exercise and PVCs

[kat23]

I have read all the exercise & PVC questions in the archives.  I am left with a few questions - a few people have stated that these are associated with a higher risk?  can you expand on this?  I was diagnosed with rate related PVC's and now am worried about exercising.  When the PVC's start, should I let up on the exercising?  (i play ice hockey) Also, I am now 12 weeks pregnant and have been getting a few isolated PVCs even without exercising lately.  Is this due to my pregnancy?  I should say I recently had an echo and holter monitor (although I had no PVC's during the holter monitor) and two years ago i had a stress test which showed the PVC's over about 98bpm.  is it reasonable to keep my heart rate below 98 bpm and still be in ok shape? should i even try to keep it below 98bpm?  i am female, 34, about 25lbs overweight, no other health problems.  thank you for your help!

[Cleveland Clinic]

kat,

thanks for the post.

1) In the absence of structural heart disease, PVCs is not associated with any higher risk of mortality. This doesn't mean it doesn't carry some inconvience in those suffering from them.

2) When the PVC's start, should I let up on the exercising? (i play ice hockey)

I would confirm they are truly PVCs with event monitoring. If so, unless they are causing you significant symptoms, check away.

3) is it reasonable to keep my heart rate below 98 bpm and still be in ok shape? should i even try to keep it below 98bpm?

Again, unless they cause you significant symptoms I would keep exercising. You may find as you get in better condition your symptoms also improve.

good luck

[Dr. Erik]

In a structurally normal heart, PVC's during exercise or at rest do not indicate a higher risk of mortality. The big question is tolerance. Can you tolerate the PVC's during exercise? Does it bother you getting the PVC's while you exercise in terms of anxiety? If you can ignore the PVC's and exercise, you should. Exercise is very good for you.  The PVC's will not harm you. They are just an annoyance. I have learned to cope with them while I exercise and they have now practically gone away. Good Luck!

[karen23]

thank you both for your replies - i do get pvc's post exercise and that was really what i was referring to when i asked about the increased risk.  i have to admit PVC's during and post exercise do make my anxiety level rise, and my attitude towards exercise has certainly changed in the past 2-3 years, which i know is very unhealthy.  reading posts on this board over the past while has helped me realize that i am  not the only one with this problem, and i am probably on the less affected side than most.

[Makaveli]

Is someone decondintioned if there heartrate shoots up with a small amount of exertion? I was running and jumping around being stupid the other day and my heart rate went up to 193. I am out of shape, but far from obese...

[Barbarella]

Hey Fred, I know "Kat23" asked for advice, but did you have to spell it out that PVC's during or after exercise is a greater risk of sudden death?  Lots of people who go through this hell with these PVC's are already in an anxiety state about it, and hearing that you can die during exercise when having these PVC's does not help at all.  I don't mean to jump on your case, I'm just very sensitive about this issue because I used to be in a great anxiety state about these damn PVC's, and I know what people are going through worrying about them.  For me it was sheer hell.

I know what is printed all over the Internet with all the researches which btw are changing frequently.  I used to read all that, and freaked out, and worried I might drop dead while exercising etc. and this is what my Cardiologist told me:  "In a HEALTHY heart you will NOT drop dead from PVC's during exercise.  These horror stories and researches people read about are cases where people already had heart problems, ignored their heart problems or doctor's advise, but some of these researches don't mention that", that is what my Cardiologist told me.  He told me to stop reading about these researches, stop reading medical books, and listen to him when he says "my heart is healthy despite my minor mitral valve leak, and I will NOT drop dead from skipped beats whether during or after exercise".  "I have a choice I can listen to him and trust him or I can hug the couch and feel sorry for myself, and worrying for the rest of my life that I will drop dead because of my PVC's."    

I must admit that I still HATE the PVC's at times, but I am not worried anymore of dropping dead while I have them.

[arthur]

Grey hair is also associated with a greater risk of death.

[pms_barbie]

I get pvc's mainly bigeminy after I do any excertion.  My dr has run all the test.  Ep study and ablation.  He found a spot throwing off frequent pvcs but couldnt find the spot throing off the bigeminy.  They tell me the chances of me having something bad happen are less than 1%.  I also have mitral vavle prolapse.  I agree they are nerve wracking and I havnt even wanted to get out of bed.  The fear is so great.  No matter how much they try and reassure me the moment I feel those awful things I get all panicky.

[Dr. Erik]

Also, slipping on banana peels carries an increased mortality rate. I'll bet that people who are more stressed than others have a higher mortality rate. If we all let these PVC S stress us out we will all die sooner. But we all have a 100 percent mortality rate. We will all die someday. Fred is talking out of a different body part other than his mouth. PVC s before, during or after exercise mean nothing clinically significant in a healthy heart. The one true measure of predictable mortality from a cardiac standpoint is: Does your heart recover at least 12 less beats per minute for the first minute after an intense work out?
If it does you are not any more likely to die than the next person. Put that into your pipe and smoke it FRED.

[Dr. Erik]

Hey Fred. You should stop smoking that pipe. That has to increase your mortality rate!

[Dr. Erik]

I don't know. That's a pretty high pulse rate. It may be from being out of shape, but I would check it out with your doctor. You didn't mention how old you are.

[karen23]

thanks, again.  i have to admit, when i read fred's post, i felt a little uneasy!! you all seem to make a lot of sense, and i have to admit, made me laugh out loud!  kat23 (my work log on is different from my home, for some reason)

[Makaveli]

I'm young. 17. I just called my cardiologist cause I just had a holter a couple weeks ago and he said it was totally normal since I am out of shape. You know the saying, you got to walk before you run.

[Barbarella]

Thanks Pluto.  Yes my Cardiologist was straight up front, and you know what?  I needed that.  He took the fear out of me about these PVC's.  When he called me on the phone last February because my echo showed a "severe mitral valve leak" and he informed me that I needed an additonal test called TEE test. I immediately said "oh my god now I have something else to worry about".  And he replied with "unfortunately we all have to worry about something while going through life, life is not without worry, but I suggest you don't worry and wait at least till I have the result of the TEE test for echo's are not always accurate".  This calmed me down.  Had he been short and firm i.e. "the echo showed this and that, and I need another test", subject closed "have a nice day", I would have worried a lot more.BTW, the TEE test showed a very "minor" mitral valve leak. This Cardiologist done more for me calming my fears then any other doctors in the past and present. Unfortunately our Insurcance company only gave me so many visits when I got the referral, the Cardiologist checked me, wrote his report, and now its back to the General doc.

All of you on this board have a nice weekend!

[pms_barbie]

I had a heart cath that showed mitral vavle prolapse with no leakage. My echo said mild leakage.  I have been told the leakage may come and go.  I  guess all test might vary also.  I think it all depends on how good the person giving the test is at doing their job.

[Barbarella]

You are so right.  That is why I try not to worry to much anymore IF I need an additonal test, I remember what the Cardiologist said "to wait for the result of the additional test".  I learned that for example certain kind of breathing when people are under anxiety can mess up the results of an echo among other things.  I know I was nervous at the time the echo was done.

In my case its not Mitral Valve Prolapse, but a minor leak from the mitral valve.  The Cardiologist drew my husband, who waited outside, a picture about this leak, it makes sense when I look at it, but can't explain it here how it leaks, he said "kind of like a jet or spray" I think, but don't totally quote me on that. All what matters to me is that its not dangerous.

[Barbarella]

Glad we could make you laugh.  Its always good to exchange experiences, and exchange what our Cardiologists/doctors said about our heart issues.  When it comes to PVC's and also high BP I have been in peoples shoes, and I know all about the worry and anxiety and the hell some people are going through, and have been going through.  Only people who had these same issues will totally understand your concern and worry and anxiety about it.
Did any of you ever get these funny stares from people who never had these issues? and don't know what it feels and what you are talking about? and what you are going through?  I got plenty, that is why I stopped a long time ago telling people about PVC's etc.

[pms_barbie]

I understand what your saying about the het.  Dont they consider that normal in some people?

[Barbarella]

I don't know.   All I can tell you is that the Cardilogist said to my husband "there was nothing to worry about, and that I did not need any follow ups about it".  He told that to my husband right after the test, my husband was with me because after this test you are not allowed to drive home alone.  By time I came out of the room where the test was done, the Cardiologist was already gone.  Since he said "no follow up necessary" my Insurance company would not pay for another visit, and I don't know if I would get a "free" consultation over the phone :)and since he told my husband all I need to know, I arrest my case.

I'm glad to read what you told me about "these minor leaks can show up and then again not show up on tests".  Because this was never detected before on me, but I guess there is a first time for everything.  But I always read that people get these leaks from either inheritance, from Rheumatic fever when a child or after a heart attack which none of the above apply for me.  My Cardiologist said that sometimes the "aging process" can cause it, but he really did not know what caused it in my case.

[Barbarella]

Thanks Pluto for the update.  I'm so glad my Cardiologist ordered that TEE test, had we stopped at the echo we'd have thought that I had a "severe" mitral valve leak, that was the diagnosis from the Cardiologist (not my Cardiologist) who read my echo.

[pms_barbie]

hmmmmmmm my echo said I had moderate to severe prolapse with only mild reg.  Then the heart cath said no leakage but still a prolapse.  MY cardio says it may not get worse or over time it may need replaced.  He said it was something I was born with.  I just didnt know about it til the age of 35.  I have the palps but my cardio said they wouldnt attempt to fix or replace the itral valve because of the palps because the leakage wasnt bad enough.  He is I had mild left ventricular dialation. 5.7 on here I read that up to 6 is normal.  THey said I had thickened mitral valve.  I didnt understand all the echo findings but none of the three cardios I have seen seem worried nor does my ep dr.  I just wish I knew of a way to get rid of this darn bigeminy.  I have it mainly after climbing stairs.  I dont do cafeine but I smoke.  Can smoking cause it ?  anyone know?

[wmac]

I agree with fwilson, I too just read that study. I belive it said that they use to belive that exercise induced pvcs put those people in a higher catergory for sudden death, but now they belive that it is not true, but they do belive the problems is with the pvcs after exercise. They said it puts people at higher risk for sudden death. All this time I too thought it was bad if you had exercise induced pvcs.
wmac

[squeala7]

You will all learn very quickly to ignore both Fred and Arthur's posts - their main goal is to scare everyone enough that people will get up in arms and force the medical community to do more for people with PVC's so they can get rid of them.  It is ignorant to think that will ever happen in our lifetime, so it's always better to try to be positive and live life to the fullest with what we are dealt. I think the medical community is doing the best they can.  PVCs are a very strange thing / you can have them one month and never have them again. There are about a MILLION different things that can actually CAUSE pvcs - finding the root cause is very difficult. PVCS will not kill  you - - but FEAR and ANXIETY WILL.  I think there ARE enough studies that prove that!  So try to relax - enjoy life.  I have bigeminy daily / during exercise - after exercise - who cares. Im gonna live just as long as the next gal and if I don't, then so be it. (I just hope its quick hahahaa just kidding) Delete or skip over as soon as you see their names - life is too short to deal with negativity all the time.

[Sam R]

Being a Yankee fan at Fenway may also lead to a premature death

[wmac]

I have just skip read some of the postings here. And they are quite silly!!!! I agree with fwilson on the article he read I too read it! I dont think fwilson was trying in any way shape or form to scare anyone! Fwilson was stating something that he/she (sorry dont know gender) read, as I did. Trust me pvcs scare me, and so does my nsvt scare me,  Fwilson and myself were saying that pvcs wont kill you but you may be at a higher risk for sudden death if you have them after exercise. That is what the article said. They use to tell us that if we had pvcs during exercise we were at a greater risk for sudden death now they changed it.  TRUST ME NO ONE HERE WANTS TO HEAR ANY OF THIS WE ARE ALL AFRAID OF OUR CONDITIONS WHATEVER THEY MAY BE. ANXIETY FOR ONE. I just dont think anyone here means any harm. I most certianly dont and if i ever offend any one I want to say that im sorry now for it because im just as fragile as the next person. We should all try to get along, we are in this together and we need each other. One more thing to think about if we keep bickering they might just fool us all and stop this whole forum and I dont think any us want that because we all need this and each other. God bless you all
wmac

[Dr. Erik]

I think the doctor's answer says it all. good night everybody.

[amw]

I logged on tonight after having a bad day of PVCs, hoping for a bit of reassurance to make me feel better.  I got it. Thanks.

[Barbarella]

You think you are real funny don't you?  First of all PVC's are not cancer.  Second of all we don't have that kind of money to go for second or third opinions.  Our Insurance company pays for one referral.  Why should I not trust my Cardiologist??  He went longer to school to become a Cardiologist than you did I'm sure, unless you are a doctor which I don't think you are for a doctor would not post asine stuff like you did.  A Cardiologist knows more about PVC's then all of us on this board and that includes you.  We can share our symptoms and frustration over these PVC's, but a Cardiologist after examining us can tell us if we are at risk of sudden death.  If people like you have all the answers then why don't they just treat themselves?  People have enough anxiety about these PVC's they don't need for you to come on this board and tell them about "sudden death".  Read what the doctor posted, you might learn something.  I think you get your kicks out of trying to scare people. Some people might think you are funny, but I don't.  You don't joke about stuff like that.  This is a site where people talk about their heart issues, people are concerned and some have anxieties about their heart issues, this is not Saturday night "laugh in".  Give me a break!
And about you hoping that "I wont arrest my case soon" or whatever you said, don't worry about me, I went to the Cardiologist, I don't think that I am the "know it all" like you who thinks he knows more than the doctors do.

[va_tony]

I agree with Fred and WMAC.  Fred simply stated a fact. A recent Cleveland Clinic study shows that PVCs both during and after exercise are associated with an increased risk of death (twice the risk, actually).  Now it may be that subsequent studies may modify this conclusion somewhat but this is the available data for now.  Ignoring it may be good advice for the cadiac neurotics on the board but, if you are a realist, it's a call for action (e.g., lifestyle/diet change, meds/suppliments, etc.). It's also an intuitively obvious result as well.  Of course a machine (or heart) will last longer if it's operating according to specs.  Any deviation from this ideal will reduce its lifetime. Isn't that what you would expect? Isn't that what the data shows?

This is not to say that having PVCs is a cause for great anxiety.  Anxiety is counterproductive and besides the risks involved are actually still quite small.

Barbarella accuses Fred of acting as though he knows more than doctors. First of all, I don't believe Fred ever said or implied that he knew more than doctors.  He simply reported what he read. Second, are doctors really the ultimate authorities on this subject? Perhaps in the eyes of our legal/medical system they are.  However, I read (see http://www.aventisbehring.com/ABCMSPRDI/n35241pr25604/AventisBehringAssemb.htm ) that, at a recent symposium in Berlin, five Nobel prize winners in the field of medicine were speaking.  What struck me was the fact that three of the five were not MDs but Ph.D.s instead.  Of the two with MDs, one also had a Ph.D.  So it seemed to me that an MD was not a requirement for a researcher to accomplish a breakthrough in medicine, only a critical mind. So, keep up the critical thinking, Fred.

Tony

[Dr. Erik]

"Cardio Neurotics" ?  That's a real nice thing to say. People use this board to help relieve fears and anxieties as well as get feedback from the doctor and others. While your opinion is welcome, your presence is not if you are going to post things that are contrary to the doctor's answers and is intended to scare these people. If you had taken the time to read the doctor's answer you would have seen that he stated that pvc s in a structurally normal heart carry no increased mortality.

[Barbarella]

My personal opinion is if you go on a site like this to chat with people who have heart issues, you don't scare them with "sudden death" stories.  The doctors don't even post this when answering questions.  How can a person come on this board who is not a doctor talk about "sudden death" to me and others  when he has never met me, never examined me, has not seen the test results and doctors reports of my heart tests yet tells me "do something about it", "hope your case doesm't arrest soon".  What the hell do you call this?  We are not morons we all can read researches on the Internet, some of them say this today and that tomorrow. That is why some of us go see doctors to ask about what we read on the net.

Well for his information this Cardiologist was not the first one who told me that PVC's will NOT kill me during exercise.  I had this problem since I was 20 yrs old, and I am 60 yrs old now. I had quite a few family doctors througout these last 40 yrs, my husband spent 25 yrs in the military and we moved 27 times throughout these 25 yrs just to give you an idea how many different doctors I had seen, and EVERY one of them I had asked about my PVC's at my first visit, and NOT one doctor after examining me told me that I had a chance of "sudden death" including the Cardiologist I saw just recently told me I WILL NOT DROP DEAD. So you see Fred I'm still well and kicking, and walking 3 miles real fast 6 days a week no matter what kind of weather in the snow and in the rain, and this for the last 20 yrs.  None of these PVC's have killed me yet during my walks, during lifting heavy grocery bags, lifting furniture etc.  My grandmother had the same problem, worst than me and she turned 83 yrs old, and no she did not die of "sudden death". She died slowly of cancer.

If the rest of this board loves to hear from a layman about how they could drop dead from "sudden death" a layman who never met you nor read your doctor reports about your heart thats fine.  I don't need a layman telling me on this board "to do something about it" (to hell with what all the doctors and Cardiologist told me in the past) and he hopes "that my case wont arrest soon".  I think remarks like that are way over the top.  I know his type.  I used to work as a medical secretary in a large teaching hospital, and "some" not all of the first year residents acted like they knew it all. And btw Fred, I was checked out there also about my PVC's, and again was told NOT to worry.  I guess in your book all these doctors and Cardiologists were wrong, but you read some story somewhere about "sudden death" and now you have to "educate" us about it.  Forget it, I leave this to the doctors and Cardilogists.

And one more thing lots of times the Pharmaceutical companies are sponsering and paying for these researches. In return they benefit from selling their drugs and leaving tons of samples and kick packs for the doctors and hospitals.  And yes, most of these researches are done by PH.D's.

[va_tony]

As posted by CCF CARDIO MD - DLB on August 04, 1999 at 14:33:36, "cardiac neuorosis" is a very real medical/psychiatric condition. Do you oppose using valid medical terms on this board? "Cardiac neurosis is just a fancy way of saying someone is overly anxious about having heart disease, when in fact they do not. This would apply to many people who are disabled by benign PVCs.[Cardio MD=DLB]" The fact is, boards like this attract many cardiac neurotics, who allow their anxiety to dominate their lives and contribute to their PVC count. In some cases, the posters are in need of psychiatric treatment. The first step towards a cure for those suffering from this malady is recognition of their problem.

All I said (and I suspect Fred also) was that we should be realistic when discussing subjects like this.  I fully recognize that a primary mission of this board is "support". I honestly believe Fred, WMAC and I are trying to help.  Yes, I can sugar coat my opinions and say things that make people feel better.  But isn't a second mission of this board to realistically discuss heart related issues. The fact is, the latest clincal study shows that PVCs are not 100% harmless.  In my last post, I did add the disclaimer: "This is not to say that having PVCs is a cause for great anxiety. Anxiety is counterproductive and besides the risks involved are actually still quite small."

And as for whether I'm welcome or not, I really don't care. I'll continue to post whenever I feel a counter view is needed even if it ruffles a few feathers.

Tony