irregular heartbeat

[flowergirl2060]

For the last 10 years I have had PVCs, PACs (sometimes as high as 5000 per day) and occasional rapid heart rates.  My cardiologist and EP say that I have a structurally normal heart and all of this is benign. However, twice in the last four months I have experienced something different...and of course it isn't on a holter or event monitor.
Both times I have gone from a squatting to standing position, I develope a very rapid heartrate for about one minute, there may be PVC's too. I can hear my heart beat in my head and I feel as if I may blackout.  I also get very tingly up and down my arms and in my face.  My husband took my blood pressure about 15 minutes following the second episode.  It was 105/48 and my pulse was 58.  Is this episode something different from my usual PVCs and PACs?  I have had every available test including a heart cat scan, EKG, stress test, holter monitor, event monitor.  My cardiologist says he knows more about my heart than any of his other patients.  Are there any other diagnostic tests that should be done?  I take 25 mg of toprol and 2ml of lexapro.

[andie3330]

It sounds to me like your symptoms are very similar to mine. I'm 41 year old healty women with a healthy heart.  I also have gone through times with very frequent PVCs and PACs - especially during pregnancy and during the year post-partum.  For years, I have known that I can not stand from a squatting position with out feeling like I'm going to black out. In fact, I have had to sit or lie down on the floor to avoid fainting. Now I just know not to squat - I kneel instead or else I just sit on the floor if I need to work close to the ground - then I have no problem when standing up. My everyday BP tends to be low (105/55). I've never taken my BP or pulse after squatting, but I'm sure my pulse goes up quite a bit to compensate for the change in posture. I have noticed that my pulse races when I move from inverted to standing postures in yoga - and I often have to move much more slowly than others when changing positions. There is something unique about squatting though that really makes me extremely lightheaded when I stand up - I asked my cardiologist about it and she agree with me that it's nothing to worry about - just don't squat! :)

[Michael J. McWilliams, M.D.]

Is this episode something different from my usual PVCs and PACs?  

I wish I could tell you.  It could be related to a change in blood pressure and appropriate increase in heart rate with standing, it also could have been something different.  It sounds like the events are infrequent and will be very hard to catch.

If you have a structurally normal heart, your chances of dying from an arrhythmia are extremely low but no one has no risk of death.

Are there any other diagnostic tests that should be done?  I take 25 mg of toprol and 2ml of lexapro.

It sounds like you have had a lot of negative tests and do not need further testing.

I hope this helps.  Thanks for posting.

[LukeL]

Look up orthostatic hypotension it is a type of drop in blood pressure that occurs when a person goes from a lying or sitting position to a standing one. While lying the blood tends to pool in the chest and head reigion but when you stand up it rushes down to your legs and gut and in some people the body doesn't adjust quickly enough and you can get dizzy or even blackout.

Although it may make your cardiologist cringe, a tilt table test could be ordered.

With negative workups on all the other tests you should be assured there is nothing seriouslt wrong with you. I have been in your situation and have learned that if you keeping checking your body for things, you are bound to find something wrong.