Re: What is happening to my heart, I am scared!!!

Posted By Laura on June 22, 1999 at 12:11:43
I have been having these "skipped beats" almost every day recently. I have had them every now and then for 2 years, but very randomly. It feels as though  my heart goes bom-BOOM and it takes my breath away. When I try to exercise it gets much much worse. This is such a scary symptom. I had an EKG and an Echocardiogram 2 years ago when this all started.
I do have adrenal insufficency and my doctor says that this sensation is from adrenaline release?? It happens in my sleep, when I am resting, after I eat, and when I am under stress, and especially when I drink coffee. I have completely eliminated all caffeine for 6 months and now they are still happening every day. Scared! What should I do????

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on June 22, 1999 at 13:04:15
Dear Laura,
Thank you for your question. I suspect what you are experiencing is PVCs. Here is a brief summary of what a PVC is, what causes them and the treatment (if any) for PVCs.  You can find additional information in an article in New England Journal of Medicine, May 7, 1998, Vol. 338, pages 1369-1374. Your local medical library will have a copy of this.  Hope this helps.
    PVCs (premature ventricular contractions) are extra heartbeats occurring out of sync with the normal regular rhythm of the heart.  PVCs may cause no symptoms at all or may be felt as a irregular heartbeat or as the sensation of a hard heartbeat.  PVCs  are common findings in persons with otherwise normal hearts, in which case the prognosis is excellent and there is no decrease at all in life expectancy.  On the other hand, they may indicate that there is an underlying abnormality of the heart muscle (from any number of reasons).  If there is an abnormality, then the prognosis and treatment depends upon the specific problem of the heart.  The usual evaluation of PVCs is a history, physical examination, and electrocardiogram (ECG).  Also your doctor may wish to check an ultrasound of the heart.  If all those tests are normal, then you would fall into the category of people who have PVCs but otherwise no underlying heart problem. In that case, treatment depends on how much the PVCs bother you. If they are essentially asymptomatic, then no treatment is required. If they bother you, then a medication called a "beta-blocker" may reduce the frequency of the PVCs. PVCs cant be "cured", but the medication can decrease their frequency. The potential side effects of beta-blockers are tiredness, impotence in men and breathing difficulties in individuals with underlying lung disease.  Be sure to discuss these issues with your doctor and under no circumstance should you take medications for the heart without the supervision of a doctor.
Below are some web sites with additional information about PVCs.
http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/prevent.html
http://www.nhlbi.nih.gov/nhlbi/cardio/other/gp/arrhyth.htm
http://www.MedicineNet.com/Forum.asp?li=USA&ag=Y&ArticleKey=1946
http://www.onelist.com/
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist











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