Question for the Dr.

[steph4501]

Hello, I am new here. I am a 30 yr old female and I have been having pvc's for at least 8 months.  Over the past couple months they have been getting more frequent.

Over the past 2 weeks I have been getting them nearly non-stop.  Some are even back to back with no beat in between for like 2-3 beats.  To make a long story short...  I had an EKG in the E.R, an echo and stress test with my new cardiologist and wore a holter monitor for 24 hrs.

The holter picked up 4,280 beats in those 24 hrs.  896 of those alone happened in ONE HOUR and were at midnight, when I was sleeping.  

I get some bad ones that will go, "beat, skip, beat, skip, beat skip, etc...  So back to back ones, and so that go beat, beat, skip, beat, beat skip.

The cardiologist picked 9 skipped beats up on the ekg during the stress test.  She was not worried.  The echo before and after the stress test looked good.  She everything looked good and my heart was functioning normally.  And to try and "Ignore the PVC's."

I have some questions now...

1.  Can PVC's cause me to suddenly drop dead?  
2.  How can all these constant PVC's be considered NORMAL?
3.  How can I just ignore them when I feel them right in my heart area?
4.  Can these shorten my life?

I am really scared.  I have 3 children ages 6, 4 and 2 and I want to live a LONG time for them.  I am only 30.  I have Multiple Sclerosis as well.

Thank you for your time and help.

Steph

[Michael J. McWilliams, M.D.]

1.  Can PVC's cause me to suddenly drop dead?  

The truth is that any one of us can drop dead, so no one will every promise you that you have no risk. Everyone has risk for sudden death.  PVCs with a normal stress test, structurally normal heart and normal EKG are not dangerous but they do cause symptoms.  If you have PVCs during the recovery phase of exercise, that does suggest an increased risk but it is by no means a death sentance.  It simply means you have increased risk.  If your doctor has declared  you low risk, do you best to move on or get a second opinion and if the second doctor agrees, try to move on.

If that doesn't work, there are options for medications and/or an ablation but this option does carry more risk.  It is not recommended as first line -- first line therapy is re assurance that you are ok.


2.  How can all these constant PVC's be considered NORMAL?

They are normal for you.  That is the best I can say.

3.  How can I just ignore them when I feel them right in my heart area?

If you can't ingore the sensation, you need to change the way you think aobut them by not thinking you are going to die each time they happen.  Beta blockers and calcium channel blockers can decrease the sensation of PVCs but rarely get rid of them.

4.  Can these shorten my life?

PVCs during recovery phase of exercise of long term studies are associated with increased risk.  To date there is no studied treatment that will change this risk factor and it is unknown if it is the PVCs that increase risk or if the PVCs are simply a marker for increased risk.  There are many correctable risk factors like diet, smoking, exercise, etc that people can change.  I would focus on correctable risk factors.  You didn't mention above if the PVCs were in recover phase of exercise.

I hope this helps.
Thanks for posting.

[tickertock]

Just curious, what about PVCs during all 3 phases, the resting , exercise phase, and recovery phase with actually a slight decrease in the number during the recovery phase, this is what happened during my last exercise stress test which was over 6 years ago, I rarely have any PVCs thats worth mentioning anymore.

[steph4501]

First, thank you for answering my questions. I don't mean to sound negative about all this, I am just scared!  It's not fun feeling these.  =o(  Especially many pvc's per-minute all day long.

It's hard to know if I get more pvc's in the recovery phase (Which I assume you mean, AFTER I exercised on the treadmill during the stress test) since I always have pvc's.  I get them when I rest, sleep, watch tv, eat, after exercise, etc....  

Sometimes it seems the pvc's get better with exercise though.  Maybe because I don't feel them when I am up and moving around, and when I am sitting or laying down my body is still and I feel them easily.

Last Summer, I was playing basketball with my husband and I noticed PVC's after i sat down, but again, I get them all the time.  Should I be scared?

Thank you,
Steph

[Michael J. McWilliams, M.D.]

A recent article showed that only post exercise recovery phase PVCs with structurally normal hearts correlated with increased cardiovascular risk.

If this applies to you, you should know more scared than if you were a diabetic, hypertensive, smoker, over weight, etc.  They are all risk factors and all your risk factors combined contribute to our total risk.  The problem with PVCs is that you feel them and it makes them harder to ignore.  People with high blood pressure don't worry everyday because the damage being done is silent.  Focus on correctable factors like diet, exercise, no smoking, etc.

[sean1975]

A related discussion, Should I be as terrified as I am? was started.

[oldie]

A related discussion, r/t and hospitalisation was started.