What Other tests

[my3reasonsy]

I am 38 female. Exercise 5 days wk for 2 yrs. Since Dec. Pain, sob, and dizziness during exercise no palps.  Also climbing steps. Tests run in Jan. CBC, CMP, lipids fine, thyroid 1.39, stress test Bruce Protocol, achieved 97% max hrt rt(target 155,test stoped at achieving rate), 9 minutes no pain. Functional aerobic capacity 10.1.  Stated Excellent Exercise Tolerance, max bp 141/55 no arythmia, no ischemic st changes, neg. ett for ishcemia by Ekg criteria.  Echo normal 60-65% ejection fraction, trace mvr, mild tvr.  24 hr. Holter min rate 48, max 200 (during exercise and having pain, must stop workout, but can continue in a few minutes), base line is nsr with av. rate 86.  No svt or v-tach seen. 7 pacs 0 pvcs. Dx Chest pain with Tachycardia.  Lung test 4 asthma was normal. Ct abdomen small less 1 cm low attenuation lesion within inferior pole of left kidney-too small for accurate characterization and low attenuation within medial seg. of left lobe liver compatible with focal fatty infiltration. Normal. I have been on atenolol, verapamil, didn't work and now toprol 50 to take on days of workouts.  My rest. bp was 132/76 now runs up to 136/92. Now have more sob/dizz & weakness.  Hrt rate max 188, some pain, less frequent. PCP refered me to Cardiologist June 21.  What tests need to be done? It was suggested on another forum that I should have 24hr urine test to rule out Pheocarcytoma. Should I mention? Could this be caused by something besides the heart given it only happens during exercise? Could something be overlooked in the tests run? Any suggestions? Thanks you!

[Cleveland Clinic]

3 reasons,

Its difficult to recommend specific test without really evaluating you.

Overall a few thoughts though:

It would be unlikley that your symptoms are caused by coronary disease unless there were other risk factors not listen in your history such as diabetes or a strong famil history. Even then, it would be unlikely with your negative evaluation thus far.

Your blood pressure isnt that out of control and unless your episodes were associated with a rise in blood pressure, a pheochromocytoma isnt likely.

Atenolol, Toprol and other beta blockers can certainly cause fatigue. I wouldnt have you taking 2 different doses of these. I would like to see the holter results to make sure you had no arrythmias.

The best advice I could give you is to make sure you take all of your information (lab, holter, echo and stress results) to the cardiolgist with you or send them ahead prior to the appointment. It will really make the visit much more efficient and keep them from repeating test that have been done and give them the ability to focus on what to do next.

good luck

[madgrad92]

I'm sorry I have nothing to add to the original post on here, but I have some questions for anyone on the forum who might be able to help me. I'm sorry to take up room if someone has an answer for the original poster here...

I'm having a HORRIBLE day, and horrible, for me, would be a great day for many of you, I know, so I'm sorry to get all dramatic. I've had all the tests done, all normal, everything I have (PVCs, SVT) considered benign. I've carried skippybeat's post around with me the last month, and I thought, "Y'know, I've got this licked." And then, the past three days, whammo, I'm hit with a PVC about once every 5 minutes or so - some coming in clusters (like PVC, beat, beat, PVC, beat, beat, beat, PVC) and then nothing for 10 minutes or so. Then, bam, another cluster of them. I take deep breaths, try to focus on something else, start to get my head on straight, and bam, there they are again. Someone who has "gotten over" these things, PLEASE tell me how you did it. I know I'm lucky that I'm only getting one every 5 minutes, but I'm just waiting for the constant bigeminy or trigeminy to kick in. I would need to be put in a rubber room, to quote a fellow poster on this forum. I just feel like curling up and dying. I have two babies at home, ages 5 and 3, and the thought of leaving them alone is paralyzing. I need someone to help me understand how to just "turn off my brain" and to realize that even though I'm getting about 200 of these a day, I'm not going to die. How do I not walk aroudn with this cloud of doom over me? I'm constantly waiting for the next one. Always hoping it's going to go away for good, which we all know never happens. I'm on 37.5 mg of Torprol XL (been on it for about two years - lessens the severity of the PVCs, but I certainly know they're still there). I need support - I'm seriously not sure how to get my vibrant, active, fun life back. I'm walking a tightrope here. Help me, anyone!!

[Abeybaby]

Skippy beats u have asked a million dollar question. I wish I knew how to deal with problem of how to deal with pvc's. I get several hundred per day and in bigemeny form at times. So consider yourself fortunate that you get so little. Others are in bigemeny for hours and even days. While other I know get 10-12000 pvc per day. Now that enough to send u to the rubber room.

Its a very tough call on how to deal with them. Not sure its just as simple as ignoring as my cardio says but accepting them knowing full well they won't kill u but they will certainly make your life nuts if u let them get to u. Start excercising as much as possible and keep busy which I am sure u are with kids in toe.

Get some help via a psychologist or shrink and let them assist u in this ... Its not the end but it can be hard to live with I know.

Take care-

[madgrad92]

I think you meant to address your post to me and not skippybeats, but I thank you nonetheless. I need to understand that no matter what the number, no matter what the frequency, no matter "how many in a minute," no matter the intensity, I just have to believe my doctors. Trust has ALWAYS been a problem for me (esp. in the medical community). Plus, I'm also dealing with the SVT that scares the living daylights out of me when it happens (thankfully, infrequently). I'm also guilty of "symptom surfing" on the Internet, convincing myself that I have everything from influenza to testicular cancer (and I'm female!! LOL.) Having support here is great, but my husband has me convinced that spending time "on that heart forum" only keeps me thinking about the problem. Sometimes, I'm sure he's right, but it's so reassuring to come here once in a while to get help from such compassionate people!! I guess that's the price I pay for being over-educated...(sigh...)

[woodruff]

I agree with abeybaby.  A little talk with a psychiatrist, maybe a little SSRI to help you over the hump that you need to jump here.  On a rational level, you know you're not going to die from these things, but you can FEEL them, which causes the immediate, irrational, panicky response.

Now, here's the tricky part:  People who are not anxious generally do not feel their heartbeats.  I know that sounds weird, but I've been both anxious and not anxious while having pvcs, and when not anxious, I am not aware of them, even though they show up on the EKG.  In my case, a small dose of zoloft helped me turn the corner.  I heartily recommend talking this over with a shrink.  If you get relief, and then look back on the last couple of years, you will be amazed at how constricted your life had become, and how great your life is without the anxiety.

[megz22]

Honey,

I know exactly what you're going through, please realise YOU ARE NOT ALONE in all of this. Before I found this website, I thought I was the only one who suffered from these debilitating things. I am only 22 and my palps began almost 2 years ago as a result of "boyfriend" troubles (he went overseas, when he got back, we broke up, then we got back together again, but we broke up again and have now been broken up for 8 months, sorry to bore u with all the details, just wanted to give some background info!) as well as lots of other things, like study etc, and I guess my obsession with wanting to keep everyone around me happy. Do you ever find that? So, here is a little list of things I've compiled for you to help you feel better:-

* I say, if you need to cry about it, go ahead and cry. Who cares. Cry and cry and eat ridicuilously yummy food and watch a good old sad movie.
* Then, realise how AWESOME you are! Do something, however small, to distract yourself, ie - go and get a coffee (decaf of course!), take a pet for a walk, get close to nature: go to the beach, or a beautiful place where you can really just feel at one with your surroundings
* REWARD yourself for getting through a day, an hour, or even 10 minutes. You mentioned you sometimes get 10 minute intervals where you dont get many, if any, palps. Once that 10 minutes is over, dont think "wow, that was lucky I didnt get any palps!" instead, think, "i am fantastic and of course I can do it and have some time off from palps, because i control them , they dont control me!"
* Realise that palps are not some foreign thing that has come to invade your body. As weird as it sounds, they are actually a part of you now and are directly related to your thoughts, feelings, and emotions. So please dont put too much pressure on yourself in terms of trying to get rid of them! They will go eventually I assure you. It might just be that you've gotta work out some anxiety stuff first and in that case the little buggers might just hang around for a while until you have learnt how to deal properley with your anxiety. Be patient.
* Keep a heart diary. Monitor all these thoughts and feelings on paper and try and find a pattern with your palps. How many do you get a day? What is their frequency? How do they make you feel when you get them?

I dont think there's any point in trying to "ignore" them. Virtually impossible. They're there for a reason. Your body is trying to tell you something.
I do hope you start feeling better soon! Just remember we are all in this together! And there are always other options for you if things get unbearable, such as : see a psychologist/counsellor, maybe investigate other drugs, such as other betablockers, or even antiarrhtymics like fleacainide if things get really bad.

I wish you the best of luck

Kind regards
Megan (from australia!)

[axg9504]

4 years ago I started getting dizziness after about 12 mts of running at v. moderate pace. Went through all tests including catheter-found nothing. I was diag. by one EP as having Afib on basis of a couple of event monitor tests but that didn't hold up on further testing. Then I noticed that my heart rate does not seem to want to go above 100 after some time and after exercise stops it very often goes into bradycardia. My docs are calling it chronotropic incompetence and are saying I need a pacemaker. I have never had any pain though.

[jkf]

Hi-I don't post often but I read the forum about once a week.  I have had PVC's, PAC's and a fast beat called PAT for 20 years.  I am 45 now.  Here is what helped me.  

I'm not kidding -
Go to Amazon and order two books by Dr. Claire Weeks
Hope and Help for your Nerves
Peace from Nervous Suffering
If there are any other books she wrote prior to her passing I would recommend those as well.  I read those books over and over for at least a year.  I highlighted portions that were directly related to my issues.  I was getting PVC's just like you are now.  As I stopped thinking about the "what would come next" (thanks to her book) the PVC's settled down.   My last holter revealed just 5 PVC's in 24 hours.  Anxiety plays a major role in agrivating this horrible condition.  That's not to say every once in a while I'll have 5 or so a minute for 24 hours or so because I do.  I've just learned how to live with it and not agrivate them by sensitizing my nervous system all over again.
Also I take 1/4 of a 25mg of Tenormin.  Barely anything but enough to keep my pvc's under control and the little bit of Tachy beats that decide to pop their heads for no reason.  If I have an exceptionally bad day, I just take another 1/4 of the Tenormin.  I've been on it for 15 years or so.  I recommend talking to your doctor about it if you are not taking anything at this time.  You are welcome to e-mail me at ***@**** if you want to talk further.  You can get this under control.  Believe me, if I did anyone can.
Take Care-
Jodie