Advice needed PLEASE?

[shermay]

Hi All.

I wore my 24 monitor on Monday, and had the results yesterday when they took it off.  Cardio said that everything looked fine, even though my h/r was slightly elevated - she did not think it justified having any meds for it.  The monitor also picked up a few hundred PVC's.

I asked her (my biggest fear as many of you know) is that I get a run of ectopics during the resting period after exercise that can last for hours afterwards and she said  (now this is where I would really really appreciate any additional information please) that there was nothing wrong with my heart, and to carry on as normal.  She did not mention any further tests.  I explained that they started out of nowhere one day and her answer was 'no 2 days are the same' !!!!  DUH

She is a very efficient Cardio, but I am asking the forum because some of you are so much smarter than I am, do you think that I should seek a second opinion or just go with what she said?  I've not done any exercise now for quite some time because of my anxiety about PVC's after exercise and reading that a think it's a Dr Lauer (sp) article.

Any input would really help a very nervous women indeed.

Thank you,
Debs

[Momto3]

Hi Debs,

You're welcome : )
Many of us have been exactly where you are, so we understand, and are happy to help.  Your ejection definitely falls within the "normal" range of 55% to 70%, but it is still important for everything to be clinically correlated to the rest of your examination.  Sounds like your doctor has done some tests to help rule out anything serious.  YEAH!!!

Here are a few of the terms you might hear along the way or when you are reading through the posts:

Trigeminy is a pattern where your heart throws an extra beat (even though it feels like a skipped beat, it is actually an early extra beat) every 3rd beat.

Bigeminy - same thing, every 2nd beat

Quadrigeminy - same thing, every 4th beat

A couplet is when you have 2 extra beats in a row.

A triplet is when you have 3 extra beats in a row (sometimes called a "run").

A run is 3 or more extra beats in a row with no regular beats in between.

Nonsustained ventricular tachycardia (NSVT) is a run, but not lasting more than 30 seconds.

Sustained vetricular tachycardia (SVT) is a run lasting at least 30 seconds (can also be referred to as just VT.

SVT can also mean supraventricular tachycardia, "supra" meaning above the heart.  It is the same thing, but the extra beats originate from the heart's upper chambers (atria).  All of the above-mentioned rhythm patterns can occur in the atria (upper) or ventricular (lower) chambers of the heart.

Hope that helps.  Have a great day!!
Connie

[shermay]

Hey there Connie, thanks for the info.

When I said a run a meant that my heart beats trigeminy (sp) this can last for up several hours exercise.  But thanks for putting my mind at rest about Dr Lauer findings, it's not made clear (from what I read) that the patients had heart probs to start off with.

I have had an echo, which was fine, and my ef was 64% is that good??  Have no clue:/

Take care,

Debs

[Momto3]

Hi Debs,

First, congratulations on the great Holter results!  To put your mind at ease, in the setting of a structurally normal heart, PVCs are almost always considered benign.  That's not to say that they FEEL benign, but in the medical world, they are not going to harm you.

Dr. Lauer was my cardio until he, for the most part, left the CC for a new position outside the organization.  I saw him for an evaluation on my mitral valve.  At the time, I was having tens of thousands of PVCs daily, and he didn't bat an eye!!  His study is well respected, but it is important to know that a key factor with PVCs is whether or not your heart is structurally normal.  The subjects of the study had various heart anomalies and was not necessarily focused on people with "healthy" hearts.

You were smart to follow your instincts and consult with a physician.  The fact that the cardiologist is not concerned is great!!  When you talk about a "run," do you mean a sustained run (30 seconds or longer with not a single regular beat)?  Or, do you mean a nonsustained run where your heart is flipping for a shorter period of time, but it is definitely not in any rhythm?  Episodes of NSVT are treated similar to single PVCs in the setting of a structurally normal heart; however, sustained VT can be more serious and should be monitored/evaluated.

Unfortunately, these wacky beats come and go for no reason, every reason, and some reasons.  In other words, there is no single answer as to why.  Sorry, I know that's lousy!!  It's great that you have an excellent cardiologist, but if you think a 2nd opinion might help you to feel more comfortable, it's something to consider.

I was having well over 20,000 PVCs a day, and I was never restricted as to exercise.  In fact, when I was on the treadmill, my heart rhythm would normalize : )

Once you have had a medical workup, working on getting past the anxiety is key to living with the pesky beats.  Feel better and take care.  

Connie

[Nettle]

ireneo - thanks for the clarification re: the cause of ectopics, I don't drink much alcohol or caffeine and although can be anxious don't feel bad enough to cause these kind of symptoms - so was starting to question myself and think I am more stressed than I thought after my appointment today. Good to know that they can just be something that happens.

[ireneo]

Ectopics also happen simply because the heart's electrical system will be out of sync for a microsecond. It's not all your fault because you ate some chocolate, had a cup of coffee or got upset while driving home.

You mentioned that you have "runs" of PVC's. How would you describe a "run?" Your monitor only picked up a few hundred in 24 hours. Do they cluster together like every other beat? Just curious here.

Have you had an echocardiogram to see the structure of the heart, see if everything is normal there?

There are many people on this board that have hundreds of ectopics to tens of thousands of ectopics daily and understand your concern. I'm in the lower range averaging 1-5 a minute. For the most part we are told that they are not all that unusual and to move forward with our lives. They are annoying but not life threatening. It may take time for you to get comfortable with these heart hiccups as I call them but don't let them tie you down. You can enjoy life with a quirky heart.

[Nettle]

Hi Debs,

Am not very smart about all these heart things but have just come back from an appointment with a cardiologist, I have 2 things going on - junctional rhythms and ectopics. I am getting further checks for the junctional rhythms but have been told the ectopics are totally benign and are not caused by anything medically wrong - apparently they are caused by either too much caffeine, alcohol, stress or anxiety. Could any of those relate to you? He did say that beta-blockers could help keep the ectopics under control but would only prescribe if they were interfering with my life/happiness - not because they are a medical problem. I have previously had echocardiogram and MRI scan and both came back just about normal, so whether knowing that allows them to be absolutely confident about the ectopics being benign or not I couldn't say.

I think the idea is we learn to live with ectopic rhythms and are meant to get on like normal - would be nice wouldn't it!!