chest tightness/palpitations/ef questions -reassurance

[mom4cem]

Good A.M. Dr.,

40yr F,thin. slight mvp/dysautonomia. Echo/stress(yrly),ekg at visits all good. Hx of anxiety/palpitations,sinus tachy up to 130-140,recorded on event monitors and in office ekg. Last year while on trip chest felt tight, around whole chest. No chest pain associated with these episodes. Started to panic, hr up to 130s. Upon seeing Dr. had echo/stress, ekg, chest x-ray, blood etc, repeated. EF% normal, no ischemia, all sizes wnl. All good, no changes. Possible allery or anxiety related was the thought.  No asthma. Sinuses are swollen/congested. Exercise normally with no changes in breathing pattern(not worse)it does not hinder my exercise.

Experiencing it again lately.Feels like I need to take deeper breathes and let them out longer. Cardio has been following me since 94 with palpitations and sinus tachy issues which are slow rising in nature and terminated slowly. He has seen these on ekgs. After reading someone posting about ef% and low 50's not being good I worried about that as a cause. Cardio said that is not an issue for me, I am fine and will be around for quite some time :) (he is very good to me):)

Possible anxiety and/or hormonal component to this?
What is vagus nerve role in tachy/palpitation issues?
Is there an associated syndrome with MVP that could be causing this?
Does ef% change over time? Does height effect calculation?
I am starting to wonder if I really am needlessly worrying. Any insight?

Thank you again.

[Cleveland Clinic]

mom,

thanks for the post.


Possible anxiety and/or hormonal component to this?

I think ou realize that your anxiety plays a significant role in these symptoms, as it sounds like you have had a thorough workup.
While some women notice variation of their symptoms with phases of the hormonal cycles, it sounds like anxiety may be the more significant component of your symptoms.

What is vagus nerve role in tachy/palpitation issues?

The Vagus nerve is a component of the autonomic nervous system which has a role in controlling heart rate. In some people with significnat dysautonomia, there can be variations in the heart rate or inappropriate tachycardia.

Is there an associated syndrome with MVP that could be causing this?

MVP used to very commonly diagnosed and since a lot of people carried the diagnosis and had medical care, many nonspecific symptoms have been associated with it. From what ou write, I wouldnt not highly suspect this in you.

Does ef% change over time? Does height effect calculation?

Height has no role. EF is a number assigned to the images of an echo by a person that reads the echo. thus there can be some mild variability between readers. Unless your echo changed significantly -- ie from normal to abnormal, I wouldnt think too much of the number.

I am starting to wonder if I really am needlessly worrying. Any insight?

Its hard to tell you from a single post. It sounds like youve had a pretty extensive workup. The tone of your post does carry the overtones of someone with a lot of anxiety issues. if all of your workup has been negative, I would look into whether that could play a component. There is nothing at all wrong with that, and it is quite common.

Good luck

[tickertock]

Do be like me get to hung up on Ef and change of numbers. I wondered why my Ef dropped from 75% to 53% in over 4 years. On the same echo 5 years ago I had two different quotes of EF one 65% and the other 75%. The last echo print out stated EF 53%, the cardio quoted me a visual of 55-60%. I questioned him about this , he assured me that my EF was absolutely fine. I different places quotes normal EF differently, I have seen 63-75% as normal, I have seen 55-75% as normal, also 50-75% as normal.This makes quite confusing to someone looking for what is normal, from what I gather 50% and over up 75% is generally considered within the normal ranges by most cardios and institutions.

[upbeat63]

I had a stress echo done last year and they did not report the EF. Everything was normal they said. Normal is normal. It might have been a good thing they did not report the EF number because there IS wide variation and we do tend to focus on that number if there is a change, but you can go from 70% to 60% to 55% and it is only the interpretation of the echo, not that you've lost efficiency.

I just saw a cardio yesterday and he pretty much said the same thing. Normal is normal, don't get caught up on the number, if something was out of normal range in structure, they would record it.

He did however say that a stress echo only shows a handful of pictures of the heart--only left ventrical and not right, and recommended a trans-thoracic echo that shows 64 images. Are you familiar with that? Is anyone? Is this necessary if the other echo was "normal" and all ekgs have been "normal" since with the exception of the ever persistent high frequency PVCs.

Thanks in advance for any thoughts on the trans-thoracic echo.

[mom4cem]

T/u....

It is easy to get hung up on number, especially if you have a tendency towards health anxiety..or for that fact any anxiety. You are right. That last few echo copies that I do have the numbers have pretty much been in the same ballpark. I wonder what else factors into it, such as if you have not been exercising or lead a very sedentary lifestyle or if you are sick at the time etc....

Upbeat,

Why did the cardio suggest the TEE. I would think this would generally for cases that need to be asessed like valve leakage etc, something that they need a closer look at.  Other than pvc's, why does your doc do the echo?

[Momto3]

Transthoracic echo is where the technician obtains ultrasound pictures by placing the wand on the outside of the chest wall.

Transesophogeal echo (TEE) is where the tranducer is introduced through the mouth and pictures are obtained fromt he inside.

Did your doctor suggest a TEE? I think the stress echo provides enough information to adequately assess the pumping chambers.  The only time I had a TEE was to determine if I was a surgical candidate for mitral valve repair.

Hope you are doing great!

[woodruff]

"Possible anxiety and/or hormonal component to this?
What is vagus nerve role in tachy/palpitation issues?
Is there an associated syndrome with MVP that could be causing this?
Does ef% change over time? Does height effect calculation?
I am starting to wonder if I really am needlessly worrying. Any insight?"

mom4cem, I'm not doctor, but doctor has apparently diagnosed you with dysautonomia.  Since you sound educated, you perhaps have already have researched  "mitral valve prolapse syndrome," and its relationship to the vagus nerve/autonomic nervous system.   This is a google page on the syndrome:

http://www.google.com/search?hl=en&q=mitral+valve+prolapse+syndrome&btnG=Google+Search

Since your cardiologist has been following you since '94 for these issues, and has repeated reassured you about your symptoms, and since you are clearly still very anxious, it would seem that anxiety is playing a role here (your current breathing problems definitely could be anxiety-related).

Anxiety and panic can needlessly screw up a person's quality of life, and it sounds as though you may be suffering more than you need to be.  After all, worrying about your condition--even if you had a serious medical problem, which does not seem to be the case--wouldn't change it for the better, would it?

As fearfactor, one of the posters here, has learned, getting help for your anxiety problems will definitely give you some major relief from your physical and emotional discomfort, and I hope you will actively seek it.

[mom4cem]

Thanks for your comments. I am under a therapists care already.:)

[upbeat63]

It was a trans-thoracic echo, not a TEE.

Apparently recommended just so every base has been covered, because the cardio says that on the stress echo they only look at the left ventricle and not the right ventricle.

I have mostly single foci PVCs from the right ventricle. I'm not sure if the trans-thoracic echo will provide any more answers or not. Sadly, I'm trying to justify the cost if everything else has been normal. High deductible.

Basically he said, 2,000, 5,000, 10,000 or 20,000+/pvcs per hour is all pretty much the same. It's a lot, but there's not much to be done. Anti-arrythimic drugs he says are toxic and should only be used when benefit outweighs risk. And ablations aren't recommended for PVCs for the very same reason, risk of an invasive procedure versus a "benign" condition. I really have to agree even though some days....if I had the option win the lottery or be PVC free...I think all of us would choose no PVCs.

He did honestly say that not much is known about PVCs, only the miriad of triggers and that not much is known about treatment except avoid the triggers. ha, ha, ha, ha. That was a good one.

Beta-blockers decrease the workload of the heart, and that May or May Not decrease Pvcs. yadda yadda. Further, no one is studying high frequency PVCs because SOOOO many people have them but not many are dropping dead of them. There's no urgency. (for researchers). but he still thinks a trans-thoracic echo should be done. I don't know.

[Momto3]

UGH!!  This visit was not supposed to lead to more tests = more money.  YUCK to the high deductible.  I remember when deductibles were $100....a LONG time ago :(

I'm glad it was a TTE and not a TEE. If you decide to go ahead, it should not be as costly.  I didn't realize that stress echos only looked at the left ventricle.  I'm going to try and remember to ask my doctor if mine is done the same way.  I'm going in a couple of weeks...Boy, times flies by!

I'm also not sure whether the trans-thoracic echo will provide any more answers. I'll try and remember to ask that question.  

I kinda got the same feedback about the frequency - "it's a lot, but it's still benign."  My doctors have never wanted to put me on anything other than BB for pvcs. Eventually, I just got used to them and used the BB's only for the BAD days. There was talk early on of trying anti-arrythmics, but no one was comfortable with that, me included.  

Once I was put on anti-arrythimics, I did get some relief from the never ending pvcs. But, no thanks to the side effects...Hence, the ablations.  I agree whole "heartedly" that taking potent meds or attempting ablation in the setting of a benign condition is not warranted.  Hang in there Upbeat!! You have such a great handle on your own situation and I'm sure you are "tuned in" for any changes.  Hmmmmm.....PVC free of the lottery.  I'll have to think on that....Can I split the difference?  Deal or NO deal?  LOL

Oh yes...the "triggers."  I never really have much luck with figuring that out.  Other than my God-given anxiety, caffeinated beverages, and occasionally, my love for chocolate, I didn't have any really triggers.

Good luck with your decision on the TTE...Keep us posted and stay Upbeat : )

[rambios67]

Hi. I am 38 years old and I have suffered from Panic attacks for almost the past 3 years. They started 3 weeks after I got married to the love of my life.  Since then, my/our life has been one ER visit, Urgent Care vist, doctor visit, after another AND a complete cirlce with various meds. It has cost my family thousands of dolls, thousands of hours of lost sleep, and many many arguments. My wife and I feel that the first years of our marriage have been stolen from us.  

The docs keep pushing me to try more SSRIs. I have been on Paxil, Zoloft(Tremendous weight gain, lethargy, no sleep and nightmares), Cymbalta(horrible nausea), Effexor(disturbing hand tremors, Prozac and Imipramine(huge increase in attacks, and now my docs want me to try Lexapro and from what I have read on this forum, Lexapro is just as worse...even if the the docs say the side effects are less...they are not the ones taking it.

Anxiety and panic can ruin people's lives unless they get good support from a therapist who actually cares.  I am just coming off of 30 day STD from work because of the meds. I am now back on Klonopin (.25mg AM and .25 Noon, and .5 before bedtime) and it has stopped the attacks. I am still wound up and anxious a lot but that is my normal genetic makeup and I am learning to accept it.  I have been told and I have read that Benzos are terrible in the long term but you know, they work for me.  And with Congnitive Behavioral Therapy, I hope to slowly wean off Klonopin this summer and be psych drug free.  Therapy is the answer, not meds. They really only mask symptoms conduct no curing at all unless you have depression.

In addition, I suffer from PVCs that drive me crazy when they hit.
These palps have send me to ERs and home early from work. I have spent many, many hours worrying about my heart, even though my EKGs, sress tests (3 of them), Holter and Event (2), Stress echo (3), echo(1) blood work ( near infinite) have all come back normal

Then early this year. They stopped!  But in the last three weeks when I went on STD, they came back full force. One doc thinks it is my hay fever pill, Allegra, that started them. So I stopped taking it.  We shall see if they decline.  I have been told that my panic disorder is the main reason I have PVCs and chest wall pain, but a big part of me still thinks I have a heart problem.
I worry everyday about PVCs and what they may do to me. Even though several cardiologists and docs have said to me "live your live and enjoy your new family and home." It is so difficult to do that when you are always scared.  I don't fear the panic anymore, but I am terrified by the PVCs. They hit whenever and wherever and  I am a little agoraphobic about them.  They have disrupted my professional and personal life.  This whole panic thing has caused significant damage to my new marriage. I accept the full blame as I am not the person my wife married anymore and I dream every day to return to that individual.

Meditation, yoga, relaxation are the answers and cures. Remember, that you recover from panic and anxiety, but you may never be truly cured.  It is how you allow them to be a part of your life and let the dissipate on their own.  They do. Trust me.  I am now learning that panic is caused by my fears only...and when one comes on, I say "ok, hit me with everything" or I say "oh, a panic episode, no big deal" and they stop quickly.  You then gain confidence.
I hope this helps!

[talylor]

SO SORRY FOR POSTING HERE...but the other thread was closed and I really needed to vent my fears and get some reassurance. My friends and family all think I am overreacting but they dont feel what I feel. I do not have the results of the holter monitor yet. I did have some symptoms while on it but not the STRONG ones. Of course, I had three very STRONG ones yesterday AFTER the monitor. So since then I have been upset cause these things are so scary and overwhelming that I can easily spiral down into a depression. It felt like my chest and throat were falling down a hill or being hollowed out. I hate them and I have no idea what they are or why they started but I want them to stop. I read on this forum things like PAC, PVC, SVT, VT and so on and that people can have several types going on and so I am worried that what if I have more than one thing going on and the monitor didnt pick it up cause I didnt have THAT one when being monitored. I am doing the best I can to remain optimistic and calm but when they come...my attitude changes quickly. Afraid these arent the "benign ones". Afraid one of these days a strong one is going to do me in cause sometimes when they come...it doesnt feel like its going to stop. This forum is the only place I have found where people seem to understand what I am talking about cause they have felt it. My doctors tell me to wait it out and lets see what this and that shows but that is SO MUCH easier said than done.

[woodruff]

I know it's scary, because I have been there.  What helped me, and what may help you, was getting up from the chair, bed, or wherever I was when I felt those frightening sensations, and noticing that I could do my usual activities.  I really could.  I could cook, sew, take a walk, talk with my husband, even though my pulse felt chaotic.

Can you do your usual activities when you have those strange feelings in your chest?    If you can, it is a sign that your heart is doing its job just fine.  You note that you can feel yourself spiraling into depression.  That means that you understand how important your emotions are in what's going on with your body right now.  

I think trying to stay calm and optimistic is not where it's at for you.  Rather, I think you should go to your doctor or psychiatrist and simply say that worry is driving you frantic, because that's the truth.  Your doc can discuss this with you, and if you are clear about how miserable you are, she/he will be able to prescribe medication or therapy that will help you over the anxiety that is making you even more miserable right now.

[talylor]

Today has been an especially bad day. Had ALOT of strong ones and since I dont know what is going on yet (no holter results yet)...I dont know if this is just a bad day or if this is a sign if they are getting worse or what. For months I have been getting these things and from day one I told the doctors it was my heart or lungs (cause the breathing problems and where the pain was) but they said it wasnt with all the tests they ran (the stress, xrays, ekg's in office, etc)and I even asked WAY back when if it could possibly be an arrhythmia and they said no. But I come here and read all these posts and see what people say they feel and I told my docs the EXACT same thing and yet it didnt ring a bell. I mean, I wasnt feeling the palpitations and racing heart, just the hollow/sinking feeling so I thought I guess its not an arrhythmia thing...but how didnt the docs think my symptoms sent up a red flag? seems to me the hollow and sinking feeling is pretty common. Until they put the holter on this week, they were still telling me gastro or anxiety and I was getting angry and anxious cause I knew that was the wrong road to go down and my symptoms would keep coming. But in these past two weeks I have become more convinced its the heartbeat cause I have been reading up on it to try to figure all this out. Checking my pulse...I feel the pause, I feel the strong beat, and it seems so obvious to me now. What I dont understand is how this all happened...why they started.

I have started counseling and had a rx for Xanax filled at my docs wishes after I broke down in his office out of worry and frustration. I know I neeed to learn to handle this better. But I also know my anxiety NOW is NOT what caused all this and my docs needs to figure this out. I am scared aftet these 4 months whatever this is has gotten worse and when they do figure it out it will be too late. I dont know if this is all these things work. I read about "sustained" and "nonsustained" and I dont know what qualifies for either. My rate goes up to 120 or higher sometimes. i dont know if THAT means something bad. I dont know if i get the strong ones all day like today if thats a bad sign and I need to call my doc or if its just a bad day and i need to wait for the holter results. I am trying not to drive myself and the docs insane. Truly doing my best.

[woodruff]

Talylor, can you do your usual, daily activities?  Can you walk around OK, go up stairs, drive, lift ordinary weights like groceries or kids?

[talylor]

What I notice is bending can bring on the chest and throat sensations. Exertion (walking, lifting, ect) can make me sometimes short of breath b ut overall...I can physically still do things. As soon as they are over...is like they never even happened...again...physically. Psychologically though...they stop me in my tracks.

[andie3330]

Hi,
If you can feel the short pause in your pulse and then the stronger beat, you may well be having PVCs - thats how I finally recognized that my symptoms were due to PVCs. I recognize the anxiety in your last post because I had extreme anxiety about my PVCs when I first found out my symptoms were heart related. But I can certainly reassure you that having PVCs, even though they feel very scary at times, will not hurt you physically. I've felt my PVCs off and on for over three years - there are many people on this forum who have had symptoms from PVCs for ten, twenty years or more. Some people have had 20 or 30 PVCs every minute of every day and they are fine.

I assume that you have already eliminated ALL caffine from your diet, even chocolate. Also try to get plenty of sleep and stay well hydrated. These things can help reduce the frequency of PVCs. Stress might increase the frequency of PVCs, but again, even with very, very frequent PVCs, you'll be fine - just uncomfortable.  

When I read you last post, I empathized so much with you, I know how terribly difficult and incapacitating the anxiety over these issues can be. I wish I could give you an answer that would help to ease you mind. I'm happy to answer any questions that you have if you'd like me to. Andie

  

[talylor]

Thank you so much for responding. Actually I thank anyone who has responded and tried to help me and educate me thru this very very hard time. I am terribly afraid. To the point that I have crying fits almost every day. I wake up, trying to be in a good and positive mood and then one hits and I simply lose it. Mostly out of fear that I cant imagine that this is how I am going to have to live the rest of my life. That thought terrifies me. Since I dont have the holter results yet...and i dont know what type of arrhthymia I am having...knowing there are BAD and SERIOUS types out there terrifies me. I sit here hoping it is a PAC or PVC but even THEY terrify me since I read there is no cure.

I have cut out all caffeine and chocolate which upsets me cause I ADORE chocolate and now I cant have it. I have friends and family looking forward to the warm weather and going to amusement parks like we always do and I am afraid that part of my life is over as well. I NEVER know what type of day I am going to have so making plans to do anything has been hindered...afraid to make plans with anyone and then I have a bad day and I ruin the day for everyone around me. My life prior to this happening seems like a far off dream. I dont even remember it anymore.

[woodruff]

Talylor, if you can do your ordinary activities, it is reasonable to think that your heart situation is NOT dangerous.  The bad and serious arrhythmias that cause physical disability or death almost always cause such pain and and weakness that people are unable to do even the most ordinary physical stuff.  You don't have to concentrate on being cheerful or optimistic, but you can say to yourself, "Hey, I can do x, y, and z, just the same as always--except that I have these weird and awful sensations.

I think counseling will be a big help to you, even after you get your holter monitor results.  I am not trying to minimize your pain here; I hope you know that.  But you clearly understand that a big part of this problem is emotional, and that's why we see counselors.

[andie3330]

Just because you are having a lot of symptoms now does not mean that it will be that way for very long. I had a ton of PVCs -several a minute - for a few months, but now I probably only notice a few a day and I hardly think twice about them.  I don't remember reading your profile - age, etc, but are you going through any type of hormonal changes? Sometimes people have a lot of PVCs for a while and then the PVCs seem to go away when hormonal changes resolve.  A lot of women notice PVCs as part of PMS.

Like Woodruff said, if you can function fine physically while you are having these symptoms, then certainly your heart is working fine. My doctor once put it to me this way -  healthy, young hearts have more variability to their rhythem (this is a positive thing) and ectopic beats show that the heart has a back up system to the SA node.  Also, even if you do have other symptoms (like shortness of breath) along with these palpitations, the other symptoms could also be caused by intense anxiety or panic attacks.

For me, focusing my attention on something concrete in the present moment helps to get my mind out of the vicious cycle of scary, obsessive thinking. Scary thoughts are just thoughts - they are not truth. Could you take at least a little time to focus on something positive that has nothing to do with your heart health - just to get a fresh perspective.   Honestly, spending time on this forum is not the healthiest thing for me to do - because I just end up with more to worry about. Sorry I can't be of much help to you - I wish I could - but I know it's just so hard to be waiting for results. Just not knowing is the worst - but I believe you're going to be just fine.

[codeblue1018]

Hello all. Nice to see others have the same annoying problem that I have. I am 33 years old and have irregular heartbeats (PVC) for approximately 3.5 yrs. Mine occur frequent and as everyone knows, it is irritating. Since that time, I have had every test under the sun with the exception of invasive and nuclear tests. All the tests came back negative for heart blockages etc. The cardiologist says my heart is fine - no problems. For some reason, I cannot except that. Since September of 2005, i have had "soreness" near my heart area. Not chest pain relating to that of a heart attack but like a faint pain directly on my heart. Happens whether im relaxing or exercising. Cardiologist cannot explain this besides saying my heart is ok. I'm confused and frustrated. My father passed from heart disease at 67. Our lifestyles were different. I exercise, he didn't. My wife thinks it's anxiety but I don't feel anxious. My cardiologist gave me medications to try in attempts to slow down the palpitations - digitek .25 mg once a day and altenol 25mg - once a day. I stopped taking the digitek because my pcp scared me saying she didnt understand why the cardiologist gave me such a "strong" drug for only palpitations, although it seemed to help. Altenol made me tired. Dont know what to do.. Any suggestions?? thanks you for any input.

[tarat]

Hello everyone,

I'm a 34 yr old woman with pvc's/pac's/svt. I know how everyone feels on here. I have had this since 1998. I went off the beta blockers they were killing me making my pulse so low and bp. I'm only taking ativan now because I get severe anxiety when my heart goes crazy everydsy. I think the only thing we can do is keep praying they will go away and that GOD will heal us in his time i truly beleive that. I use to take my good health for granted and never thought twice about it until these heart concerns came on now its all I think about. I will keep praying for everyone with this concern and I just hope everyone will be healed of this horrible ailment.

Tara

[talylor]

Thank you SO MUCH for your kind words and support and advice. I am driving my family and friends insane. They dont want to hear it anymore. keep telling me to move on with my life. They just dont understand what i am feeling.

So I just got out of the hospital. On top of my recent problems with the chest and throat, I have a neurological problem for the past year or so and my neuro scheduled me for testing. This was scheduled two months ago and when the time came for me to go this week I was very upset and nervous saying I was not in the right state of mind with everthing going on. That I wanted to focus on my "heart" problem. The hospital said they would monitor my heart. So I was there for 3 days. 3 DAYS OF MONITORING. Not to mention the 24 hr holter monitor my GP did last week. And of course, because I tend to get the feelings during the day and when up and about and random, and the BIG ones only coming a day here a day there, I didnt get ANY big ones there. NOT ONE. Had some small ones. But mostly on the left side....not the ones in the upper middle chest and throat that FREAK ME OUT. Neuro came in and told me he viewed everything and EKG for all 3 days was fine. I told him I didnt get the BIG ONES so it wasnt "captured to evaluate" and he said "doubt they are cardiac though". My GP called this afternoon, holter came back NORMAL OUTSIDE OF A FEW PVC'S BUT DONT THINK THAT EXPLAINS ALL THE SYMTOMS. NEED TO START THINKING ANXIETY OR GASTRO. I asked him if the log i kept matched the pvc's on ekg and he gave me a vague answer that I dont even remember right now. I really need to know if my log matches the ekg cause than  I will know.  

Do you think I need to drop the BIG ONES aspect? I mean the fact that I didnt have one while being monitored? I cant help but wonder if THOSE are something different that didnt get picked up or just the same symtpom just worse? Should being on a EKG for 4 days overall be enough to rule out serious heart problems without getting the big ones?

Since being home I have had alot of them. I have also been more active then just sitting in a hospital room for days. So i contribute it to that...my family however says, SEE...STRESS. AS AS SOON AS YOU ARE OUT OF THE HOSPITAL...BOOM...YOU GET THEM.

I just dont know what to think anymore.

[andie3330]

I think you can be VERY reassured that your heart is fine after the holter and hospital monitoring.  I know that my PVCs sometimes feel very strong and sometimes I hardly notice them. I think it depends on my activity level - ie how hard/fast my heart is beating at the time - and also on my body position - I seem to notice them more when I bend forward - but there are probably lots of factors that play into the equation. Do your "big ones" feel basically the same as the smaller ones, just much more intense? If so, I think you can probably chalk them up to PVCs also. That has been my experience anyway.  You have great news concerning your heart! I am very happy for you - you just need to get to the point now - in your own mind - that you can write these worries off and move forward in your life. Best wishes, Andie

[talylor]

Hello again. The BIG ONES I tend to get in the upper center chest, sometimes to the left, and in the throat. These last a little longer, but by that I mean 5 or so seconds, cause all the feelings last only seconds. Those are the ones that if I feel my pulse I can feel the change and those are the ones that have the "going down a hill" or "hollow" type feeling. The SMALL ONES I tend to feel just on the upper left chest, sometimes as if it is coming from the breast area, sometimes even on the side of the breast. I call them "flashes" cause they are so quick. 1-2 seconds. I guess I wish I got a big one while being monitored so I know that these are all the same things. I have read that people can have more than one type of thing going on at the same time.

I tend to get mine while active. Bending is a key factor I notice. And just being active period. I will get them at rest but they come during the day when up and about and then I sit to work or watch tv or such. If I am just home in bed, like in the hospital, doing pretty much nothing, I will get very few. I NEVER get them sleeping. At least I am not aware of them.  I tried to be active in the hospital, walked around the room, bended here and there, but the exertion level just wasnt the same as in every day life. I told everyone I was getting the big ones there because of this and they said OR you are more relaxed because you know you are being monitored and you feel at peace and close to an answer, so your symptoms are less, hence they said ANXIETY. Nope...dont buy it. I KNOW it does factor in...I am well aware of that...but these things started from something else. The anxiety makes them worse I am sure...but they are not the culprit.

[andie3330]

If the "big ones" are the ones that cause a pause in your pulse and then a stronger beat following the pause, they are almost certainly PVCs as well - that is the classic description of what PVCs are like - along with the throat/chest sensations. The "little ones" could just be less noticable PVCs or they could be PACs - premature atrial contractions.  PACs are usually not felt nearly as strongly as PVCs and, of course, PACs are also benign - many people have both PVCs and PACs - I've had both. Generally PVCs get more attention because they are more noticable. I truly think you are just fine, given the information I've heard.  Best wishes, Andie

[talylor]

Just picked up my holter test results. Doc wasnt there for me to go over with him. Have appt next week. Even more confused with what results say. Dont know how to read it:

RESULTS:
TOTAL BEATS 111810
0.02% WERE VENTRICULAR
0.O5% WERE SUPERVENTRICULAR
0.0% WERE PACED BEATS

MEAN HEART RATE 79
MAX HEART R ATE AT 8:45PM WAS 145
MIN HEART RATE AT 7:43AM WAS 47

VENTRICULAR ECTOPIC TOTAL 25, SINGLE 21, PAIR 2
SUPERVETNTRICULAR ECTOPIC TOTAL 66, SINGLE 12, PAIR 2, BEATS IN RUN 50, LONGEST RUN 22, @6:08AM - RATE 91

COMMENTS:
NSR, RARE PAC


I dont understand. He states rare PAC? no mention of the 47 times i log in my event log to see if symptoms coincided with anything...unless this means my symptoms were not coming from the heart at those times after all????????????????