many pvc's (bigemini/trigemini) after flu/sore throat virus

[Bernd]

Dear Sir,

I have PVC's since 1991. I am 41 years old and also have a mitral problem. After the flu and three weels later a sore throat virus i now have an enormous increase in these PVC's (many thousands a day).
Normay i have some hunderds a day, now they come in bigemini and trigemini (after second and third beat). This is going on for three weeks. Last monday i went to the ER. Could not cope with it any more. After some time my heart went ''normal'' again.
For some hours. It came back again
Sometimes i have 20 or more pvc's for minutes and 5 through 10 for hours. I have no medication. 29th march i have an appointment with my doctor. Will get an echo and holter.

Please will you give some answers:
1) I have read that more than 5 pvc's in a hour is dangerous.
   Is that true?
2) Why did i get such an increase after a virus and why do i  still have that increase after three weeks?
3) Can i get a ventricular tachycardia, ventricular fibrillation, heart attack or can my heart stop with so many PVC's?
4) Is medication an option?
5) Is it a serious problem when i have them so irregular (sometimes after 2 beat, then after 4 , 3, 10, 8, 5 ect).
for many hours.
6) I also have sometimes (not always) shortness of breath when i have these many PVC's. Is that dangerous?
7) I have them also in rest and they wake me up. Is it a problem when you get trigemini pvcs for minutes through half an hour and night?

Many thanks,

Bernd

[Forum-M.D.-bkj]

Berd,

Thnaks for the post. A lot of people notice changes in the frequency of thier palpitations over time.

1) I have read that more than 5 pvc's in a hour is dangerous. Is that true?

No. You probably have been evaluated for this already. im not sure that another echo and holter will tell too much else, but with a normal cardiac evaluation the occurence of PVCs will not have a significant overall risk on your life.

2) Why did i get such an increase after a virus and why do i still have that increase after three weeks?

As I mentioned a lot of people notice changes in the frequency of thier PVCs over time. Sometimes changes in a womans menstrual cycle or an intercurrent illness can precipitate this noticible change.


3) Can i get a ventricular tachycardia, ventricular fibrillation, heart attack or can my heart stop with so many PVC's?

No.

4) Is medication an option?

Some medications will suppress PVCs such as betablockers or other antiarrthmics. Every medication carries some side effects so you would have to balance the risk and benefit of the medication.

5) Is it a serious problem when i have them so irregular (sometimes after 2 beat, then after 4 , 3, 10, 8, 5 ect). for many hours.

Not if you have had a normal cardiac evaluation in the past.

6) I also have sometimes (not always) shortness of breath when i have these many PVC's. Is that dangerous?

You would have to dicern what exactly is the cause of your symptoms. Sometimes anxiety can cause the subjective sensation of dyspnea. If that is the case treating the axiety is the cure. If you are having an extremely large number of them and they are causing the symptoms, then looking into medications to supress them may be helpful. You should discuss this with your physician.

7) I have them also in rest and they wake me up. Is it a problem when you get trigemini pvcs for minutes through half an hour and night?

No. Not if your other workup has been unrevealing.

good luck

[mariop]

Here's a link that provides a decent explanation of different PVCs.

http://www.americanheart.org/presenter.jhtml?identifier=565

If medication fails to reasonably suppress PVCs you may be able to undergo a PVC ablation.  This is an option you should talk to an Electrophysiologist about.

[LukeL]

Sometimes we look for a cause/effect for PVCs, or we become more aware of bodily sensations when we have something else wrong with us. (a sore knee might make you more aware of a cough because you are already aware of one bodily sensation)

What I am trying to say is that your PVCs may only have increased in your mind because of your flu. (which of course has symptoms in the chest which will make you more aware of that area)

[Bernd]

The big problem is the enormous increase in these pvc's.
Normally several hundreds a day and now many thousands a day.

Every third beat for several minutes or for half hour, i never have had them in these frequencies. Also i will get more of them when i am tired.
Now i have for more then three weeks 10 to 15  pvc's a minute.
That makes me very scared.

Are there more people with that kind of problems?
How to deal with these extra beats?

I am worried that i will get ventricular tachycardia and my heart will stop beating.

Bernd

[ireneo]

I understand your concern about the sudden switch from a few PVC's a day to thousands (?) a day. I had the same experience a little over a year ago. I do have PAC's and PVC's all day long and am quite adept at ignoring them. But one day I was feeling kind of tired and achey (achy), thought maybe I was going to get the flu. The next day I felt a bit better, no illness but my heart was pounding out prematue beats at 15 - 25 a minute with no break. Hmmm. I waited (for 2 weeks) to see if they'd settle down. Not really. I started to have some relief, an hour here and there but still had the strong and frequent heart hiccups as I call them for 4 - 11 hours at a time. Finally ended up wearing a monitor. Yep, it was PAC's and PVC's but that's all. Great. I knew that much. What was so annoying was 1. what caused the sudden change (never found out) 2. they were very uncomfortable and causing some ache in my chest and back and 3. I was getting so tired from loss of sleep from all the racket in my chest. The good news is I waited and waited and it gradually settled down to my usual blips and I'm just fine. It's the not knowing that gets to a person. Once I knew it was just what I suspected I went on with my life. Kind of like having a sprained ankle. It's there every day and it's inconvenient but you work around it. Hope you feel better soon.

[tickertock]

I have had occasional PVCs all my life,I'm now 42 male, but in 1992 is when they came in prolonged episodes and would visit for weeks to months at a time then disappear for years in the 1000s daily bigeminy, trigeminy you name it.

It could not be explained "only just the nature of the beast " is what most cardios /EPs told me, meaning waxing and waning. So far since 1992 this is the longest I've gone without a prolonged episode 5 years si I'm counting my blessing, but being sufferer I feel everyone's pain, when you feel them life is not fun and the days are dark, but you have to fight them and not let them win.

[Bernd]

Thank you so much. Only people who have these pvc's know how they can control your life.

Its hard to think ''nothing is the matter, i am oke'' when you heart is having those frequent heart hiccups (great word, i am going to use it).

I hope my visit to the cardio will have the same outcome as always.

Still i am very scared. But i have to live with it. There are worse things.......

But i still am not sure because some say that if you have 5 of more pvcs a minute you may get VT and your heart can stop beating.
And how long can your heart handle these trigimeni beats.

The main problem is also that i am so very tired. Can hardly do anything and  i must work.

Hope they appear less frequent. Thanks again people for your support!

[outofsync]

Hi there, I too have MANY pvc's and have had holter monitors and EKG's, lab work and echo's.....all show nothing other than EXCESSIVE pvc's and "mild" mitral valve prolapse.  

I am a nursing student and am learning more and more about cardio and have found out that pvc's are totally harmless in a normally functioning heart.  The one common denominator is STRESS.  If you have anxiety or stress, it will set them into high gear.  Last year, about this time, I was under a LOT of stress with school and started having bigeminy and trigeminy.  I was scared.  I went to my Dr. and had an echo with a holter and it showed 19,000 pvc's in a 24 hour period...that is close to 13 pvc's a minute.  I take Tenormin and Klonopin (the Klonopin does more good than the Tenormin because it helps keep the anxiety under wraps) but still have the pvc's.  Kinda funny, after my report came back from the 19,000 pvc's, the results read...(and I kid you not) "Normal sinus rhythm w/ excessive pvc's."  NO SH*T, Sherlock!!!  I laughed out loud when I read that!!  Now, when you get into 13 a minute, YOUR HAVING FUN!!!!!!!!!!  After that I was put on the Klonopin for stress and it has helped. (until I have a deadline to meet for school and here they come again, like right now)

Seriously, guys, we are ok.  Textbooks say we are ok, Instructors say we are ok, my Dr. says we are ok (as long as we are talking about pvc's w/ confirmed normal hearts).

I have noticed a correlation between reflux and pvc's....the vagus nerve that controls heart beats is very close to where the inflammation occurs w/ GERD (heartburn, ie. Reflux) and my instructors say there IS a correlation.  My reflux is bothering me this morning and my pvc's are going crazy as I type this!!  BUT I LAUGH IN THEIR FACES!!!!!!!!  HA HA HA!!!!!!!!!!!!!!!!!!!!!!
(you see these pvc's really do make you crazy!)  Just kidding, has anyone else noticed the correlation between pvc's and reflux??

[aussie mum]

Hi every one just wondering what is the difference between PVC & PAC ?? Do they feel the same ??

I do think there is a link between reflux and "HEART HICCUPS" (gotta love that saying!!)

[gismatrix]

I must say that there has to be a link between GERD (or at least some type of digestive issue) and PVCs.  I have posted here many times about my troubles with this...now I am having one of those bad periods in time where the PVCs are awful.  I know I have them mostly all the time to some degree (tolerable at that), but after I eat, and it doesn't matter what, I get terrible PVCs that last for what seems like a couple hours at least.  I feel short of breath (probably from the anxiety) and have chest pain and lots of belching.  The belching makes them subside a little for a few moments.  I also feel such pressure in there.  I am a 33 year old male, and have had two ablations for AVNRT SVT.

[blankpagenurse]

hey there,
I used to teach nursing school, tried not to make it so stressful that it caused arrythmias!!! ha. But just wanted to throw this in about the reflux.  I worked in NICU for about 20 years, and one of the most important reasons for treating reflux in premies was due to the correlation between reflux and arrythmias (usually bradycardia) caused by the stimulation of the vagus nerve.  And, you are right about the stress factor, it can do a number on you from head to toe!! Hang in there, you will get through school!!! And, I am now speaking from another perspective, as I am currently back in school as a student, finishing my Masters!!  Good Luck!

[StevePsych]

I have GERD and occasional PVC's that can be quite distressing.  The GERD is more or less under control and I don't worry about it much (although I still get some heartburn, and burning under the breastbone combined with PVC's can be very scary!)  Thanks to comments on this site, I'm prepared to not worry about the PVC's (although it's hard not to, and I'm a psychologist!). I'm especially intrigued by people's anecdotal suggestion (here and elsewhere) of a link between GERD or Hiatal Hernia and benign PVC's, perhaps mediated by the vagus nerve. Some have suggested that postural manipulation can even reduce or eliminate these PVC's once they start, and I can confirm this seems to work for me too.

I've done a search of pubmed and come up with very little literature supporting any connection, which may explain why doctors don't seem willing to accept the connection.  However, one recent article entitled "GERD Symptoms Linked to Cardiac Dysrhythmias"  finds that episodes of Acid reflux and episodes of dysrhythmia were significantly correlated in 56% of the GERD patients, and in none of the control participants.

Also, the following link is a recent paper in which the authors link GERD to cardiac dysrhythmias (possibly PVC's):

Nature Clinical Practice Gastroenterology & Hepatology (2006) 3, 478

Unfortunately, these are hard to get without membership to the journals or access to a big library.  I'm going to bring it up with my doctor, however!

Best wishes to everyone.