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Heart Disease (Expert Forum)
PVCs?
Answered by
Cleveland - OH
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PVCs?
by JasJas, Oct 12, 2004 12:00AM
Thank you for taking my question.
I have had skipped heart beats on and off for about 5 years. I’m 42 and about 40lbs over weight. 5 years ago my echocardiogram was normal and recently I’ve had half a dozen ECGs that have all been normal.
A doctor from a walk-in clinic gave me a diuretic for slightly elevated blood pressure 130/85. (When I take it at home it’s 125/80). I took the diuretic for three days and my potassium dropped to 2.7. The palps were very bad them. My family doctor put me on a potassium supplement and it is now 3.8. I’m still having palps almost every day. They last anywhere from 15 minutes to 3 hours.
I managed to get hooked up to an ECG machine while they were happening. My doctor said they were PVCs.
However, she said she can’t make an accurate diagnosis unless she has seen them on a Holter monitor. When I wore the Holter I didn’t have the palps, just rapid heart beat. My resting pulse is always about 90 bpm.
Now that my doctor has seen the Holter results (no PVCs but some ventricular tachycardia) she says it’s fine and I don’t need another one. That in all likelihood these are PVCs. I pushed her to do another Holter and to do an echocardiogram (I’ve done neither as of yet).
If the Holter shows no PVCs again and the echocardiogram is normal, is it safe to conclude these are just PVCs?
My doctor also told me to take a lorazapam (1 mg) when I get them and if they are continuing after an hour or they seem worse than usual, to go to the ER. I get these every day or every other day. Do I really
I have had skipped heart beats on and off for about 5 years. I’m 42 and about 40lbs over weight. 5 years ago my echocardiogram was normal and recently I’ve had half a dozen ECGs that have all been normal.
A doctor from a walk-in clinic gave me a diuretic for slightly elevated blood pressure 130/85. (When I take it at home it’s 125/80). I took the diuretic for three days and my potassium dropped to 2.7. The palps were very bad them. My family doctor put me on a potassium supplement and it is now 3.8. I’m still having palps almost every day. They last anywhere from 15 minutes to 3 hours.
I managed to get hooked up to an ECG machine while they were happening. My doctor said they were PVCs.
However, she said she can’t make an accurate diagnosis unless she has seen them on a Holter monitor. When I wore the Holter I didn’t have the palps, just rapid heart beat. My resting pulse is always about 90 bpm.
Now that my doctor has seen the Holter results (no PVCs but some ventricular tachycardia) she says it’s fine and I don’t need another one. That in all likelihood these are PVCs. I pushed her to do another Holter and to do an echocardiogram (I’ve done neither as of yet).
If the Holter shows no PVCs again and the echocardiogram is normal, is it safe to conclude these are just PVCs?
My doctor also told me to take a lorazapam (1 mg) when I get them and if they are continuing after an hour or they seem worse than usual, to go to the ER. I get these every day or every other day. Do I really
Doctor's Answer
by Cleveland Clinic, Oct 12, 2004 12:00AM
, Oct 12, 2004 12:00AM
If the Holter shows no PVCs again and the echocardiogram is normal, is it safe to conclude these are just PVCs?
The holter should show what the rhythm is. If PVCs are causing your symptoms, you will see them on the holter. If you do not see PVCs on the holter, PVCs are not causing your symptoms. An even monitor might be a better way to flag the occurence of the symptoms.
Generally, if it is PVCs, and you have a normal cardiac workup, you most likely will not need to go to the ED each time you have symptoms. Work out a plan with your physician.
Also, work on your fitness level and weight loss. You will feel better in the long run.
The holter should show what the rhythm is. If PVCs are causing your symptoms, you will see them on the holter. If you do not see PVCs on the holter, PVCs are not causing your symptoms. An even monitor might be a better way to flag the occurence of the symptoms.
Generally, if it is PVCs, and you have a normal cardiac workup, you most likely will not need to go to the ED each time you have symptoms. Work out a plan with your physician.
Also, work on your fitness level and weight loss. You will feel better in the long run.
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Do I really need to go to the ER every time the lorazapam doesn’t stop them?
Thanks,
Jas
Anyway, the PVC's are frightening and really do impact the quality of life ...........best thing I've found is to simply deal with them and take a low dose Valium (for the anxiety) when they get nasty. These boards are a God-send though as just reading about the fact that many other folks are in the same boat helps to lessen the fear/anxiety.
Hang in there ------ it's not fun but CAN be dealt with! God Bless!
I have been on/off beta blockers for years. Tried acebutolol, tenornim, Inderal and maybe one other...I forget : )
I have the same problem as you describe...YIKES!! I am only taking 2.5 mg of lisinopril because 5 mg/day was making me feel wobbly and shaky. Took about 1 week to adjust from the dizziness. Back to the beta blocker --- The Inderal made me a bit sleepy, but other than that, it was OK. Everyone is different, so you may find another BB is preferable. One thing, it definitely helped the pvcs.
connie
Jas
wxci --- As for the Valium -------- it doesn't help the PVC's one bit but it does calm me down enough so that I'm not up-tight and can go about my daily routine without being totally conscious of the skipped beats. It used to be that when they kicked up I would go into "frozen" mode and concentrate on them, but not now. My Doc 'scribes them for me because he knows that a script for 30 tabs will last me for a year the way I take them.
Momto3 ---- Am happy to hear that a Beta blocker will tend to reduce (or eliminate) the PVC's and just may decide to give that a try. I don't stay on meds for long (maybe a few days) if they give me ANY side effects at all as I, like you, am just too medication sensitive. Thank goodness my Doc recognizes this aspect and is trying his best to find something that will work for both the HBP and the PVC's. I'm just leery of Beta blockers from everything I've been able to read on them (but then, I'm leery of any/all medications anyway).
pms_barbie --- I know what your saying about the ER being unable to do a thing except hook you up to the machines, do blood work and then send you home. Actually, it was an ER nurse who suggested the Valium to me as she also has skipped beats.
God Bless you all.............
I am a 42 year old woman who has had thyroid disease and asthma and I suffer from anxiety, back in 2002I developed
these "missed" beats , after echos and EKG's nothing showed , I quit smoking cold turkey because I was so afraid of these "missed beats " I was in the ER crying because then I felt like I had a lump in my throat and so on and the anxiety just spiraled .. FInally figuring out that I was Hyper now on the thyroid disease and not hypo anymore they treated me with "Atenolol" which didnt last because my asthma exacerbated .. now here we are 2 years later , my thyroid once again bordering on the high end of normal ( am on tapazole) and these palps are bad they came out of no where and the coffee I was drinking ( 4 - 5 cups ) gone...
I had a holter monitor 3 weeks ago and it showed double and tri PVC's ,but say they are not the 2 dangerous ones and they are finally treating me with "verapamil " and "Paxil" and I still have normal EKGS and a ultrasound , they saw these PVC's on the ultrasound and my bp is 125/80 my pulse is 78-84 , I actually ended up in the ER a few days ago because I had GERD so bad these PVC's didnt go away till the GERD subsided
1-will this ever go away ?
2-this only happens bad at night , I am not woken up but if I get up and try to sleep they start up
3-I heard that the thyroid can trigger these but can also have them when the thyroid is low
4-will this become dangerous ? I think this scares me the most
5-is it hereditary?
Thank you so much for your time
I don't find seditives help the palps either but they sure do help calm me down when everything else fails. I took a seditive and had the palps for an additional 2 hours. My pulse was alright. At one point it went up to 110 but my resting pulse is 90 so that's not too much of a jump.
The wierd thing was that I felt fine today...then all of a sudden I get really light headed and felt like I was going to faint. Right out of the blue. This was an hour before the palps started. Fortunatly I was in the cardio clinic waiting room when I started to feel really bad. They hooked me up to an ecg and said they saw only pvcs. I said, "Get the 24 monitor on quick before they stop!". So hopefully this will be the end of the monitors. Just have an echocardiogram on Monday.
Btw, I tried the deep "belly" breathing today and it didn't help. I guess some days the palps will just do as they bloody well like no matter what we do.
Jas
I found your comment about getting lightheaded and feeling like you were going to faint just right out of the blue interesting because that is exactly what happened to me a few weeks ago when these PVC's started to rear their ugly heads again. I wasn't having any palps at the time I felt lightheaded so I wondered if it was some sort of panic attack. I'm still getting the PVC's however they seem so different. I feel them in my vagal area of the upper part of my stomach. It just feels like a pause. I don't feel anything in my heart. Has anyone felt pvc's like that before? I wore the 24 hour moniter last week but of course my doctor hasn't called me back yet. He makes me feel like a looser.
Jodie
I think the reason I felt light headed was due to a new medication I was taking for asthma. I'm also pretty sure the anxiety I felt due to the light headedness was what started my palps.
Regarding your Holter monitor results... It took 7 - 10 days for my doctor to get the results to my monitor test last week. If you are anxious then call your doctor. You need to be responsible for your health. Be proactive...maybe even a little pushy if you have to be. It's your body and you have a right to know what's going on.
Your aortic regurg may get better months later. Mine didn't, but I've adjusted to having to see a cardio. They're not so bad, and the brilliant ones have a funny -- albeit sometimes morbid -- sense of humor which keeps things light. Life's too short.
My son is almost 14 months old and thriving! What joy.
God bless,
Carolina
Hi Everyone,
I feel the pain and frustration of everyone that suffers with PVCs being a off and on again PVC sufferer myself.
Being a survivor of Hurricane Ivan that devastated our Island with sustained winds of above 155 mph with gusts recorded at 248 mph for over 16 hours, I realise that pvcs are a walk in the park to a frightening life threatening event, in fact since surviving this hurricane this is the less frequent my pvcs has been in my life, who knows maybe Hurricane Ivan blew them away also(just joking). Just Wishing everyone well.
Here are 2 quotes for PVCs sufferers that I learned since the hurricane and it is weather related, but might give some insight at dealing with PVCs.
(1) Square up your shoulders and hang on tight and smile at the stormy weather, we'll all be here when the storm is gone, no storm can last forever. (Note: unfortunately not all is here when the storm is gone, but I liked the quote anyway.)
(2) Some ships sail East and some sail West with the very same winds that blow, it's not the gail, but the set of sail that determine the way they go.
Take care and peace to all. Life is sweet , live it to fullest, you can be wipe out in a heartbeat and PVCs are very , very, rarely the cause.
Regards,
Hank.
Connie
I love you comments and your quotes. Thank you for sharing your words with us. Reading your posts made me feel better.
Jas
I too hate the palps I feel from time to time (it keeps reminding me how mortal I really am). You just have to live with them. I am not on any medication (yet). What I find that helps me during frequent palps is laying down. I'm sure you don't want me to explain the physiology of it, but it does seem to work for me. Laying down will not totally knock all my PVCs, but it does decrease the frequency. I hope this helps!
Jas
It is my understanding that even some types of sustained VT(known as idiopathic normal heart VT) are rarely life threatening also. Maybe the doctor will answer your question and clarify this for you.
Regards.
Thanks , I guess i don't have to tell you how scary an experience it can be, i think here in Grand Cayman we had sustained winds documented for over 165 with gusts up to 248 when the wind guage broke for over 12 hours none stop, a living nightmare, over 95% of the Island was damaged, but I'm grateful to be alive and still wouldn't change it for anywhere else to live in the world. Ivan was very unusual powerful hurricane, I think they are just finding out how powerful it really was , the area i live in was hit hardest, the eye crossed within 9 miles of my home right by the sea, but unbelievably my house sustained the less damage in that whole area, I am really blessed and very thankful to be alive and lucky as a whole to have such minimal damage when others lost everything.
Take care and I'm glad to hear you are fine also.
Hi ,
Ventricular bigeminy is a PVC every other beat, so it is the same PVCs, but much more frequent, trigeminy is when every third beat is a PVC.
Are you aware of them or was they just discovered by accident(as they sometimes are when a patient is asymptomatic).
Bigeminy and trigeminy PVCs are almost always unifocal, meaning one focus is responsible for the PVCs rather than your PVCs being multiformed or multifocal occuring from more than one location or site in the ventricle.
Check with your doc and see what he says, this is just my understanding of PVCs, he might have alot more info to offer.
Good luck.
Just reread your comment, apparently you are aware of the PVCs as you said you had symptoms, being in bigeminy is no fun, it is along time since I been in bigeminy, but I remember the feeling, almost feels as if your heart is rolling over and over without any rhythm whatsoever, kinda sucks the wind out or takes your breath away.
Hope you feel better soon.
As you know pac occur as an early trigger(foci) in the atria and pvc occur as a early trigger(foci) in the ventricle, in pac there is usually a pause, but not a full compensatory pause such in a pvc, but it can be full in a pac or not full in pvc also depending.
Usually PVCs are more pronounced in feeling, but can be hard to tell without documentation on a ECG, there symptoms are basically the same, such a skip, thump, pause or miss beat.
With pacs the ventricle usually have more blood to pump when the pac is a occuring , with pvc it is usuallyof much less volume and a detectable is usually not with a PVC, it can usually be detected with a pac, though it is slightly irregular.
They both are considered "benign" in the absence of structural heart disease, both can trigger PSVT(paroxsymal supraventricular tachycardia).
Pacs can be a forerunner of a-fib and PSVT, though pvcs even when symptomatic is rarely a forerunner v-fib though the trigger is in ventricle.
PVCs are more common and usually more symptomatic than pacs, for a few it is the other way around, but both can be totally asymptomatic in most persons.
Bottomline both PVCs and PACs are considered nothing more than a nuisance in a structurally normal heart, PVCs pose more of a threat to person with heart disease or certain cardiac syndromes.Like I said before pacs can be precursor to PSVT or a-fib.
They are both considered normal finding on a 24 hour holter monitor and depending on the quantity and symptoms associated, coping methods, reassurance, medication or ablation might be considered, mainly for symptomatic relief.
This is my understanding of PACs and PVCs, a qualified EP or cardiologist could provide you with much more insight regarding the difference between pacs and pvcs.
The third paragraph should read a detectable pulse is usually not felt with a PVC.
What a Godsend. did not even know this forum was out there. this is my first time and i have been reading the previous comments and have already found some help in that there are lots of tips and that some one besides me is having the same problems.
i am 67 and have moderate aortic valve stenosis. i have an excellent cardiologist and internist. i have had the usual EKG's and echos and lab work ups. i discovered two years ago i have PVC's while having an allergy to Ciprofloxin taken for a major hand infection. have caught lots of PVC,s and PAC's on tracings. i am heavy and have lost some weight and exercise regularily and do distance speed walking 20K+ and do 4 miles/day regularly. I also have "mentation" in which i hear or feel my blood flow in my right year all of the time(bam bam bam). kind of like tinnitus but not that. my problem is that i try my best to control the night rythum changes which will wake me up with the sudden cessation and/or irregular beating as you all have. On occasion when i take an Diazapam or Lorazipan it will help but not lately. it seems to occurr after a meal even if a light meal for diner and within about 4 hours. i do not smoke and gave up wine (my french wife is ready to choke me) as precipating factors. the PVC's seem to be increasing in spite of all the "correct things i do. not all of the time either. i have a light diner now of salad and a fruit. i am losing sleep when i "awaken with a start" from the irregularity and await for the next beat to make certain i am not dying and that my heart has not stopped. my internist and cardiologist feel this is "normal" and not due to my aortic stenosis. their comments are as you expect "live with it and try all of the tricks you can and take your pill." i am ready to try a Beta blocker but am now a little "afraid" of all of the side effects balanced against maybe not even helping (i am also on a receptor blocker for my hypertension which is in excellent control for over a year.) i am ready sometimes mentally to give it all up but am not certain any alternative is better. I guess i am just "scared" and hope that maybe someone out there can "hold my hand" a little and maybe reassure me that one doesn't really die of this or of the lack of sleep. bless you all
Be assured you are not alone with the struggle of PVCs. i take cozaar 50mg daily and atenolol 100mg daily in divided doses mainly 25mg of atenolol every 6 hours, i find it more effective that way in treating pvcs and my doc agrees with me. I am almost pvc free. I take the cozaar 50mg daily with the atenolol for ultimate blood pressure control, I also take diazepam 5mg(valium) twice daily and aspirin 325mg daily for ankylosing spondylitis, most other anti inflammatories don't work well with me, asprin 325mg sames to help along with valium which is an anti anxiety agent, but is also used to relax muscles( that is what i use it for).
Beta blockers are safe medications despite some of their unwanted side effects, but they are not for everyone, everyone is different and respond different,also beta blockers is the one line drugs that has proven effective in decreasing the mortality rates in persons who have suffered a heart attack, have heart disease, and now has shown a benefits in treating heart failure. Check with your doctor and if prescribed,you might want to give them a try, if you have asthma, beta blockers is not usually prescribed, if you decide to take them and suffer unwanted side effects, your doctor can advise you how to taper off them.
Good luck and try to get some sleep(I know they can keep you awake, the mind and body has a way of adjusting to a chronic problem, that is why person that have episodic PVCs such as myself have a problem sleeping with them also, if you had them for more than 3 months everyday you will find your mind and body adjust to feeling and sleeping becomes less of a problem)
One again take care and hope you feel better soon.
wmac
Anyone else live in Ontario? I'm disgusted in our medical system here. We don't have enough doctors or nurses and the waiting in the ER is hours...I mean like 10 hours.
Sorry..just a little venting.
When you say you have had 10 in a row...do you mean 10 PVCs? Are a string of PVCs called V Tach?
I haven't seen a cardioligist. My family doctor is taking care of the tests I've had ie)ecg, Holter, ECHO. I assume I would see a cardiologist if she thought there was a problem. Does one have to see a cardiologist if with a family doctors diagnosis of PVCs?
Jas