Re: PAC's

Posted By CCF CARDIO MD-APS on July 24, 1998 at 18:24:20:

In Reply to: PAC's posted by Debbie on July 23, 1998 at 19:30:14:






Hello, My name is Debbie I am a farely healthy 44 year old female.
About 4 years ago after experiencing very annoying and scary heart palpations and begging the doctor to put a halter monitor on for 24 hours,  I was told by my doctor that I have PAC's.  She gave me atenolol .25mg per day. And Elavil to help me sleep. I only took these on an as needed basis. It has been under control basically for the past four years only with an occassional incedent.
About three weeks ago in a dead sleep I was woke up by my heart skipping beats. I went into the doctor and of course it didn't act up while I was there. They did an EKG and said that nothing looked abnormal. But I continue to have episodes when my heart adds these beats over and over again for hours at time. Of course it happens mostly at night - but not always. It makes me cough and I am scared out of my wits. It feels as if someone is taking two fingers and pounding on my chest. I experience no pain associated with it. I have a pinched nerve in my neck so I have constant pain in my neck and down my left arm - so I always worry that I'm having a heart attack but would never know the symptons because I already have constant pain there. The doctor refilled my medication for Elavil but I have yet to take any. I don't drink alcohol. I love my morning coffee but have cut that out since this all reoccured. I am a chocolaholic and have also cut that out.
This thumping has got to quit. I can't stand the answer that it is just normal. Why do I feel them so intensly if it is so normal. I can't sleep because I am so scared I won't wake up. HELP ME MAKE THEM STOP OR I'LL GO OUT OF MY MIND. I have to sleep. Why does it come and go?. Why does it never happen when I'm at the doctors office? What is it exactly? Can it cause an irregular heart beat that can cause a heart attack? Is is effected by what I eat? (other than caffine) Is it related to potassium or electrolites??
Help me to understand! I would love all the info I can get. Any place I can go to do research on it. Maybe the more I understand the less afraid I will be. Does it affect exercise? Should I not exercise when this is happening?
(as if I'd even want to.) Would exercise help make it go away.
Sincerely
Nerotic
Debbie
These PAC's keep me awake night after night.



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Dear Debbie,
Firstly, PACs are a completely benign, that is to say they can not and do not
cause disease and certainly not a heart attack.  Because they are benign, very little
research has been done to better understand the condition, therefore a lot of
the treatments are inferred from other atrial studies.  Electrolyte imbalances, caffeine
and alcohol intake, as well as stress are all things that exacerbate the condition.
If you were taking the Elavil regularly and have abruptly stopped it, you could be
having more PACs simply because you abruptly stopped the medication.  The only way
we currently treat PACs is to try to alleviate the patient symptoms.  It sounds as
if your PACs bother you very much and it would do you good to go to the nearest
univeristy medical library to read about PACs as there is nothing about this condition that
should make you afraid of a bad health outcome.  Any drug, legal or illegal can
cause the PACs, over the counter or preccription- you should also know that many over
the counter drugs contain caffeine and that many de-caffeinted products do have small amounts of
caffeine.  Exercise often helps to reduce the number and extent of the discomfort created by the PACs.
It also would behove you to concentrate on other aspects of your health such as eating a healthy diet,
exercising regularly, and finding hobbies that minimize your anxiety that seems to be out of proportion
to your problems.  Anxiety is not easy to control, and relaxation and reduced stress  are very important to
minimizing your PACs, so you should consider all possible relaxation techniques in addition to daily exercise.
Good Luck.  Information in the heart forum is intended for general informational purposes only, actual diagnosis
and treatment can only be made by your physician(s).