Stress Test or Echo?

[Bossa]

Thank you for taking my questions.  For the record, I searched through the archives for a similar question, but could not find one.

Like many others on this forum, I have been suffering from PACs and PVCs and have had EKGs and Holter tests.  My question:  Can a stress test or echo uncover something that doesn't show up on an EKG or holter which cause PACs or PVCs?

Is there a prognostic difference between a PAC or PVC, other than the location of their occurance?  I heard PVCs are more dangerous.

Lately, I have experienced odd palpitations.  Instead of a premature beat followed by a pause then a compensatory beat, I am getting three or four beats in rapid succession.  For example, beat...beat...beat beat beat beat...beat.  I hope I have explained it clearly enough and appreciate your insight.

Thank you again...this forum is a fantastic resource!

[Bossa]

Thanks doc and Lynn for the advice/input.  I am going to see my doctor tomorrow.  I hope these darn things (palps) go away.

[LynnSB]

>>Q3:"For example, beat...beat...beat beat beat beat...beat. I hope I have explained it clearly enough and appreciate your insight."

Some patients with symptomatic PACs go on to develop atrial fibrillation (afib). Afib can feel like what you described. A holter monitor is often a good way to determine what is the source of quick runs of extra beats. <<

Your "beat" pattern sounds exactly like what I have/had a lot. It as called "atrial runs" and also "spurts of atrial tachycardia".. that is, I have runs of 3 to 20 atrial beats , then it goes back to normal.

No one can tell you what your arrhythmia is for sure unless it is caught on a monitor, so please be assertive ( if these symptoms bother you) and tell your doctor you need an event monitor to catch these things. good luck.

Lynn

[CCF-M.D.-RCJ]

Bossa,

Thanks for the post.  I'm sure the other readers thank you for your efforts in looking through recent posts.

Q1:"Can a stress test or echo uncover something that doesn't show up on an EKG or holter which cause PACs or PVCs?"

Yes, on occasion, but infrequently.  Most PAC/PVCs are caused by alterations in the electrical system, which cannot be visualized with an echo.  However, rather uncommonly, a person's first manifestation of either (1) coronary artery disease, (2) ARVD, (3) a cardiac tumor, (4) new valvular disease, or (5) another miscellaneous disorder will be new onset of PAC/PVC.

Q2:"Is there a prognostic difference between a PAC or PVC, other than the location of their occurance?"

In persons with structurally normal hearts, no apparent prognostic difference has ever been found.  The prognosis for persons with heart failure or history of myocardial infarction is worsened if they have PVCs.

Q3:"For example, beat...beat...beat beat beat beat...beat. I hope I have explained it clearly enough and appreciate your insight."

Some patients with symptomatic PACs go on to develop atrial fibrillation (afib).  Afib can feel like what you described.  A holter monitor is often a good way to determine what is the source of quick runs of extra beats.  

Hope that helps, and thanks for your support.