Chronic PVC's and Activity Induced Tachycardia

[Kim5670]

Some History: I am a 38 y/o female, 128 pounds, with a life-long history of heart murmurs, which come and go. The last ECHO (3 years ago after I had my 1st child) showed Mitro valve regurgitation with no substantial abnormalities. I have had PVC's and PAC's that also come and go, with a marked increase since I had my first child.
I have had a pretty constant arrhythmia the past 2 months. I will check my rhythm at work on a heart monitor occassionally with my colleagues, and we haven't seen anything of any concern until recently, (PVCs with occassional trigeminy and bigeminy) but this past week I have been feeling "not well" at times, nauseas with syncope at times while walking, and some hot flashes and quite often short of breath, even sitting or lying in bed. Over the weekend we put the heart monitor on again, and I'm in the 60's-70's while resting with just some PVC's and missed beats, and my sats are 98% resting. If I get up and do a SLOW walk up and down the hall, my sats drop some, and my heart rate immediately goes up to the 130's and 140's with frequent runs of PVC's and Bigeminy, and I've noticed my QRS is much wider than normal. I don't go to the doctor often, (as a nurse, I don't want to look like a nincompoop to my colleagues), but I'm wondering, with my family history of heart problems (my dad and grandfather were in their 40's with their first heart surgeries), would it be out in left field for me to ask my doctor for an exercise ECG or stress test? I have been through an F5 tornado (May 2007-Greensburg KS) with severe injuries, and this started up with the increased storms and tornado warnings around here, so I'm not sure if I need a chill pill or maybe some Cardizem-oh, I was on Cardizem while I was pregnant for activity induced Tachycardia. Thanks, Kim

[Michael J. McWilliams, M.D.]

It is definitely worth talking to your doctor about.  It is very likely that there is nothing wrong but you need some reassurance.  This is very common in nurses, MAs, EMTs, etc but no one knows why.

If i saw you in clinic I would do a Holter, EKG, echocardiogram and stress test.  Once we knew all the test were normal and your prognosis was excellent, I would recommended that you stop checking your vitals so frequently -- that can feed into the problem sometimes.  Checking your vitals all the time is like watching the weather channel if you are afraid of storms.  It makes you think about it too much.

I hope this helps.

[hatemyheart]

While I respect the opinion expressed by the Doctor, he is obviously not one of 'us' (those who suffer with palpatations) meaing he does not have to put up with this on a daily basis. Are you taking any meds for your condition (atenelol, etc) . As a nurse you obviously know more about this than me (computer technician only) but you should not give up on finding some relief.  Good Luck!

[Kim5670]

It sounds like you think it is an Anxiety issue. This is very common in doctors... :) I'm sure you are right, and I should not try to "self diagnose"...we ARE famous for that. I DO have weather-related anxiety, it's probably no coincidence that this started during the tornado warning with the 70 mph winds..I'm feeling like the ECHO probably doesn't need repeated, if it were a cause it would either be anxiety or autonomical nervous system related?? I still want to do the exercise ECG or stress test. (Reassurance) I have been practically sedentary for over a year recovering from Pelvic fractures and going to school. Big time out of shop most likely. But thank you for your response, and I Promise, I WILL quit checking up on the PVC's.