Aa
PACs
About 7 weeks ago, I has about a 3 day episode of continuous skipped beats (checked by pulse). Sometimes up to 10 per minute at times. They eventually "resolved".
In the past week, I have experienced the same type of 2-3 day episode and I went to ER late on day 2. They caught PACs on my EKG and also on the monitor it was put on.
After some blood work, I was discharged with these being treated as a benign finding in a structurally normal heart (I have recently had stress echo and treadmill stress test which were normal).
These went away for 2 days, then came back again. I am extremely nervous as to what these are and it is affecting my daily life. I am more concerned that I possibly could have been in A-Fib prior to my visit to the ER. Although my heart rate was never elevated.
I am 42 years old an am an avid runner ( 5 days per week at 7-8 miles per day).
Do you believe these to be the benign findings as noted in ER and by cardiologist or something more sinister?
Thanks for your time and consideration.
In the past week, I have experienced the same type of 2-3 day episode and I went to ER late on day 2. They caught PACs on my EKG and also on the monitor it was put on.
After some blood work, I was discharged with these being treated as a benign finding in a structurally normal heart (I have recently had stress echo and treadmill stress test which were normal).
These went away for 2 days, then came back again. I am extremely nervous as to what these are and it is affecting my daily life. I am more concerned that I possibly could have been in A-Fib prior to my visit to the ER. Although my heart rate was never elevated.
I am 42 years old an am an avid runner ( 5 days per week at 7-8 miles per day).
Do you believe these to be the benign findings as noted in ER and by cardiologist or something more sinister?
Thanks for your time and consideration.
MEDICAL PROFESSIONAL
Thank you for your question. What you are describing is a very common clinical scenario and a very common reason for patients to seek evaluation in the clinic.
Thus far the objective data you have presented all point to a benign course (PAC's only detected on telemetry, normal ECHO). However, you are symptomatic and this is causing you anxiety.
The key to these evaluations is to demonstrate clear "symptom-rhythm" correlations, that is, capturing these events on telemetry while you are having symptoms. I recommend you ask your physician for prolonged ECG monitoring with a Holter monitor. The symptoms are fairly infrequent, you may need 2-4 weeks of Holter monitoring to find a number of "events" to capture. If you are only found to have PAC's on the monitor when you are having symptoms, you can ask your physician about treatment with a beta blocker like metoprolol tartrate or metoprolol succinate at a low dose to suppress these ectopic beats.
Thus far the objective data you have presented all point to a benign course (PAC's only detected on telemetry, normal ECHO). However, you are symptomatic and this is causing you anxiety.
The key to these evaluations is to demonstrate clear "symptom-rhythm" correlations, that is, capturing these events on telemetry while you are having symptoms. I recommend you ask your physician for prolonged ECG monitoring with a Holter monitor. The symptoms are fairly infrequent, you may need 2-4 weeks of Holter monitoring to find a number of "events" to capture. If you are only found to have PAC's on the monitor when you are having symptoms, you can ask your physician about treatment with a beta blocker like metoprolol tartrate or metoprolol succinate at a low dose to suppress these ectopic beats.
You might find the information in this video of interest.
http://www.youtube.com/watch?feature=player_embedded&v=Y6U728AZnV0#at=561
http://www.youtube.com/watch?feature=player_embedded&v=Y6U728AZnV0#at=561
To further note to the doctor. I am followed by a cardiologist at the Cleveland Clinic as a result of a CTA that was performed in June 2006 during a physical at their hospital. (I was 35 at the time )
It show mild plaque in 2 discreet locations in my LAD (mid and distal). All other arteries were clear at the time.
Since that time, I have been treated with cholesterol lowering medications to reduce my numbers to ideal range, a good diet and exercise (I run 30-40 miles per week). I do have a very high LP (a) - hence further reason to get all my other numbers down. My most recent were HDL - 78; LDL - 61 ; Triglycerides - 63 - Total cholesterol - 152
I have had several stress tests (without thallium since then) as well as the stress echo referred to previously and all have been noted as completely normal with good functional capacity. My ejection fraction is 69% and I have mild mitral regurgitation and trivial tricuspid valve regurgitation.
It show mild plaque in 2 discreet locations in my LAD (mid and distal). All other arteries were clear at the time.
Since that time, I have been treated with cholesterol lowering medications to reduce my numbers to ideal range, a good diet and exercise (I run 30-40 miles per week). I do have a very high LP (a) - hence further reason to get all my other numbers down. My most recent were HDL - 78; LDL - 61 ; Triglycerides - 63 - Total cholesterol - 152
I have had several stress tests (without thallium since then) as well as the stress echo referred to previously and all have been noted as completely normal with good functional capacity. My ejection fraction is 69% and I have mild mitral regurgitation and trivial tricuspid valve regurgitation.
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