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Heart Disease (Expert Forum)
Questions about PVCīs
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Questions about PVCīs
by Martin-Palm, Oct 15, 1997 12:00AM
Posted By CCF CARDIO MD - HSB on October 20, 1997 at 16:12:55:
In Reply to: Questions about PVCīs posted by Martin Palm on October 15, 1997 at 10:31:03:
: I have a question about premature ventricular contractions.
I am a male, 26 yrs old, had smoked from age 18 to 24, was allways in good health, and had
done much sports until age 21. Then suddenly over night these pvcīs came in my life.
I have them now since around 4 yrs and I feel them in many variations. Most times I feel
them as a kick in the stomach or as a short painful BANG in the middel of the chest. Sometimes
I feel them also as a flutter for 1-3 seconds in the chest. Sometimes I have 100īs of them
a day and feel about 50 % of them, and sometimes I have a few days nothing. They come and go
as they want. Sometimes after one pvc my pulse is pretty normal, sometimes it speeds up to
140 - 150 bpm for a few minutes, and today I can say for sure that itīs not my anxiety who
speeds up the pulse. I also had 1000 - 2000 pacīs a day in one holter.
Iīve been to 3 different cardiologists who all did ecg, treadmill, echo,
and holter (one for 3 days). They didnīt found anything wrong except these pvcīs.
There also have been 5 pvcīs in a row, but they werenīt concernd about that.
They said they are benign and most young people have them, and I have to ingore them.
Thatīs not so easy, the scare me a lot ! So maybe I made a mistake when reading books about
cardiology to learn more about these things.So I read many, many books a
In Reply to: Questions about PVCīs posted by Martin Palm on October 15, 1997 at 10:31:03:
: I have a question about premature ventricular contractions.
I am a male, 26 yrs old, had smoked from age 18 to 24, was allways in good health, and had
done much sports until age 21. Then suddenly over night these pvcīs came in my life.
I have them now since around 4 yrs and I feel them in many variations. Most times I feel
them as a kick in the stomach or as a short painful BANG in the middel of the chest. Sometimes
I feel them also as a flutter for 1-3 seconds in the chest. Sometimes I have 100īs of them
a day and feel about 50 % of them, and sometimes I have a few days nothing. They come and go
as they want. Sometimes after one pvc my pulse is pretty normal, sometimes it speeds up to
140 - 150 bpm for a few minutes, and today I can say for sure that itīs not my anxiety who
speeds up the pulse. I also had 1000 - 2000 pacīs a day in one holter.
Iīve been to 3 different cardiologists who all did ecg, treadmill, echo,
and holter (one for 3 days). They didnīt found anything wrong except these pvcīs.
There also have been 5 pvcīs in a row, but they werenīt concernd about that.
They said they are benign and most young people have them, and I have to ingore them.
Thatīs not so easy, the scare me a lot ! So maybe I made a mistake when reading books about
cardiology to learn more about these things.So I read many, many books a
Doctor's Answer
by CCF Cardio MD-HSB, Oct 15, 1997 12:00AM
Dear Martin:
Premature ventricular contractions are the amongst the most frequent disturbances of cardiac rhythm. They occur in people with and without heart disease. Treatment is directed towards the underlying heart disease and symptoms. Patients with structurally normal hearts and "PVCs" are at no greater risk for suffering sudden cardiac death than patients with normal hearts without "PVCs".
Symptomatic patients are often evaluated with an ECG, extended ECG monitoring (24 and 48 hr Holters), Echocardiogram, stress tests and a complete history and physical exam. If the work up reveals a structurally normal heart, the patient can rest assured that he is at no increased risk for cardiac death.
Treatment in patients with structurally normal hearts is limited to those with severe symptoms. Symptoms include palpitations, episodic discomfort in the chest and possibly dizziness. Patients are often first started on a class of medications known as beta blockers or calcium channel blockers. In addition, any "stimulants" such as alcohol, caffeine, tobacco should be eliminated from the diet as they may provoke or exacerbate symptoms. If severe symptoms persist, other medications such as sodium channel blockers, i.e. flecanide, may be utilized. If incapacitating symptoms persist despite "optimal" medical therapy, catheter based radio-frequency ablation can be considered. This is generally considered a therapy of last resort.
Catheter based ablation is not feasible for all patients and is dependent upon the electrocardiographic characteristics of the "PVCs".
I hope that this has been helpful. If you are seeking an evaluation at the Cleveland Clinic, an appointment can be made by calling 1-800-CCf-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of disease can only be made by your physician.
