Re: PVCs

Posted By CCF CARDIO MD - DLB on June 18, 1998 at 20:40:51:

In Reply to: PVCs posted by Karen B. on June 18, 1998 at 02:47:17:






After a week-long experience of feeling like my heart kept skipping a beat, I consulted with my family physician, who did an EKG.  At the time of the EKG I was not experiencing any symptoms and therefore was informed that everything appeared normal.  I further informed my doctor that I do not smoke, consume caffeine (with the exception of some occasional chocolate), take any medications (over-the-counter or otherwise), or drink alcohol more than once a month.  There is no family history of heart disease, and I am not under any abnormal amounts of stress.  I do, however, rotate shifts every three months an am currently ending my three month stint on nights.  My job is an office job so there is no strenous physical exertion, and it appears these arrythmias occur when I am most relaxed.  For these reasons the doctor decided to put me on a holter monitor for 24 hours and three weeks later informed me I had PVCs with palpitations and I'm not sure what else.  I am waiting to get in to see a cardiologist, but am concerned in the meantime.  The doctor prescribed Atenonol (sp?) and I have not had an episode since I began taking that medication.  What can you tell me about possible causes of this problem, prognosis and treatment options?  This condition is not painful, but irritating.  I am a 35-year-old female who used to lead an active lifestyle but now am relatively  sedentary.  A nurse where I work has listened to my heart with a stethoscope during these episodes, and he seems to think I have a serious problem, like perhaps a murmur or some blockage.  He initially thought that maybe it was a short in the circuit somewhere and my heart was just not getting the message it is supposed to beat.  Anyway, any information you can give me on this would be appreciated.  Thanks!
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Dear Karen:
First of all, I agree that you should formally be evaluated by a cardiologist to make sure that you do not have any underlying serious heart disease.  However, PVCs are usually a benign condition, with no serious adverse effects.  Sometimes, they are quite annoying to particular patients, in which case medications are used to control the symptoms of palpitations.  Atenolol, a type of medication called a beta blocker, is among the most widely used and safest of the medicines, though it can have unpleasant side effects.
Your cardiologist will check for any evidence of structural heart disease or serious problems with the hearts electrical conduction system.  If nothing is discovered, it would be reasonable to continue the beta blocker to help the symptoms.  It sounds like you are already avoiding things like caffeine, alcohol, tobacco, and stress.  Also avoid any stimulants, either over-the-counter, or illicit; I only mention this because shift workers sometimes use these to stay awake.  Getting enough rest is important too.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.