palps during exertion and I am scared to death

[flip-flop]

Seems my palps have changed a bit lately...I always have a few days of them during my period and I am in perimenopause. I will be 50 in a few month and my hormonal symptoms have been quite bad the last couple of months... But this month my palps started started up again during my period as usual but instead of having them at rest like usual I am getting them when I am up and about more than at rest...I am not having a lot of them...just a few to several a day. And as soon as I sit down and rest they settle down and I feel perfectly fine. I am just freaking out a bit from them and since they are happening when I am up trying to do things it is making me want to stay in my chair and not do anything...please I could use some advice and encouragement. I have allowed the palps to control my life before and make me practically housebound and I don't want that to happen again...please help!

[CCF-M.D.-MJM]

Hi Flip-flip,

don't panic about this.  What are you afraid of?  When I ask this question, I used to be surprised to hear that people were scared of sudden death.  PVCs and PACs do not cause sudden death.  If you have had the cardiac work up to rule out pathology (echo, ekg, labs and some cases a cath), you are at greater risk crossing the street or driving a car.  The best advice I can offer is to continue with your life as is and do not let these palpitations control you.

I hope this helps.

[wmac]

I totally undersand where you are coming from. My heart has been behaving for the last week and it was so wonderful!! Now since yesteday they have cut loose with a vengence! The ones that kinda hurt in the throat as well. Yesterday I couldnt do anything without my heart freaking out I even had to sleep in the chair last night which still didnt help, then today I was doing great till about 2:45pm and boom I walk out to get into my car boom boom boom and it totally is freaking me out I then get out of my car to go get my son boom boom, then I get back in boom again and again. I was on the verge of calling the doc, why I dont know just to make me feel better I guess. I am so sick of these terrible things just when I think I have them figured out they change on me. I hardly selpt last night. Im really really sick of these terrible things. Just hard to understand that they are benign I know. There is absolutely now rhym or reason to them at all!!! But yes im totally freaking out and I even have to go back to work and I dont know if I can pull it off or not its really hard to stand there and do hair cuts and hold your composure while its happening. I can relate to the house bound problem too cause I have been there and about to go back to it.
wmac

[woodruff]

Flip-flop, if you have been given a clean bill of health by your doc, I would suggest that you take yourself to your friendly local shrink to help with your anxiety.  I did this, and after talking with me, my nice doc prescribed a drug to help with the anxiety that, for many, many people, often accompanies these nuisance heartbeats.  Actually, it took several trials of a number of medications before we hit upon the best one, but I consider it essential when my pvcs recur.

You really do want to get on with your life, I can see.

[alistinker]

Hi

I can totally sympathise with your fear and concerns.  I am 34 with 3 childen...the youngest being 10 months and I have been plagued with these horrible pvc's for the last 9 months.  The last couple of months have been good and I have only experienced the odd one of two but this month was terrible.  I suffer bad with pms and have been diagnosed with Post Partum depression which is under control and also Post Partum anxiety which my dr says is contributing to my pvc's...so fluctuation hormones + PMS + anxiety =PVC's!!!!  I hate them.  They are so debilitating.  This weekend was terrible for me.  I had a house full of 8yr old boys for my sons birthday and also have PMS.  I bent down to do something and I experienced a run of around 3 or 4.  I totally freaked out and nearly dialled 911 as I feared I would pass out of die.  Well obviously I didn't but went to the dr's office the next day for an EKG...well that came back perfect (obviously as i was onl on it for like 20 seconds!) and so today i am finally wearing an event monitor and have it for 30 days so they can finally catch the dam things.  They still say that they are going to be benign and I am in no danger but i think they arranged this for my own peace of mind.  I have also, like the last poster, have been advised to take an anti anxiety medication for a few days a month to help me through the severe PMS anxiety i get but I fear meds like that, although never tried them.  But I am seriously considering it.  I currently take 12.5mg of atenelol twice a day...sometimes it helps great but that time of the month it doesn't seem to do anything.  I really hate feeling like this.  I would take a migraine anyday than having to suffer from these.  

Email me if you need to talk.

Take care everyone

sharon

[dquenzer]

PAC's and PVC's tend to come and go.  I had a period of time when I was having PAC's nearly every other beat.  This would often come while I was under stress.  I couldn't walk up a flight of stairs without getting irregular beats.

Then after a period of time they subsided considerably.  Why?  Not sure.  Probably stress related.

At present I only have them now and then.

I would encourage you not to stress out.  Becomes a vicious circle.  They aren't going to kill you.  They are annoying.  And it does take time to adjust.

[madgeOwens]

Hi flip........I am 54 and this happened to me at about your age, but the culprit was chocolate (which I ate to get rid of mood swings) , then caffeine as well.........if you are having any of these items eliminate them and see if that helps. I do think there is a correlation between hormonal changes in women and increase palpitations, but this is just my oppinion. Good luck and Merry Christmas to you.

[jwinst]

I feel your pain. I suffer from PVCs everyday. This is a relatively new thing for me. They just started to get bad this year. What scares me is that I am only 23.  Guess I have years of PVCs to look forward to! I cant wait:( I have noticed that overeating really sets them off, as well as alcohol. But sometimes they just come on for no reason whatsoever. I am in the process of learning to deal and not let them control my life....easier said than done I know. I am so thankful for this forum.  It really helps to know that we are not alone.
Good luck and happy holidays!

[fearfactor]

I have hormone-related palps, too (mostly PACs).  I just have come to expect that during mid-cycle and menstruation I'm going to have lots of palps, and lots of anxiety to go along with them.  Thank God, I am coming to realize this happens every month, I'm not dead yet and am not going to die from this.  I have lost lots of time and energy to terrible fears of palpitations, too.  I'm trying so hard to get over this fear and just go on, but it is hard sometimes.  This board keeps me sane just knowing there are so many others like me - thanks, everyone!

[flip-flop]

Thanks for the replies everybody....these palps are just so darn hard to deal with and it is difficult to keep my anxiety in check when I am having a bout of them...six years ago when they were really bad I was practically housebound. I didn't want to go anywhere or do anything and I don't want that to happen again but I can feel the fear building and I can see that happening again unless I get a handle on this. It just seems like no amount of reassurance is enough when the palps are bad. Yes the drs. alway say they are harmless and intellectually I know that, the problem is they don't feel harmless. I just can't seem to wrap my brain around that fact. It does help to come here and read though when I am having a bad day and thank you very much Dr. for your reply. I do appreciate it very much...I have an appt. with my regular dr. on Dec. 30 and I am going to mention I am having a rough time and maybe he will refer me to a psychiatrist. Perhaps seeing a psychiatrist for some therapy is a good idea...I saw one a few years ago to help me deal with my anxiety from the palps and it did help.

[ihatepvcs]

Long time listener, first time caller...

The statement by the doctor illustrates the problem exactly for most of us sufferers:

“What are you afraid of? When I ask this question, I used to be surprised to hear that people were scared of sudden death. PVCs and PACs do not cause sudden death.”

This is precisely the point at which the doctors begin to lose their patients.  Why the surprise?  It is the heart after all.  It’s kind of a special little organ, especially to the unlucky ones among us when it keeps reminding us of that fact.  We have two eyes, two ears, two lungs, and two kidneys, two of many parts and pieces, but only one heart.  You can even takes huge chunks out of livers, intestines, and even brains and people will still function quite normally.  But the heart is different to us.  That is why we are scared.

PVCs indeed may not case sudden death, but I’ve never really seen a simple black and white explanation as to why that is. I wonder what it is that the doctors know that we don’t.  Is there some kind of medical secret of which we are not aware?  For most of us, “don’t panic” just doesn’t get the job done psychologically.  

I’ve had PVCs now for over 10 years.  All the tests – most twice – some more.  My first echo had the word “normal” no less than 17 times in the same report.  To this day I still do not feel normal.  Yet in all those years, I have experienced sudden death not even one single time, so maybe the doctors are right.  But when I do get PVCs it is my very first thought each and every time.

When I try to explain this to non-sufferer’s I use hiccups as an analogy.  A hiccup in and of itself is a benign thing.  No one will die from the hiccups.  But let’s say that you came down with a mysterious condition that caused you to hiccup once a minute.  Imagine trying to “ignore them” and being told that you are “normal” and to just live your life.

From the 1992 Simpson’s episode: Itchy and Scratchy: The Movie

Kent Brockman: Tonight, on Eye on Springfield, we meet a man who has been hiccupping for 45 years.
Hiccupper: *Hiccup* Kill Me *Hiccup* Kill Me *Hiccup* Kill Me.

Then they understand.

[flip-flop]

Very well said ihatepvcs. I totally agree with you.

[tickertock]

I second the motion. Every thump from a pvc reminds you of your own mortality. No doubts for the vast majority they are benign condition or many of us would not be here after 10-40 years still talking about them, many many benign conditions dont kill you, they merely punish you to death even if you live well pass the average lifespan.Still I agree you must keep going on with life regardless of how horrible you feel, amazingly even though annoying once you can harness your anxiety how much it helps mentally even if the physical uncomfortable feeling is still there.

[fearfactor]

Yep, you said it!  Everytime I get a big palp, I feel like it's going to degenerate into v-tach and sudden death - I can't help it, can't get over the fear.  Most people don't understand.  You're right - the heart is a "special" organ - if it stops working, you are pretty much out of luck.  That is why it's so terrifying when you just know something isn't "right" in there.

[madgeOwens]

How about if those hiccups cause chest pain, shortness of breath and dizzy/lighthead?  They still shrug their shoulders at you! Oh well........hic

[prjose56]

Hi everyone.  I wanted to ask you, wmac, if you have sudden changes is heart rate associated with your palps.  With me, any movement or exertion causes my heart rate to jump up sometimes 20bpm.  I just don't understand why.  I've had all the tests including an echo and holter and all come back fine.  My holter showed I had about 4000 pacs in 24 hours but surprisingly this isn't what bothers me.  It's the variability in my heart rate.  I can't see how anxiety, which is what I've been diagnosed with, is causing this.  Can anyone help?  

Hope everyone gets better soon.

[Momto3]

Personally, I'd rather have pvcs than migraines or persistent hiccups.  I know a number of migraine sufferers and I wouldn't trade my pvcs anyday.  That's just me tho...we're all different.

I am curious about a couple of things.  First, I know first-hand how frightening pvcs can be.  What I don't understand is why some people are so afraid the pvcs will lead to sudden death.  It doesn't happen. Is it like when you are nauseous and you KNOW you really aren't going to die, but you feel like you could?  I'm not trying to be inconsiderate or insensitive, I just want to understand.  As far as I know, none of us knows anyone who has died from pvcs. I DO understand how debilitating they can be, but not b/c I might die.  For me, it is the systemic reaction they bring on (sweating palms, palps, nervousness, nausea, etc).  I hope this makes sense.  I think that the real problem with pvcs is not their medical significance, but the crummy anxiety that results from the pvcs. I KNOW the pvcs will not kill me....I'm here to tell ya, I would have been long gone.

Second, why do people obsess over pvcs (once medically cleared) when they continue to ignore behaviors that are proven to be detrimental to our health (smoking, fast foods, excessive alcohol - you get the idea)?  I'm not excluding myself here cuz I love fast food.  Maybe it's human nature to ignore the obvious and obsess on the insignificant? I hope I'm saying this right cuz I don't want to come across wrong. I really do understand the fear, but just not the "fear of dying."

Those of us who believe in a higher being (all denominations) must accept that some things are way beyond our control anyway. Yeah...I hear ya....MUCH easier said than done.  

Happy Holidays to everyone!!  Hope everyone is feeling better.

Connie

[fearfactor]

Hi, Connie!  I understand what you are saying.  I can tell you that the reason PVCs/PACs make me fear death is because from what I have heard and read, what starts off v-tach which can turn into v-fib and sudden death is indeed PVCs (3 or more of them in a row is considered v-tach, I believe).  I fear that the one PVC I have now may turn into a couplet (which I think I've had) and then just one more and it's v-tach and not so far to v-fib and you're dead!  That is the way the thinking goes in my mind.  I don't know if you've heard about Jiri Fischer, the Red Wings hockey player who went into v-fib on the bench at a game last month, but I fear exactly what happened to him...strenuous exercise leading to arrhythmias, leading to SCD (thankfully he was where they had a defibrillator but I don't have one at home and fear being home alone where no one can help me).  As for me, I have cut out all the usual suspects like caffeine, white sugar, alcohol, am now in the process of going off all pastas, breads, have given up aspartame - heck, I can't even have a piece of cake for dessert at Christmas!  It's just so frustrating because I have given up seemingly everything and they STILL won't totally go away.  I do fear the clogged arteries from fast food and avoid that, I would LOVE to go out and run 6 miles a day again like I once did but can't for fear of dropping dead.  So, it's like a spiral, once you're in it with the fear it's so hard to get out of it.  You said your PVCs make you nervous - why do they make you nervous if you know they won't kill you?  I'm not being a smart alec, I'm just curious because I sometimes think if I could just get over the SCD worries I'd be ok but it seems you still worry even though you know SCD isn't possible.

Also, thanks so much for the kind words to me in a previous post.  Yes, it's tough going to law school with these darn palps!  My grades have suffered, my concentration is gone pretty much.  Thank God I wasn't having palps when I took the LSAT - I only started this hellish experience in Aug. 2004, the summer after 1st year.  The LSAT is pretty tough for sure - with palps it must be a nightmare!

Take care and happy holidays to you!
Stacy

[Momto3]

Hi Stacy!

Thanks SO much for responding.  You asked why I would get nervous when I had the palps.  For me, it was like a whole body reaction and the palps were just a part of the scenario. I'd be out to eat at a restaurant and my stomach would start to rumble (a sure sign of trouble for me, but that's another story). Next, the palps would come on, the sweaty palms, the nausea....and this very jumpy feeling....like a panic attack.  It wasn't b/c I was afraid of dying. It was more of a physical reaction cuz I knew what the "rumbles" meant.  Hmmmmm....Let's see.  I think for me, the bothersome palps were exasberated by the stomach grumbles...UGH!!  I notice a lot of people with palps also have digestive trouble...

As for the VT....Maybe this will help. I used to have plenty of couplets, triplets, salvos, etc., and even then when I asked my doctor if it was VT (she is an EP) she said, "technically, no."  However, every other medical person (not EP's) I encountered would call it VT.  My doctor's specialty is arrythmias so I trusted her diagnosis.  Medically, I had "NSVT"(non sustained vt, making it a bit more concerning than isolated pvcs, but still not alarming (once I was given the once over)  It is not true VT. If I understand correctly, VF is an entirely different entity. I think on rare occasions, true VT CAN turn into VF (like the RedWings player), but it has a different underlying mechnism.  

My doctor and I have had a lot of conversations about all this stuff, and when I asked her if my pvcs were b/c of anxiety (I am considered an anxious person, no surprise there...lol) she said, "NO."  I could get them anytime, anyplace, any reason, no reason, every reason.  The only things that made them worse caffeine and MSG.  But, they only made the worse, they were always there anyway...I had pvcs so often that when I would get anxious over something (like that dumb LSAT), it would get worse.

Have you finished your entire first year?  That's supposed to be the toughest.  Hang in there!!  We need ya!!

Thank you again for your thoughtful and thorough response.
Connie

[fearfactor]

Thanks for the explanation!  It is reassuring to me.  I am in the middle of my 3rd year now - I will graduate in May.  It's been an uphill battle with my anxiety and palps, but thankfully it's nearly over and hopefully I can get on with life!  :)  I do want to do something worthwhile that will help people - possibly medical malpractice plaintiff or defense work (of all things!).

[kristylu]

I read your post and just wanted to give my personal reasons why i get so scared. The actual palpitations don't scare me it's when I get shortness of breath and chest pains. They scare the heck out of me. One night last week I felt like I couldn't breathe and someone was sitting on my chest for 12 hours straight. Went to the er had chest x-rays (normal)test for blood clots (normal) ekg(abnormal as always). they basically told me it's "probably" just anxiety and gave me a specialist to see so i could be put on anti-anxiety medicine.  I am a former drug user, particularly cocaine and the way I feel when I have these attacks is how I would feel when I came down from using drugs which is why I quite. I just worry every time that I get a chest pain or shortness of breath that I've done permanent damage to my heart from the drugs I used to do. I've also had an echo which says that my heart is normal. I just have a hard time believing it when I got through these episodes.  I can't believe I ever put something so toxic and damaging in my body. What was I thinking.

[woodruff]

If it helps, here is a website with an animation showing pvcs and the electrical pathways of the heart.  To go beyond page one of the piece, you do have to register, but it might be helpful to some here.

http://heart.healthcentersonline.com/arrhythmia/pvc.cfm

[Momto3]

Thanks so much for sharing your personal experience.  I can understand why you are frightened.  Do you feel comfortable discussing your situation with your own doctor?  

Hey, don't be hard on yourself....lesson learned : )
We've all done stuff that we wish we hadn't.  The main thing is that you learned from the experience and moved forward.  Kudos to you for quitting a bad habit!!  

I won't tell you not to let the pvcs scare you, cuz fear is such an individual thing and it really wouldn't matter if I said that anyway.  What I can share with you is that pvcs in the setting of a structurally normal heart (which your tests indicate), are totally benign.  As for the anxiety - not so benign.  Dealing with anxiety is also a very individualized thing.  That takes patience, practice and skill.  Think of it like learning a new sport/skill.  First, you are a beginner.  You must learn to trust the "teacher" or the expert, if you will.  After you have built up some confidence in your skills, you venture out on the limb a bit, but still not too far.  After more practice, you're out there with the best of 'em.  Next thing you know, you're confident enough to help someone others.  All the while, you never let up on taking care of yourself and improving your game.  Hey, I'd be willing to be that you've already helped someone just be sharing your experience : )

Take care! Congrats again on kickin' the habit!!

Connie

[4paws4me]

Six years ago I was diagnosed with idiopathic dilated cardiomyopathy - ejection fraction 35%.  I was also told that I was having "benign" PVCs at a rate of over 40,000 per day.  Apparently, I had been having them for years, but at certain rate, you just don't feel them anymore.  Occasionally, I would have a strange cough accompanied by a thump in my chest, but it never occurred to me that it was my heart.  Initially, my doctors treated me with Coreg for the cardiomyopathy with little mention of the PVCs.  However, once they told me I was having them, I became obsessed with them.  They scared me.  It's hard to explain.  After a few years of complaining to the doctor about the PVCs, she ordered a Holter Monitor to assure me that I was fine.  Unfortunately, instead of telling me I was fine, she told me that I was still having over 30,000 PVCs a day with occasional runs.  She referred me to an EP.  During my EP study, I had an episode of VT on the table and subsequently had a defibrillator implanted and was started on Sotalol to control my arrythmia.  The defibrillator helped alleviated my fears of sudden death and the Soltalol helped reduce the number of PVCs to around 15,000 a day.  That was 3 years ago.  Over time, the PVCs have increased again - 25,000 on my last holter.  I'm scheduled to meet with my EP in February to discuss ablation.  Ablation was ruled out before.  I'm not sure what will be different this time, but I've finally found a doctor who is convinced that controlling the PVCs is the key to restoring my energy and possibly restoring my cardiac output.  Occasional PVCs may be benign, but in significant numbers, they make you feel horrible and lead to heart failure.

[NBCT]

I can relate to all of the above posts with regards to feelings of fear, anxiety, convinced iminent death would occur with the multiple PVC's and PAC's experienced by all of us on this thread. It took time, confidence in test results, and a compassionate cardio. who listened to every concern I had and was very reassuring.
Finding this forum years ago and reading everything and anything I could find about the palps. empowered me to take back my life. One of the most helpful sources was the cardiac history and EKG's of many of my patients. They read like their time was up any minute...severe this..severe that...runs of this...many of them underwent procedures, surgery, etc. without incident and lead active lifestyles despite a strong cardiac history. So I guess I can understand the frustration of some MD's (never rudeness though) when trying to convince patients they are not in danger. Hope this helps. Best Wishes to All.