forget how bad it feels when the times are rough.  Also, they change over time.  I have experienced the gambit of sensations and the ones I get before falling asleep used to be quite comforting!  Can you believe that?  I have had bigeminy...well, the works.  Remember, I work in a critical care cardiac unit of a major hospital.  I have seen a lot.  Maybe I've seen too much.  I also think I get through the most stressful times with little palps.  They seem to come when I am winding down.  This time, however, they are with me for days and the accompanying feeling of exhaustion is what is scaring me.  I am wondering if I'll ever feel like my old self again.  I do understand the need for funding of terminal, serious diseases.  I will never dispute that.  But they do research for many things that are not terminal.  How about this one?  One more thing.....how about all the people who drop dead for no reason?  Sometimes I wonder.

[tickertock]

I understand everyone's frustration with the PVCs and believe me I had my share, in the 1000s daily for up to 6 months non stop luckily I rarely have them anymore(that's mystery also). I MUST agree with the FORUM MD and JEFF 67 though Statistics show that those with PVCs in normal heart have about the same risk as those that don't.The FACT is most people have PVCs but most don't feel them so they are not worried.Doctor's do understand what causes them to a certain extent irritable ectopic foci in the ventricle/s, what they don't understand is why some feel them and others don't, usually the irritable foci is irritated by stimulants, stress, hormones and other factors too numerous to mention.Why they wax and wane is also a mystery as this the pattern with the majority of sufferers, all I can say I feel for anyone who is tormented by them as the symptoms can be downright debilitating for some, others are able to get by.PVCs bother a minority persons, others have them in 1000s daily and don't know, I think the key is findings a way to completely numb the sensation and not necessarily abolish the PVCs, PVCs are a part of normal heart action to certain extent, such as other body functions like  burping and passing gas.Hope everyone gets relief soon, but for the last 30 years this has been a phenomenon that has raised eyebrows and panic in the medical community before it was holtering monitoring and other sophisticated studies that have shown them to be "harmless" in the majority of persons, nowadays people are sent home from the ER feeling like they have been betrayed or brushed aside as if they are "neurotics".Hopefully in the very near future the feeling of PVCs will be a thing of the PAST. Best wishes to all.

[Carrie41]

Hey Rita.  Just out of curiousity since you are a Cardiac Nurse can you tell me how many people you see with PVC's?  Is it true that everyone gets them?  Some days I get on a few and other days I get 100's.  Doctor says everyone gets them?  Do they really??

[Forum-M.D.-MJM]

There is nothing like a PVC post to stir things up.

To clarify:
We don't fully undertand what causes PVCs, but we do know that people with structurally normal hearts statistically do very well over the long term.

Believe it or not, everyone has premature beats, atrial and ventricular, at varying frequencies.

It suprises me that people think that doctors are withholding the big PVC secret.  If you want to take a completely jaded approach to this -- if there was any proven risk to frequent PVCs in structurally normal hearts significantly increases risk of death, we would be putting defibrillators in everyone.  Remember, the financial structure of the US health care system is still based on productivity. Procedures based treatments reimburse better than clinic visits.  If there was any reason to do more procedures and be justified with data to support it, we would be more aggressive.  The data is simply not there to warrant aggressive treatment of PVCs -- there is more risk to aggressive treatment. Reassurance is the standard of care.  In some people the symptoms are severe and affect quality of life -- it is this group that we consider additional medications if beta blockers fail and possibly even ablation if appropriate.

I am not trying to minimize symptoms.  If your symptoms are severe, additional treatment options may help.  People may not like the following statement but I think it is true.  If anxiety due to the fear of sudden death is main limiting factor and the PVCs stimulate that fear, the safer treatment is to treat the anxiety first with a medications like an SSRI.  Medications like flecainide have risks, more risks than than PVCs alone.  This is the reason we like to avoid them.  Why I talk to people about treatment of PVCs, my impression is that they think I am trying to minimize the symptoms and indirectly tell them they are crazy at the same time.  Fear/Anxiety is a major component of this condition and if it can be treated with a safe medication like an SSRI (prozac, zoleft, ect), it is worth a shot if it may improve your quality of life.

[RNRita]

I truly believe everyone gets them.  I watch monitors 8 hours a day/5 days a week.  Some with the worst hearts have none that you catch by watching, but mostly everyone does have them when they come in.  That includes people who are there for other reasons but are on watch.  I have seen one discharged at the age of 42 with abrupt onset bigeminy (two days) and they told her it was benign.  That was when I really believed I was okay.  Some of these people with the WORST NSVT and even VTACH do NOT feel a thing.  Can you believe it?  So I totally agree with the person who said it should be a matter of making us not feel them.  It is more the horrible sensation anymore for me than fear of dying.  Heck, I'm almost resigned to that one day...hahaah.  Unfortunately, I think it would be easier to figure out how to stop the PVCs than figure out how to numb US!  But what a novel idea!

[Carrie41]

You have no idea how much better I felt reading your posts.  I honestly can't believe that people don't feel these things.  I feel every little skippy skip skip it does and HATE it.  I have an excel spreadsheet I keep tabs on these things and I do get them everyday.  I HATE the sensation.

I sometimes get them one after another for hours on end always figure it is the end of me.  I only had two today but it still freaks me out.  I did try the SSRI route but it didn't seem to take away my anxiety about these things.

I had to laugh at the comment from the doctor at the clinic though.  He is probably totally right in saying they would be more aggressive and putting defib's in everyone if they were deadly.  

I just don't get it that my friends don't feel these things but I can be sitting at my desk at work and it feels like my heart stops and then jiggles around and then starts again.  It can do that every couple of beats and then go back to normal.  I mean how normal is that????  I just hate them.

I have had every test because of I keep on going back to the doctor saying there is something wrong and they keep on telling me that nothing is wrong and I have a normal heart.  I just don't get it.  I wish there was a magic pill to take to stop me from feeling them.

RNRita do you get skips and drops and other weird sensations every day as well?  I wish I could get it thru my head that I am not going to drop dead but I sure feel like it when these things are happening.  I am terrified of my own heart!  How crazy is that.

[Carrie41]

Okay I was just laying in bed and thinking about it and I had to come back to the computer to type this.

So let's say a healthy person (like myself), age 43, gets let's say 3 PVC's or PAC's per hour.  Is that NORMAL???  That is 3 per hour not per day.

I need reassurance that it would be a normal occurance in an normal heart?  Any comments?  

[CollegeGirl143]

3 per hour is not a high instance of pvc's at all.. That

[CollegeGirl143]

by the way, that post was in no way directed at any one person, just my personal feelings on health related anxiety and the cardiologists role :)

[tanns]

I have really appreciated your input, answers and advice over the past couple years.  I find it truly amazing that you answer questions and often come back and repost to address the comments from us afterwards.  It shows that you are really concerned about us and our continued fears about PVC's (and other issues).

Thank you for your time.

[RNRita]

Yes, I have periods where they come right on top of one another.  PLUS they can feel differently each time.  Sometimes a kick in the chest, sometimes I feel like I have to cough, my chest drops and rolls, I get lightheaded but never have passed out (scary when driving), sometimes they are positional. (One time driving home from work it got so bad I felt the need to take all my clothing off, beat THAT!) Sometimes I only get a few a day.  Those days are a blessing.  This week they are more than 3 a minute, maybe 10 or more all day long!  Like I said, I've had them for 30 years and I've gotten used to some, but the ones right after another (sometimes I don't even feel a normal beat in between) make me a little woozy.  Unfortunately, those (I think they're couplets) never showed up on a holter or event that I know of.  Also, I have some periods in my life where I go without any that I feel.  After a time like that where I am normal, going back to having them all the time makes them seem even worse.  Like I said, I have to work.  It is a new job.  It is hard to concentrate.  I am just hoping they give me a rest for a while.  I wish there was a support group.  Maybe we could all talk about them for so long we'd just get SICK of it...hahahah. And the THINGS WE DO!  A spreadsheet?  I found that funny, but I'll bet you would find this funny:  I've considered buyiing my own EKG machine, holter, and/or defibrillator!  

[RNRita]

I forgot to mention one thing in my original post (We only have 1500 characters).  I have always had normal EKG's which was a comfort.  Well, I also have another job (lots of nurses have more than one) and they were testing the new EKG machine...on me.  It showed a left fascicular posterior block.  Now I KNOW I've seen that show up on an EKG in the ER when I went there for a terrible virus a few months ago, but no one even mentioned it there.  It means that I have a possibility of underlying heart disease.  Yes, my Dr's are telling me these mean nothing only because I have no heart disease.  I think that is why I am questioning everything again.  

[ireneo]

Wow, well said. I agree with all that you've written. I understand when someone develops an arrythmia and they don't know what's happening. There's the fear of the unknown. But once it's checked out and it's a healthy heart just acting up occasionally, then it's best to adjust and go on. Since I've had arrhythmias all my life I've had plenty of time to adjust. I see it in the same realm as learning to live with an arthritic finger (sore, inconvenient and bugs you but not life threatening). PVC's at 3 a minute is not extreme. A couple winters ago my heart became a brat and was hiccuping at 15-25 per minute all day and night. I couldn't figure out why it changed. I wore a monitor, found out it was PAC's and PVC"s (duh, I knew that) but everything looked fine. So on I went with my life. Took 5 months but it all settled back to my normal routine of 1-6 per minute. Yes, they can hit hard, take your breath away for a moment, even make you feel woozy. But they're still benign. I just know they won't kill me and that's good enough for me. I like my life.

[Carrie41]

Wow what posts huh!  I can't believe the people that suffer with these things.  I really laughed at RNRita's post about buying her own defib and ekg machine.  Well if it makes you feel any better I have purchsed a stethscope and like to lay there and start getting anxious over my heart and listen to it skip.  I don't know why I want to do it beause it just scares me listening to it.

So everyone thinks 3 or so PVC's a minute are nothing huh.  That gives me a bit of confort I guess.  I don't really even get that many but sometimes it acts up and does start at three or so a minute.  I have always read that if you have more than 6 a minute you should go to emergency.  When it does act up and does one every second or third beat I always think this is the end I guess.  I would give ANYTHING to get rid of these.

I don't believe the cardios when they say nothing is wrong.  Why doesn't my cardio get them?  He said he doesn't get PVC's so I think he doesn't get it.  My friends don't get PVC's and I don't get it.  I feel every one of these missed and dropped and extra beats.  How do people not feel these if everyone has them???  I don't get that one!  

[RNRita]

Oh, I love you people.  I am SOOOOO not alone here.  Carrie, you like to listen to your heart with a stethoscope?  I have two, but I'd rather feel my pulse...HAHAHAA  To each his own.  Everyone here has valid points.  You guys, like me, have researched this material.  No one wants these.  When I have a few a day they are NOTHING.  I am telling patients at work the same things some are saying here:  "Just live your life."  For about 10 years they have not bothered me much at all.  I have been through stressful school, got married, started great jobs, moved to three new houses, and went on many fun-filled vacations.  I've started my own very successful business and realized my dream of being a nurse.  I guess you could say I didn't let them bother me.  Why all of a sudden are they horrible now and I can't get past them, you might ask?  Who knows? We all have different experiences.  I am going to try to live one day at a time.  I think my exhaustion is coming from worry which exacerbates these things.  I don't know.  I just don't like my cardiologist (who also doesn't get these, as he says) telling me they are nothing.  I've been reading obituaries again.  Three people under 55 were "stricken at home."  All I can say is, it better have been by lightning!  

[ireneo]

Oh, thank you for the laugh. People being stricken at home, it better have been by lightning. Very good!

I do own a stethoscope but I use it for my asthma.

I expect/hope to live much longer (I'm 54 now) in spite of my arrhythmias since many women on my Mom's side have them and they've gone well into their 80's. I do work hard dealing with wildlife. Even with my wacky heart I manage to grab Bald Eagles, lift 45 lb beavers and wrestle with angry raccoons. And that's just a start. I don't know much about statistics, don't trust them that much but I know things are OK for me for the time being.