How DO you tell when PVC's are life threatening?

[Lisa33167]

Thank you in advance for any help, information or suggestions that may be made.  I've read so much about benign PVC's but how do you really tell there is a problem and what are the stats of PVC-induced cardiomyopathy?

I went to my pcp not feeling so great; he said he was concerned about my heart. He did a few EKG's in his office and said I was having PVC's and he thought I had damage to the valves in my heart due to previous use of Phentermine.  

Background on phentermine:
I started in April 2006  went off after 6 mths; lost 47 lbs, and kept with my rountine until December 2008. I wanted to lose an additional 25 lbs so I went back on Phentermine, but only stayed on 1 month (Jan 2009) because they made me extremely "sick" feeling.  I went off Phentermine in Jan 2009 and kept my routine 5-6 days a week for a bit, but kept getting worse.

ln April 2009 I was so tired and sick plus alot of other symptoms I could barely drive. Blackouts, fatigue, breathing problems, swelling in my left leg/ankle, palpations, dizziness etc.  I went from walking & running 5-6 days a week for 18 mths straight, plus taking care of my youngest children, school, family & business to barely able to do anything.

I have had 3 workups including CBC's, diseases and genetic testing. All of my bloodwork came back within the normal limits with the exception of Sodium (135) & EGFR (59 & 73) lvs being alittle on the lower side

My PCP sent me to a Cardiologist and an EP. They each did ekg's, plus cardio did ECG, stress test & holter monitor so far, and they did extra EKG's because they think my others are wrong :P   I passed out on the treadmill stress test due to 5 VT's/Pvc's (one of them, my head is still swimming from all the medical terms) in a row.

They all conclude that my heart beats an EXTRA 54,000 times in a 24 hr period, even during rest & sleep.  If my heart is healthy and there is no other cause can this be happening; Could Phentermine be the cause? Could I really have valve dmg and not know it, how do I tell?

They say I have VT, SVT's and PVC's and that every third heartbeat (Bigeminy) 24/7  is one of these "abnormal" beats and ruining my life.  These specialists are wow'd and speechless when they read my reports. They told me it's amazing I am sitting in their office because at this rate I should have gone into heart failure.

The electrophysiologist wants to do ablation surgery, which makes me very uncomfortable.  He also said if it doesn't work and they remain or come back there's no reason to redo surgery at my rates - and the meds are toxic so I would have the same problem all over and in a "very short period of time" go into heart failure and cardiac arrest with NO reasoning.   There must be some cause or reason they are missing....maybe it's something they are missing or not looking for?  

I do not have copies of my tests, they were a bit miffed to say the least that I wanted a second opinion and I'm fighting with them to get my records from their office.

My previous EKG's have said this -
4/27/2007
Sinus Rhythm, rate 51[Normal P Axis, rate]
Multiple Ventricular premature complexes [Short R-R, wide QRS]  
Incomplete right bundle branch block [QRS 110ms, terminal forces right]
QT interval short for rate [QTC ,360 ms]

11/21/2008 (3rd EKG in a row)
Normal ECG except for rate [Sinus Bradycardia] vent rate 58

6/25/2009
Sinus rhythm with frequent pvc's
Poor R wave progression
Septal T wave changes are nonspecific

6/25/2009
Sinus rhythm with PVC's
Septal T wave changes ar nonspecific

PLEASE help me...has anyone heard of this, what can cause an EXTRA 54,000 beats? what can cure it...will it really turn into heart failure and damage from it beating so much in a short period of time like he is saying?

Is there any correlation between Endometriosis (severe) Adenomyosis and PVC's - that's the only thing I know is wrong with me - and I have a suspicion I have mild sleep apnea - which I am going to do a sleep study for next month.  

BTW can you have sleep apnea if you sleep on your side? silly question but I thought it was when you slept on your back?


This discussion is related to Could my doctor be missing something with my PVCs?.

[Lisa33167]

Im so sorry I thought I was posting this in the ask a doctor forums, can this post be deleted? I already posted this :)

Thank you

[ireneo]

Don't worry about it. It will scroll down in a day.

[smepeldi]

low magnesium is related to pvcs.  I tried mag tablets without help.  finally tried a brand natural calm which has mag citrate, which is more absorbable.  seemed to have worked.

I also have endo and wonder if there is a correlation.  Frankly, I don't think they have studied it much. So I suspect the "experts" don't know.  However, I did find one book that talked about an endo organization that did a poll and found a high prevalence of mitral-valve prolapse (which PVCs seem to be a harbinger of).  

[wmac]

I also have pvc, pacs, svt and nsvt and aivr.. I have a normal healthy heart. I have what they call idopathic nsvt which is of no known cause or reason. What is your EF (ejection fraction) I didnt see you wrote anywhere I will double look. That is one of the most important factors in all of this. Ok I didnt see it. These are only ekg reports. They need to do a echo cardiogram. If your EF is good that is a BIG plus. You really need to find that out. The ef tells them how strong your heart is. Meaning the amount of blood it pumps back out after filling up. I will also tell you that it depends on where they put those leads on you when doing a ekg too. One of mine said myocardical infraction...Yikes that means heart attack... I had my ekg done at the docs office went to the cardio and she said no way and did one herself and it was all good. One other time it said right bundle branch block. It was wrong as well. I know there are certian places to put those leads but sometimes if just misplaced slightly it can say something terrible.
As far as the ablation goes dont worry I have had two attempted ones they just couldnt induce my nsvt. They know what they are doing. also ask for a single average ekg that is a very import one as well...
good luck keep us posted
wmac

[Lisa33167]

sorry this was a double post when I first started posting here - I thought I was posting in the doctor help section; instead it went to an overflow discussion into the members section  - I do have another post in the member section just like this with all the updated info.

I had a stress test, Ekg's; echo, CT, holter montior and my EP did a Tilt table test (positive) EPS w/Ablation, Cardiac MRI, Cardiac Cath - all showed I had V-Tach & I ended up going into VFib during my ablation; which I flatlined 3 times & had to have a pacemaker/ICD implanted.

My EF when I had the echo was 55%

[wmac]

With my first ablation I too went into V-Fib and they had to shock me back. Did they induce your VT during the ep study? They told me that they can induce vfib in anyone if they try hard enough. They were very aggressive with me and still couldnt induce my nsvt but did the vfib. They also said its more worrisome if they induce the nsvt or vt during the eps. If they had induced mine I would of ended up with a icd more than likely.
why did you end up with a icd?

[Lisa33167]

oh yes, the induced the long polymorphic runs of VT; 3 separate times which is why I have a pacemaker/icd now

they said it was dangerous and it was either caused by cardiomyopathy or arvd - my implant surgery showed I had developed non ischemic cardiomyopathy, so hopefully this helps