Advice for upcoming cardio visit

[sarahc77]

I've been reading this board for a few weeks now and I'm hoping some of you can provide me with advice about my upcoming cardio visit. Here's my story.

Last summer, while pregnant, I started to experience heart palpitations. Originally I chalked up these palpitations to a worsening of my exercise-induced asthma but when a particularly bad "attack" landed me in the ER I realized what I was feeling was related to my heart, not my breathing.  My ER visit turned up nothing substantial and my midwife told me that palpitations were totally normal during pregnancy and should go away after giving birth. I went on with my pregnancy and learned to deal with the palpitations.

Fast forward to six weeks after giving birth and my palpitations have not disappeared. My Dr. recommends that I see a cardiologist who has me wear an 72-hour event monitor. The results show sinus tachycardia and PVCs. The cardiologist says these are benign, that my best bet is to learn to live with them. In the months after that visit I paid more attention to these palpitations and learned a few things. First, that they are set off by being in certain positions, primarily bending over and sitting while holding my son and, second, that they are worst in the evening. For the most part though, the palpitations were mostly an annoyance.

Then two weeks ago, while putting my older son to bed, I leaned over and had a string of palpitations for the first time. A few minutes later I had another. That went on for several hours that night. It was very scary and since my husband was out at a bachelor party I actually had my father come over because I didn't want to be alone. In the two weeks since then I've noticed a dramatic increase in the number of my PVCs and instances of these strings of PVCs.

I go to the cardio in a two days and I'm wondering what tests I should ask for, questions I should ask, really any advice you can give me that would make this visit as productive as possible. I'm also wondering if there is any know connection between hormones and PVCs. I am breastfeeding and have yet to have my period return and I'm wondering if that, along with the start of these palpitations during pregnancy, might point to a connection with a change in hormones.

Thank you for your help!

[Brooke_38]

Palpitations are very common. They usually aren't serious or harmful, but they can be bothersome.

Many things can cause palpitations. You may feel palpitations even when your heart is beating normally or somewhat faster than normal. In these cases, nothing is wrong with your heart.

However, some palpitations are a sign of an actual heart problem. Sometimes, the cause of palpitations can't be found.

Causes not related to heart problems:

Strong emotions-

You may feel your heart pounding or racing during anxiety, fear, or stress. You also may have these feelings if you're having a panic attack.

Vigorous physical activity-

Intense activity can make it feel as though your heart is beating too hard or fast, even though it's working normally. It also may cause an occasional premature (extra) heartbeat.

Medical conditions-

Certain medical conditions can cause palpitations. This is because they can make the heart beat faster or stronger or cause premature (extra) heartbeats. These conditions include:
*An overactive thyroid
*A low blood sugar level
*Anemia
*Some types of low blood pressure (hypotension)
*Fever
*Dehydration (not enough fluid in the body)

Hormonal changes-

The hormonal changes that happen during pregnancy, menstruation, and the perimenopausal period can sometimes cause palpitations. These palpitations will likely improve or go away as these conditions go away or change.

Some palpitations that occur during pregnancy may be due to anemia.

Often, palpitations are harmless and your heart is working normally. Palpitations can be a sign of a more serious problem if you also:
Feel dizzy or confused
Are lightheaded, think you may faint, or do faint
Have trouble breathing
Have pain, pressure, or tightness in your chest, jaw, or arm
Feel short of breath
Have unusual sweating

The cause of palpitations may be hard to diagnose, especially if symptoms don't occur regularly. Often, the first test that's done is an EKG. Even if your EKG results are normal, you may still have a medical condition that's causing palpitations. If your doctor suspects this is the case, he or she will order blood tests to gather more information about your heart's structure, function, and electrical system. An  event monitor which is similar to a Holter monitor, is the best tool to capture symptomatic ectopics in the heart. You wear an event monitor while doing your normal activities. However, an event monitor only records your heart's electrical activity at certain times while you're wearing it.

For many event monitors, you push a button to start the monitor when you feel symptoms. Other event monitors start automatically when they sense abnormal heart rhythms.

Event monitors can be worn for 1 to 2 months, or as long as it takes to record your heart's activity during palpitations.

Hope this helps to prepare you for your upcoming appt. Best of luck and let us know how you make out. :)

[Bromley]

There is a known connection between pregnancy/hormones and PVC's. Most likely that is what you are experiencing. You are lucky that your PVC's have been looked at and are benign. I would not sweat this.  Annoying yes, but we can deal with that.

I would follow through with the appointment mostly for your peace of mind. Write all of your concerns down and take them with you to your doctors appointment. Given that you had a string, they might want more tests. But given you were recently pregnant, they might be inclined to keep it well within reason. Good luck.