Echocardiogram offered for skipped beats. Question

[Rosemary349]

Hi everyone

I saw a cardiologist today for pvc's.  Unlike the previous one I saw, who almost told me to get out of the room, pvc's are not dangerous, etc, this one seemed more cautious.  He asked if my pvc's have ever actually been recorded.  I said I didn't know, that I didn't think anything significant was recorded but that the cardiologist just kept saying 'you don't have heart disease.'

This new cardiologist is the sort of cardiologist I want, but at the same time I'm nervous.  He agreed that I could have an echocardiogram, that if this returns normal then it is further evidence of low risk with the ectopics.

My concern now though is that the echo would pick up coronary disease, because we all have it don't we?  Those of us who've lived a western lifestyle...so I'm concerned that I've pushed for tests that actually will just cause more distress, because it will pick up things that others have, but who are just happily getting on with their lives and probably will never have a problem.  

Anyone understand what I'm trying to say? I don't mean that coronary disease is not serious, it is, I know that, I lost my dad to a heart attack.  I'm just saying that if you look in anyone's arteries, even teenage girls, you can find plaque.....What are your thoughts?

Thanks :-)

[JamesManalili]

For me its not a danger. The doctor will not tell you that, if it will trigger or harm you to something.

[Rosemary349]

Thanks James.  Appreciate your response.  

[Shasari]

The echo could be useful in one of two ways. First and what everyone would hope for is that it confirms you have low risk ectopic beats, eg no other underlying condition to which the ectopic beats can cause complications.

Echocardiograms can detect plaque on the arteries, as well as valvular problems, and any dilatation of the aorta.

The other end of this is that if there is an underlying cause, or something that can only be detected by an echo, you'll find out about it and they can start a course of treatment. I'm not saying this to worry you, but to give you an idea of what to expect.

[Rosemary349]

Thanks

[Rosemary349]

I know this is not relevant to this forum, but it being part of the whole picture, I wonder if anyone has any thoughts.

I get these episodes of raging hunger and ectopics, often eating will calm everything down but I eat loads.  Then sometimes there is still a weird 'wooshing' feeling around the chest area (but more like an 'energy' than the heart specifically), both carotid areas of the neck have a sensation (they are clear, was told after ultrasound last year)....often this 'carotid sensation' is before my menstrual period.....and sometimes a flushed face.

So of course at my age, 46, I'm wondering if all this is peri-menopause. The doctors keep asking me if I get hot flushes and I say no.  I'm not hot.  But the skin on my face burns.  Anyone been through menopause here that can tell me whether this is sounding like a flush or not?  What about the 'wooshing' sensation in my upper body?  

Thanks.  

[achillea]

Look up da Costa's Syndrome:

https://en.wikipedia.org/wiki/Da_Costa%27s_syndrome

[Rosemary349]

Thanks achillea but right now I'm too anxious to read any more about my health....

[Rosemary349]

Ok I looked it up.  Without an echocardiogram nothing can be ruled out, that's from a cardiologist.  da Costa's Syndrome is essentially considered a psychosomatic condition with various 'irritable heart' symptoms, but with normal test results.  I haven't had the relevant tests yet.  I understand you're trying to help and I know I need to address my anxiety but it's hard to do so fully yet because all the tests have not been done.  Once they are, and I'm told they've actually seen what I'm describing and they know it's not serious, then of course, if I'm still anxious, I need to really address that.  I am trying at the moment but I know how quickly things can happen

[coffee101]

Isolated PVCs are benign and don't cause health problems. Everyone gets them, some people will notice them more than others. Your first cardiologist is likely confidence that what you are describing are indeed isolated PVCs especially if he has holter results.

Increasing PVC load and particularly with polymorphic features can be a sign of scarring of the heart (from a previous MI) or ischemia (from underlying coronary artery disease). Not saying this is what you have, especially since you had a holter done which was normal. Just trying explain what your second cardiologist may be thinking and that is to risk stratify you further as minimally invasive as possible. A normal echo would confirm your low risk status.  

An echo can give a good picture of the current size (large hearts are more prone to arrhythmia) and function (poor function are also at risk for arrhythmia) of your heart to help with risk management. It will also pick up other simple arrhythmia (like AF) if you happen to have it at the time of assessment.  

Also like the other poster mentioned, echo does not pick up coronary disease directly. However, it can detect a heart attack which could be due to an underlying coronary disease.

[Rosemary349]

coffee101, there was an increase in the last three weeks and also they came from different 'areas' - like I felt some in the stomach, which I don't usually.  They've been quite frequent.  I've felt ok in all other respects....

apart from my hormones were all up the wall (I'm 46 and female, so possibly approaching menopause), my period was a week late.  Also I had this very odd trembling sensation in my thighs for three weeks.  I also had a mark on my skin and the doctor is going to test me for lymes disease because it looked vaguely tick bite-ish.....but it will probably be negative.

Can you get an increase in ectopics if you're just a bit under the weather?  I think I was unwell with something.

[Ger57]

The echo will not show coronary artery disease (so no need for concern about plaque info :-) ), but perhaps might come up with another explanation for your PVC's.

Normally PVC's  are recorded with a Holter device to see how many there are in 24hours and what the ECG looks like. In almost all cases, they really are not dangerous although they can be annoying.

[Rosemary349]

Thanks Ger57.  The cardiologist was aware I've had holter and event monitors in the last 4 - 5 years.  I brought a recent ecg result to him (done last week).  Those have all been normal.  So I guess he's thinking that the echo is the only thing that hasn't been done.  

Thanks for answering the question.  :-)