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Problem laying on left side?
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Problem laying on left side?

I'm a 50 year old male, 6-2, 200 pounds.  I've always been active and enjoyed a lot of sports when I was in my 20's and 30's.  My knees are junk now so I've slowed down a little, but I'm still relatively active in pretty good shape.

I've had what doctors tell me is a "functional heart murmur" since I was little, but they've also told me it's no cause for concern and it's never been an issue.  (Passed my Army physical with flying colors. <g>)  I've also had PVC's most of my life, but they've never posed a problem other than being an annoyance once in a while.

I've had numerous EKG's done in recent years (prior to knee or back surgeries) and they show nothing abnormal.  Since I'm in otherwise good health (heart rate 60, bp 120/78) my GP repeatedly tells me to stop worrying about it.

For the last few months they've gotten more intense and irregular.  I've also noticed they are more prevalent in the late evening and early morning hours -- particularly if I'm laying on my left side.  They will occasionally wake me up at night.  When I'm in bed, if I roll over on my right side they go away... roll back to the left and within seconds they start again.  Lay flat on my back and they're noticeable, but they're not as intense/frequent.

I have no other symptoms like pain, dizziness, or weakness... the main discomfort I feel is the anxiety that something may be seriously wrong.

I've got my annual physical coming up next month, but wondered if you or anyone else might have any ideas?  Why would laying on my left side cause them to get worse?

Thanks for any insights you can provide.
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239757_tn?1213813182
bob,

thanks for the post.

As you're aware from the other post, in the setting of a structurally normal heart, the presence of PVCs carry no significant risk of adverse outcomes.  However, they certainly are a major annoyance.

The etiology of changes in positioning is not clear.  Changing positions can slighlty change the filling of the heart, as well as change the hearts orientation in the chest cavity slighlty.  You could hypothesize that these small changes could lead to the extra beats.

hope this is a start.

good luck
9 Comments
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Avatar_n_tn
I get them when I lie on my left side as well. Can't sleep on my left side anymore. Sometimes sleeping propped up with pillows helps. Not exactly great for the neck but I'd rather have a sore neck and get some sleep.
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Avatar_n_tn
I came across an explanation for the left side phenomenon in a medical text about arrhythmias.  One reason given that involved a sloppy valve (murmur) on the left side of the heart, claimed that the extra pressure on that side (when lying down) causes some stress on that tiny part of the heart and induces the skipped beat.  Another theory held that the extra pressure just makes them easier to notice when they come from the left side.

-Arthur

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66068_tn?1365196781
Even though I'm on Rhythmol, I still have afib every month or so.  I find that lying on my RIGHT side will sometimes trigger an episode (especially after a hard workout at the gym)! However, I really don't feel strong palpatations when that happens until I roll over onto my LEFT side. Then I really feel it. I assume that the combination of the left ventricle emptying forcefully into the aorta (during a palp) and the heart being slightly to the left side in the chest accounts for making it easier to notice the palpatations when on the left side. Moving back to my right side seems to reduce the palps' strength to where they are barely noticable (though by feeling my pulse, I can still tell I'm in afib). Lying on my left side doesn't seem to trigger afib when I'm in NSR.

Tony
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Avatar_n_tn
I have been in chronic afib for years. I have pacemaker, been cardioverted many times and take several medicines and continue to be in afib.  I have never been able to tell by feeling my pulse.  Maybe, because I have pacemaker that is set on 80bpm and am 100% paced?
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Avatar_n_tn
You seem to know a lot about arrhythmia.   Do you know why when you have an extra beat every few beats it would make a person feel weak? Also why when someone gets into that bigeminy or trigeminy it makes the heart race at times but not always? Thanks.
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Avatar_n_tn
Ive noticed that when i lay down i feel pressure or tightness on my chest. I mostly feel it in the middle of the chest or sometimes to the mid-right. Also at times when im like sort of laying on my left side the pressure increases and i feel a "pvc" does that mean something is really wrong with my heart? I had a echocardiogram, chest xray, ekg, and a holter monitor done 4 months ago. My doctor hears no murmur in my heart but could there still be something wrong??

Ive had this pressure the day after i did all of those tests. Im not sure if it is my heart but it was like 5 degreez outside and it was cold especially all you northeastern people you know what im talking about! I went outside in my garage then i started running on my treadmill in 5 degree weather! In just 2 minutes i was huffing and puffing and i couldnt breathe. I then went to the ER and the doctor gave me a inhaler. When i felt better i went to sleep and all of a sudden i started feeling that pressure or tightness on my chest and ever since then i have felt it. Could i have injured something in my lungs or the structure of my heart?

I hope someone can answer my similar problems. Thank you.
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Avatar_n_tn
As most of your issues have been addressed by others (notably the very well informed pluto), I just wanted to address the "weakness" issue.  As far as I can tell, if your heart is normal, in particular, the ejection fraction is fine, then it would be very hard to feel weak because of PACs or PVCs, even when they are occuring frequently, since a "skipped" beat is made up for with the next one.  I can attest to this personally, since I used to get PACs at a typical daily rate of about 2-6/min, with an occassional but rare, bigemminy lasting only minutes.  I am an aging athlete, still quite active, and I am very sensitive to any signs of cardiovascular weakness, and I can say that regardless of PAC activity, I've never felt actual weakness, even during soccer matches when I could feel the skips occurring.  I did suffer from anxiety (due to the PACs and PAF), and I must say at that time I did feel weak when the arrhythmias were present...now I can say that this weakness was simply a manifestation of anxiety...it can really drain you.

-Arthur


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39623_tn?1265417041
I have this problem also... everytime I lay on my left side.  I take a very low dose of xanax and atenol before going to bed and this seems to help me sleep.
I also wonder if having alot of pvcs, trigeminy, bigeminy and an ejection fraction of 42%.
I had a 30 day monitor which showed all of this going on and a few time sinus tachycardia with 122 beats per minute with isolated premature ventricular contractions.
I have been told to live with it and it will not hurt me.  But
still I am wondering if the ejection fraction can make the fatigue worse? Does anyone know the answer to that question.  I always feel like ****!!!!!
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