Re: One more question on arrhythmias

[Carole__0]

Posted By Carole on August 04, 1999 at 09:32:52
I apologize since you answer so many questions on this topic.  I have read many of them, but am still curious about one aspect of mine, so please put up with one more.  I've had PVC's and PAC's over the past 4 months for the first time in my life.  I'm kind of high-strung anyway and have had heart palpitations and rapid beat when I'm scared like most people do, but this was different.  
My husband and son were having some major conflicts and I felt that that coupled with my workload may have caused it.  However, a cardiologist ordered an EKG, Holtor monitor and stress test.  I had PVC's and PAC's but they were determined to be benign and the EKG and stress test were fine.  My family has since settled down and so have my palpitations.  However, what I now notice is a periodic "wham" of two or three real hard beats, out of nowhere and then calm.  
Last night, I was getting ready to go to bed but decided to surf the channels for the 11:00 news.  Suddenly, I had the sensation my heart had stopped.  Now, since I had not noticed it beating to begin with, I don't know how I knew it stopped, but I gasped for air, felt 3 or 4 heard beats then everything was fine.  I had no dizziness or pain, but was scared to death.  This happens just once in a while-maybe 3 or 4 times a week.  If it's nothing to worry about, fine, I can deal with it, or should I see the cardiologist again?  Thanks for all the help and support you give everybody.  Unfortunately, many of us don't get that from our own doctors.

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on August 04, 1999 at 10:55:48
Dear Carole
Most people actually do not feel the PVC itself, but rather the pause and more vigorous normal beat afterwards. If you are having very long pauses, that could be a problem. The solution may be to wear a Holter monitor long enough to capture these episodes so that your cardiologist can determine if you are having dangerously long pauses or whether it is just PVCs.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Paul__0]

Posted By Paul on August 04, 1999 at 16:26:40

I recently had an Echo,  I have a borderline size left atrium and a trivial amount of mitral valve regurtation.
My Bp since has been perfect for about a year and a half.
Can eithor contribute to my atrial fib or currently my pac's.
Thx'

Paul

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on August 04, 1999 at 18:18:22
Dear Paul
An enlarged atrium predisposes to atrial fibrillation and PACs. A trivial amount of mitral regurgitation is unlikely to contribute.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Paul__0]

Posted By Paul on August 05, 1999 at 12:51:56

What can I do about a borderline left atrium,  my BP has been perfect (recent halter shows 11662 average.
Will a lot of aerobic exercise help?
Other wise I am healthy No blocked arteries etc.
My cardiologist feels my atrium shows some enlargement due to my previous BP problem.

Thank you for your comments
PAUL

[Paul__0]

Posted By Paul on August 05, 1999 at 13:38:44

Sorry I forgot!
Could my trivial amount of mitral and tricuspid regurgtation contribute to a borderline left atrium or is it due to elevated BP.
I appreciate your response
Paul

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on August 06, 1999 at 09:49:44
Dear Paul
I think it was the BP. Valvular regurgitation can cause atrial enlargement, but it usually requires a significant amount of regurgitation, not just trivial amounts.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Jodie__0]

Posted By Jodie on August 07, 1999 at 00:44:12
Okay, I have been reading these for quite some time now and have been feeling pretty comfortable with my symptoms based on your reasurring comments...except for your answer to the one more question on arrhythmias.
I also get all types of arrhythmias.  I have been checked out for over 20 years (I'm 39) and get yearly checkups with my cardiologist.  I have had halter monitors, stress tests and echo cardiograms.  The one arrhythmia it has never caught (and I've told my doctor about it) is one where I feel a little fluttering, then nothing (a pause for at least 3 or 4 seconds) THEN, it beats really fast and irregular for another 10 seconds or so, and back to normal.  This happens about 4 times a year.  When I feel the pause, it is long enough for me to get up, walk over to another room and yell for help before it starts beating again.  I'm not dizzy, however I do fell like things start to fade.  (only in these 3 to 4 seconds) then I'm fine even though it has starts to beat very fast.  Your comments say that if it pauses to long it could be a problem.  How long is to long?  
I worry enough about these, so please respond as soon as you can.
Thanks,

[ml__0]

Posted By ml on August 07, 1999 at 15:57:24
ok. i also have very long pauses occasionally. i have also been told by my pcp that they are benign, then he added unless they happen "alot". i asked what he meant by alot and his reply was "numerous times all consecutive". now i read that they never become dangerous, so what gives? what was he talking about? when the long pauses occur (i dont know how long, timing them doesn't usually occur to me) it is very different from my usual pvc's. like the others have said, when the beat comes, usually with a bang, the the heart races for a time, then slows. it gives one time enough to think that it is not going to beat again and start for help. i had the holter for 24 hours, and  while the pvc's and svt were recorded, these long pauses were not occuring at the time. i get light headed, but not really dizzy. so how long is too long? is it safe to assume that if we can move towards getting help, that we are not in real danger?                              thanks in advance  ml

[Deb__0__0]

Posted By Deb on August 07, 1999 at 17:07:07
Hi,
I too had the feeling of the fast and slow heart rates. I would wake up tired and I was able to avoid passing out at times by sitting down or moving fast....but I had the pauses for a while and have passed out many times.  I worked in the same hospital my doctor did and I had to beg him for a Holter.  I was happy to get a 24hr one out of him, the feeling I had happend many times that day thank God, and yet when I got the results back, he said the cardiologist read it as " NORMAL FOR A WOMAN MY AGE !!"  Needless to say, I got a copy of the Holter and It WAS NOT NORMAL !!  IN the 24 hrs, I had 19 hrs of a high and low rate between 38 and 156.  At times in the same hour. It was at times within seconds though because I could feel it.  Even with the heart rate being in the 30's and low 40's for 19 of the 24 hours, they only picked one slow rate of 38 to show the doctor and that was at 4 AM !!   But the doctor who ordered it said it was for palpatations, not for fast and slow heart rates. I also have a cardiology background, and my husband designs medical monitoring equiptment.  So, we both knew it was wrong.  Well, I made a appt. to see a cardiologist, and just a day before it, I passed out from the slow rate and fractured my skull.  Lucky me I was in a room full of doctors at the time.  But they all said, people do not survive them to often.  I had a complete work up, but nothing showed.  One year later I was at work and I felt the heart go crazy and went to the ER and on monitor I had a sinus arrest of 4 seconds and another 1 hour later of 12 sec.  I ended up with a pacemaker.  I really think you need to go see a cardio doc and then DEMAND a loop recorder for a month.  If they say no, go to another.  Keep going til you find someone who will listen to you.  

[Jodie__0]

Posted By Jodie on August 07, 1999 at 21:54:09
Deb,
Well now you have me scared.  I have to say, I never have the slow then fast rates.  I only have episodes of pvc's and pac's.  THEN, every once in a while (maybe 4 times a year) I get that unnerving pause for about 4 seconds, (long enough for me to put my finger to my pulse and feel nothing) then a fast beat.  I never have passed out, I don't really feel like I will, I do feel like I am fading out during the pause, but as I said, it doesn't stop me from jumping up and running for help.  Once the fast beat follows, I do not feel as though I will "fade out" any more.  Because this happens so infrequently it makes it tough to catch on a holter.  
When you say a "4 second sinus arrest" is that like the pause I am talking about?  My docter calls it a momentary pause, whatever that is.  This is just his answer based on my description of what I feel.
I hope the doctor here answers us soon, and I hope it will be reassuring!
Jodie

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on August 09, 1999 at 08:38:11
Dear Jodie
Your situation does not sound at all like Deb's. The pauses you are having are unlikely to be 4 seconds long, as this would cause symptoms in most people, and I doubt you could run around if this sort of pause were occurring.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.











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