Nervous about a stress test

[snooks69]

I am a 41 year old woman and was seemingly healthy until the first of Dec when I went to the er and was diagnosed with pvc's.....and then the anxiety set in....and wow is it getting the best of me...I am on beta blockers 50mg and sertraline 50 mg and ativan as needed till the sertraline kicks in....my blood tests came back amazingly normal....my echo cardiogram came back normal...my holter (24 hour) came back showing 7,000 pvc's in a 24 hour time period but everything else was normal....and my ekg was normal except for the pvc's....my doc has ordered a stress test with isotopes to rule out anything else to do with my heart but told me that he would be very surprised if anything showed up because everything else is normal.....I think he is trying to ease  my anxiety.....I'm a bit nervous about the stress test....they are going to inject something into my veins to go to my heart and that scares me a bit and I am not suppose to take my beta blocker the night before......I guess I just need to be reassured....

[snooks69]

Went to my cadiologist today...I really liked him.  He went over EVERY test result that I have had since my trip to the ER and showed me the charts.  He assured me that my echocardiogram was great.  There is nothing at all physically wrong with the structure of my heart.  The PVC's are just what they are...PVC's...and he has ordered an echostress test.....he told me he didn't think I needed the nuclear stress test....and he thinks the insurance company will be more inclined to pay for the echo stress test ....he again thinks that the test will probably come back normal but he wants to be sure since I do have discomfort from time to time...and I do have family history of heart problems.  I feel better since seeing him....and my echostress test is scheduled for next Friday....and he will give me the results immediately following the test...everything is done in his office!  Thank you everyone for your support....I can't tell you what these boards have meant to me these last few weeks....

[Mom2four85]

the heart rhythm tracker here is great and there's a place to put notes as well as many different symptoms =) I found it very useful when I first started here.

[snooks69]

I'm guessing that the insurance company won't cover it because of my pcp...he ordered it...so I'll go to the cardiologist and he can order it and my pcp said the insurance company will pay for it then.....my beta blocker has settled my pvc's down that is for sure....I think now I am dealing with so much anxiety and panic from this whole situation and just knowing that every test comes back normal will help....then I can maybe move on and begin to live again....the idea of the journal is a good one...I'll start that today....I do notice that they seem worse in the evening....and sometimes 3am is a trigger....not sure why!!  Between the cat and the pvc's my sleep pattern is very disturbed!!

[Mom2four85]

wow because you're 41? I was 42 and had one and I've read others who are younger than we are who have had them.  I would call my insurance company and ask why - it may be that the pcp can't order one and they pay for it and that it has to be ordered by a cardiologist; some insurance rules do not make sense.

have you or your dr found what's causing your pvc's? 7,000 sounds like a lot but it's about 7% of the "normal" heartbeats that typically beats 100,000 daily - dr's usually treat 6,000 - 8,000 pvc's daily with meds unless there are other things going on (symptoms such as fainting, bradycardia) or structural heart problems.

try not to let them make you anxious; that will only make your symptoms worse...also try to find what your triggers are - a good tip is to keep a journal or use the arrhythmia tracker here - then you can see if there's a pattern or anything that makes them worse/better

[snooks69]

My doc called yesterday...my insurance company refuses to pay for my stress test because of my age...!!!  SOOOO my doc has referred me to a cardiologist and he said the cardiologist will order the stress test and then the insurance company will pay for it....so I will see the cardiologist on Friday instead of getting the test....I know all of my other tests have been normal but I can tell you these last two weeks have been awful...last week I had panic attacks EVERYDAY....I think I am glad to be going to the cardiologist...sort of a second opinion and a specialist who only deals with heart issues....I just want to be able to relax and know I am okay...I'll keep everyone posted....

[Madge270]

I had that test  about a dozen years ago (to check my mitral valve function), and it really wasn't bad at all.  You'll be okay. They really do watch you all during the stress test, as Ihatepalps2 mentioned. Later in the day I went out for dinner. Felt fine.

Two years ago, I had a regular treadmill stress test and everything was okay. But two months later I developed PVCs.The monitor I wore showed 8500 a day. All heart tests were okay.

I sometimes find that, lately, my heart pounds from just mild activity (climbing up and down stairs, walking quickly, etc.) I can feel it pounding in my neck and head. But the PVCs actually have decreased so I think I'm fine.  I never took a beta blocker, because my cardiologist told me my heart rate is normally on the low side, and I'm one of those who has more PVCs when my heart rate is slower.  If I get my pulse above the mid eighties, my PVCs are almost all gone. So he felt I should not take a beta blocker...why slow my heart rate down if I'd just have more PVCs?  I was impressed that he didn't try to push medication on me.

I don't want to give you the idea that I think beta blockers are bad. They're not. I was glad I didn't have to take them, though, because I have heartburn a lot, and some beta blockers can cause acid reflux.  You'll do fine, and let us know how it goes, okay?

The hardest thing is the anxiety you feel when you're trying to get used to dealing with PVCs.  I've had anxiety and panic issues too, and probably many of us on this forum do. I think you have a good doctor and it's great that he's trying to put your mind at ease.

[snooks69]

Thank you so much for your story...it helps sooooo much to hear ....I am also dealing with horrible anxiety right now....I have had multiple panic attacks over the last 5 days...almost debilitating.....my stress test is next week....I am praying I can get through the next week and get there and get this over with!!  AND I sure hope my doctor is right and the test shows nothing but a normal heart so that I can move on and tackle this anxiety!

[Ihatepalps2]

Hi, snooks. I am just a bit older than you are...female..and Ive had PVCs for about 18 years now. 7000 PVCs seems like alot, I know...I have had more...and less. Ive had echos...actually every kind of heart test. Ive been told the same as you...everything normal except the PVCs. Ive had so many holters over the years. Ive also had several stress tests, the recent being just in July of last year. Ive had them both ways, the "simple" ones..just get on the treadmill and take off, and Ive had the "Nuclear stress test" (what its called here). That is where I went in, in the morning, they had me get on the table for a scan (its wide open, if you have claustrophobia issues) ..they want to see pictures of my resting heart. Then I went to the radiology dept, and they inserted an IV line in my arm, just the pic end of it, and injected me with (safe!) radioactive type dye. I went home for a couple hours. Came back after it had a chance to get all thru my heart...and got on the treadmill. All hooked up to monitors that you can watch as well (if you want). They put a blood pressure cuff on you. The doctor is RIGHT THERE as well as a nurse and sometimes a technician. They start you off VERRRRRY slowly on the treadmill. I was NOT in shape at all, so i really did start slow. They increase the incline and the speed every 2 or 3 minutes. As well as take your BP often, and they are constantly watching the monitor for anything that would change. It does get challenging--they increase it pretty quickly as they get going..and they are talking to you. They want you to talk a bit back, to make sure you arent too breathless. If they would see ANYTHING that would be "scary" they would stop it immediatly ( never did, in all that ive had!) they keep going till you are really huffing and puffing OR till you reach your maxiumum of where they want you to be. They stop...and take your vitals right away again. You are allowed to cool down for a brief while, and then its back to the scanner--where it takes about 20-30 minutes for that scanner to move all around you, taking pictures of your heart. You eventually pee out the stuff they injected...ive never had any side effects...and...that is that. Mine were all ok, till this very last one...where they found an area they found to be " abnormal"...meaning that it was an area of "narrowing".... the cardiologist felt mine wasnt enough to send me to the cardiac cath lab...so we are trying to correct things with risk factor fixes...I went on cholesterol lowering meds which worked right away, I started an exercise program (which Ive been off of for 3 months now due to a sore calf!) and a diet.
SSOOOO...bottom line...its really truly not that bad. I was nervous for my first one too. Well, I will be honest, with all of them. Ikept thinking what if something happens when Im on the treadmill? But....the Dr is right there, and really nothing has ever happened.
The ONLY part I really disliked, was the going off my Beta Blocker! I HATE HATE HATE that feeling--Icould tell that I hadnt taken it...I could feel my heart pounding...whereas usually I never felt it. But....they knew I was off of it..and they were fine with it.
Im sorry this is so long, but when Im nervous about something, I like it when someone breaks it all down for me. Good luck, and come back and tell us how it went.