Symptomatic PACs

[JPope]

Hello,

I am a 29 y.o. Caucasian female, otherwise healthy with no previous history other than mild depression on Zoloft and PRN Xanax and Ambien (as well as two previous C-sections).  I'm a normal weight (128lbs at 5'3''), exercise regularly (walking/running at least 2-3x a week for 30 minutes), eat fairly well, and have yearly physicals/OB visits.

After a period of tremendous stress (mother diagnosed with terminal illness and subsequent passing, separation leading to divorce, and birth of child) I began noticing an increase in fatigue, anxiety, and began getting lightheaded.  I work on a telemetry unit and hooked myself up to the tele boxes one night and noticed I was having PACs/PVCs.  

I was seen by a cardiologist who preformed a resting echocardiogram, and EKG, and drew a set of cardiac enzymes.  Everything came back normal except for occasional PVCs/PACs; I was sent on my way with the notion that my anxiety was causing the irregular beats, rather than vice versa.

A month later I am still have symptomatic irregular heartbeats, though they are now typically PACs only.  I notice my heart "skipping beats" in my chest and become very anxious as I can feel my heart pounded into my neck and head (my heart rate is in the 80s when this happens, though I can tell it is irregular by taking my peripheral pulse).  I am still fatigued, frequently lightheaded even while sitting or laying (it IS worse when I change positions).  At times I even become nauseated.  This happens more in the evening/night (although maybe it's only that I notice it then?) but I do work nights.

My doctor has since prescribed 25mg Atenolol PO but I have not filled the prescription yet as I'm concerned with my BP as I'm normally 90/60 to 100/70; I'm afraid of my blood pressure lowering further.

Because I'm feeling so very yucky, is there anything else that I could try?  I've been told to "lower my stress" but I'm not sure how this is possibly given my situations.  Should I try a different beta blocker or other meds altogether?

Thanks

[Jerry_NJ]

Sorry to read of the high stress times you've been going through. It is very understandable that you have some heart reactions.  Hope that helps with your frame-of-mind, try real hard not to try real hard...yes relax without thinking about it and getting anxious when it doesn't work.  The best thing most of us use is exercise and distraction.  

I agree your BP is low enough and a Beta Blocker may lower it further, along with your pulse which seems to be acceptable.  BB can also act as a depressant physically if not mentally, and you don't need that.  

I think BB is usually the first and least aggressive medication for PVC etc., but given your situation a arrhythmic drug (propafenone) may be better, you can ask your doctor.  One problem with the arrhythmic drugs is they tend to be expensive...depending on insurance if you have it.  

[Wisconsin2007]

Sorry to hear about your situation.  Sometimes it feels like you're in an impossible situation - you're told not to worry but how can you when it's your heart?  You're told to reduce stress but your life's schedule at the moment just won't allow it, short of quitting your job and living in a cardboard box.

Because I've walked quite a few miles in your shoes, I might also suggest the following placement for the cart and the horse - stress is your horse, pulling along with it a cart full of upset stomach, light-headedness and PV/AC's (and not the alternative, the PV/AC's are the horse, pulling along the other symptoms).

There are many ways to try to reduce stress, meditation, tea, exercise, an engaging hobby, etc.  Try some of that out for awhile to see if it doesn't help.

Good luck