PVC's - can they kill me?

[jhopper]

I have been experiencing PVC's for the last six months. Needless to say I have some questions. I want the cold hard facts.

I am a 26 years old, male, 6' 1" and 190 pounds bp 150/ 85. I do a lot of physical work (laying bricks, digging ditches). I watch my diet although I enjoy a large frappucino every morning.

Signs and symptoms: With a stethascope I can hear a lub dub dub ... DUB . I notice them standing and especially when laying on my left side in bed. I haven't experienced any syncopal episodes nor dizziness. I have experienced up to 12 in a minute.

Medications: none

Medical history: Mother has mild arteriosclerosis and stable angina. Father has a history of benign PVC's.  I have been to my primary care doctor for an ECG - I threw no PVC's during the test. Doctor ordered blood tests, but I have not been able to get them done as I am a selfpay patient.

Provocation: They occur throughout the day, and daily; however they occurr more often upon exertion, and when fatigued.

Because I am not able to visit a cardiologist I have researched this condition extensively, and have learned about these funny little heart beats in Paramedic class. I plan to go to fireschool in the autum and hope to work as a firefighter. My question is: what are the chances of this conditon being life threatening, and how does a Doctor calculate the risk of SCD?

[Mom2four85]

Sorry, just to clarify; I don't think I posted anything in my original post about SCD or SCA, just about benign/malignant pvc's, but SCD is a very interesting topic for me.

Im one of those irritating patients who wants to know WHY when a doctor tells me something...I'm still searching for my answers.

Here's some interesting info from AHA - http://americanheart.mediaroom.com/index.php?s=43&item=389

The trouble with sudden cardiac death (SCD) is just that—it is sudden and individually unpredictable.  http://www.circ.ahajournals.org/cgi/content/full/109/9/1073

Understanding Unexplained Sudden Cardiac Death -  
http://americanheart.mediaroom.com/index.php?s=54&item=220

Winkel 968 - from the American Heart Association News Conference on
Sudden Cardiac Death -Orlando, Fl –Nov. 15th 2009

I found this article intersting because they did ages 1 - 35; I wonder why?  There were 6629 deaths among the 1-35 years old in 2000-2006; 136 Sudden Arrhythmic Death Syndrome (what about old fogies like me? lol)

This report goes into alot more detail and was a large-scaled population-based study
Nishiyama 2702

Jone 969 - Sudden Cardiac Death at Selected Index Ages First estimates of lifetime risk for SCD

Ackerman 1894 from Mayo Clinic 2009 - has a lot of genetic info in it

Another article; the site has alot of info on it: http://www.fpnotebook.com/CV/EKG/PrmtrVntrclrCntrctn.htm

Here's an article on pvc's & scd - http://www.americanheart.org/presenter.jhtml?identifier=747

Here's a medhelp answer from one of the doctors: http://www.medhelp.org/posts/Heart-Disease/PVCs-and-SCD-Vfib/show/255137

"There is always a slight chance but everyone has that chance.  We still aren't good at predicting who the high risk people and there are so few of them, it will be a difficult question.  Your risk of having normal heart PVCs degenerate into a dangerous arrhythmia is very low.  I can tell you that PVCs with a structurally normal heart are considered very low risk and with no need for intervention".

Another answer: http://www.medhelp.org/posts/Heart-Disease/PVCs-and-Med-Literature/show/868461 (alot of info in this post)

This article shows - "Risk factors for SCD are numerous and include but are not limited to, coronary artery disease with left ventricular dysfunction, hypertrophic cardiomyopathy, congenital heart disease, primary electrophysiologic abnormalities, and valvular heart disease".  http://www.medscape.com/viewarticle/409714_2

Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death: epidemiology, transient risk and intervention assessment. Ann Intern Med 1993;119:1187-97

Doyle JT, Kannel WB, McNamara PM, et al. Factors related to suddenness of death from coronary disease: combined Albany-Framingham studies. Am J Cardiol 1976;37:1073-80

Luu M, Stevenson WG, Stevenson LW, et al. Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. Circulation 1989;80:1675-80

The last article is older, but has alot of info in it, might take a reading or two :P

[Mom2four85]

I'm still looking through my posts; but so far here's what I found; there's alot of info on SCD, SCA in this paper -

http://www.americanheart.org/downloadable/heart/1056719919740HSFacts2003text.pdf

about 1/2 way down is some info - "Who's at risk for sudden cardiac death"?

I was very interested in this when I first found out I might have [not sure if have is even the right word lol maybe experience?] scd or sca; that just led to more and more questions.  

If you're unsure about your heart, you need to look into your local health dept or see what help is available medically for you and at least explore your options.

Letting pvc's or arrythmia's get the best of you won't help, anxiety and stress will only worsen your symptoms.  I think my heart was trying for a gold medal when it started misbehaving :P

[Mom2four85]

I'm sure someone can hop in here too - the american heart association has a ton of info on rates etc.

I'm going to have to go back through my posts and see where I posted it previously.

[jhopper]

Lisa, where can I find the source for the information you provide regarding SCD?

[jhopper]

Thanks for all the input!

I don't claim to be an a cardiologist, but we have been taught to understand ECG's and basic arhthmias in my EMT/Paramedic classes. I am failr certain these are PVC's, an ectopic focii in the ventricles.

Yeah my bp is a bit high. I lived in the Philippines for a few years and enjoyed the local fare which is not very healthy.

[grendslori]

First thing that jumps out at me is the fact you are trying to listen to your own heartbeat; do yourself a huge favor and throw out the stethascope!! First off, you do not have the training to know exactly what you are hearing in the first place. You are asking about PVCs; how do you know you are not having PACs which are much more common? PACs and PVCs are both there as a back up to the normal SA Node and AV Node; to have premature beats is perfectly normal in ALL people around the world. We all have premature beats. How important are actual diagnosed PVCs? Not really too important unless the heart has a severe structural problem which causes the PVCs to go into a sustained arrhythmia because the heart wall is aggrevated by the lack of blood flow. If you had severe structural problems, you wouldn't be doing the kind of work you are doing. The systolic BP is a bit high, but you diastolic is normal, so I don't think there is much of a problem there. Anything can cause a jump in blood pressure including just walking to the store. I don't think you have too much to worry about. If you start worrying about all of this the catecholamines you are pouring into your blood system, are really going to make matters a lot worse for you; listening to your heat beat alone could cause enough stress to cause the PACs/PVCs.

[Mom2four85]

Since you had an ecg, can you ask your primary care dr for a holter or event monitor?

I always say this - the test results are only as good as your heart is being on that particular day & time; they didn't catch any on it, but sometimes that doesn't mean you're not having them.  I think my holter (24 hr) was $300 give or take some that they charged insurance, so ask if you can get one and how much it would be.

The one thing that jumps out at me is your BP, did the dr say anything to you about it?  Could be "white coat syndrome" :P which means nothing and you get higher bp at a drs office alot of people do.

With your family history you could also ask about a Coronary Artery Calcium Screening; my husband had this done - not covered by ins - about $100 for him.

As for your original question, yes pvc's can kill you - but there's like a <1% chance a heart arrhythmia is malignant; 99% are benign.  PVC's palpatations etc almost all people experience them at one time or another in their lives, try to keep track of when, what you were doing and what you had to eat or drink and see if there's any triggers causing them.

Caffeine, stress, alcohol, drugs, foods, anxiety....the list goes on of causes, but it's always better to be safe and get checked out and relax :)

[jhopper]

Thanks dood.  

Anybody else got input give it to me...

[itdood]

In a structurally normal heart risk for SCD for someone with benign isolated PVCs is the same as the general population.

The ways to determine heart function and structure are a few tests.  Stress test, echo, ekg, cardiac MRI, cardiac CT, nuke stress test.  not in that order and not all are required.  The basics are getting electrophysiology studied (EKG or stress test), then structure-efficiency (Echo, MRI, CT).  Cardiac MRI is quite expensive but it's one of the best tests.  It takes a specialized MRI to conduct this test.

Read a post or two down from yours, I posted more info on diagnosing them and treatment options.  best of luck.