Wondering about PAC's and PVC's

[l4w442]

I have anxiety and have been in the hospital a bunch on my own to get tests done on my heart which is what my anxiety revolves around. I have had an echocardiogram, bruce stress test, 24 hour monitor, two week event monitor, advanced cholesteral tests and ekg's where the doctors have raised no concerns and told me there is no need to follow up.

1. Having palpitations during stressful (mainly) and at times non stressful times. I would describe the beat as being fast around 110 bpm being constant and then having two slow heavy beats within 10 seconds. It goes like beat..beat..beat..Beat......beat..beat..beat..Beat........beat etc. Are these considered PAC heartbeats?

2. Also when I do get stressed or notice a high heart rate it usually lasts for the day and is difficult to calm it down. Does this mean anything or is there a way to manually lower it through an exercise?

Loop Monitor Results;

"The rhythm was sinus" "The single event of the presumed sinus tachycardia showed a rapid and regular supraventricular tachycardia and without a run up to the heart rate the likely sinus tachycardia, it is hard to exclude another form of supraventricular tachycardia"  

Echo:

Cardiac Dimensions:
Right Ventricle 28 normal = <30mm
Aorta (base) 32 normal = <37mm
LA 35 normal = <40mm
LVend diast 47 normal = 35-57mm
LVend syst 29 normal = 25-40mm
Septum 09 normal = <11mm
Post Wall 10 normal = <11mm
Diastolic Function:
E (cm/sec) 80 E:A 1.29
A (cm/sec) 62
IVRT: (msec)
DT: (msec)
S:D
PulmD (cm/sec)
Pulm AR
LV MAS Index Height 72 (inc) Weight 180 (lbs)
Systolic Function:
Aortic Valve:
Regurgitation: No
Peak Grad 4.3 (mmHg)
Valve Area (cm2)
Max Vel V2 (m/sec)
LVOTvel V1 (m/sec)
LVOT Diam. (cm)
Doppler Quantitation
Mitral Valve:
Regurgitation: Trace
Mean Grad (mmHg)
Valve Area (cm2)
Pulmonic Valve:
Regurgitation: No
Peak Grad (mmHg)
Tricuspid Valve:
Regurgitation: Trace
RVSP (mmHg)
Est RAP (mmHg)
PAT (n. 100msec)
PAP (mmHg)

[zephyress]

Costochondritis is diagnosis for my chest pain
Need follow up for thyroid test for rest of symptoms. All blood counts normal. Ekg, xray, cat scan normal. Need followip stress test. Thx for replies.

[zephyress]

Thx

[achillea]

At this point, you might enjoy the comments in the heart rhythm community, where people post when they have gotten some responses but still have a lot of questions:

http://www.medhelp.org/forums/Heart-Rhythm/show/92?controller=forums&action=show&id=92&camp=msc

[zephyress]

... Forgive the typos. Phone!  ( tums did not help much) and the pain is more like bruised breast bone.

[zephyress]

So I have a follow up question to this... I suffer from an iety, li g story short- i see my cardiologist every april (it is now january) and all normal.
I am now experiencing what i would call hot flashes ( sudden sweating at rest or exertion) AND in the past 24 hrs i suddenly hav weird chest pai. That i do not personally associate w my anxiety. This is more like a pullled muscle or broken/bruised breast bone, w belching that may or may not help. Thms did not help. The pain comes n goes all day.  
I would like to know what specific chest pain people speak of due to heart disease and attacks.  you stated above that the heart js ruled out due to tests normal. But since its been 9 months ago that all my echo. Ekg. And stress tests were normal, even blood tests, is there still a possibility that im ignoring something associated w my heart?   Or can this simply be an infection that suddenly gave me chest pain? Or something else simple. Thx so much

[CCF HeartMD6]

Let me first reassure you that you have had extensive cardiac testing which you have reported as normal and raising no significant concerns.  This is a good sign and that it would be very unlikely that the combination of all your testing failed to detect something.  Your irregular heart beats that you are feeling could be due to a number of things including PAC's, PVC's, or sinus arrhythmia (an irregular interval between normal beats of your heart).  It is impossible to say definitively what they are without seeing them on an electrocardiogram (EKG).  However, if your 24-hour holter monitor and loop recorder failed to detect any significant burden (meaning they happen extremely frequently), then these palpitations are usually benign with no indication for medication or treatment, etc.

Regarding your second question, if you are noticing some of these symptoms during times of stress, it is possible that there could be a component of anxiety going on.  There is no way to "manually" lower one's heart rate without the use of medications, but again, this is not always warranted.  Exercise is always encouraged no matter what the situation is - as it promotes good cardiovascular health and may also assist in helping you with any stress/anxiety you might be experiencing.