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Avatar universal

Worried about PVCs and tachycardia symptoms.

I'm a 24yo male, not overweight, but live a sedentary lifestyle and have poor eating/sleeping habits. However, I don't smoke, drink or use drugs and I don't drink hardly any caffeine, though I do have heartburn. I have suffered from the occasional "skip-beat" palpitation (usually only one at a time, but I've had three or more in quick succession before - not all in a row, but with only a few normal beats in between) for a few years now. I've had an echocardiogram done a year or so ago and I had a structurally normal heart. I also wore an event monitor for a around a week afterwards, but had to remove it early because the pads irritated my skin. The monitor wasn't able to pick up anything in the time I had it on and since the palpitations weren't too bad at the time, I let it go and went on with my life.

Recently, I've been getting the palpitations a lot more often than I have in the past and have been having runs of what seems to be rapid, pounding tachycardia. After a few particularly bad episodes a few months back, I had an EKG done which came up fine (I didn't have any events during the test, though) and I recently had a 24 hour Holter monitor and was told that I have PVCs and a mildly high heart rate (the person who called me to tell me my results was very vague and didn't give any specifics). I've also been having fairly frequent bouts of low blood sugar (I've had them occasionally for years with no issue, but I have them almost daily now).

After the recent bad episodes, I've began developing very severe anxiety problems and panic attacks. I've been a worrier since I was little, but the fear brought on by these recent palpitations have pushed me into full-blown panic attacks and now even minor stresses that used to not bother me give me anxiety. I have been researching PVCs and other heart related issues online lately and I've learned about tachycardias and the potentially dangerous complication's that develop from them. After learning the ins and outs of them, I realize now that I've been having tachycardias for a lot longer than I thought.

I've had the rapid, pounding heartbeats off and on for a long time without realizing they weren't normal. It seems that they are brought on by adrenaline from fear, stress, excitement and sexual activity. Just today during a masturbation session, I triggered a run of tachycardia before I was able to finish. I backed off and the pounding beats almost immediately stopped. I started again and when the adrenaline kicked in again, the pounding beats came right back. I back off again and the pounding subsided quickly. I decided to stop there without finishing because my body was shaking and I was afraid of what my heart was going to do. Since then, my chest has felt a little uncomfortable, but I haven't had any real palpitations.

I'm worried that the runs of tachycardia could be serious or lead to fibrillation or sudden cardiac death. All of my hobbies are capable of giving me these pounding beats in some form or another and I'm afraid to travel or be home alone for long periods of time. I'm afraid to do anything that may trigger the palpitations and I'm at my wits end. Are these tachycardias a bad sign? Can I get my adrenaline pumping or engage in sexual activity when they bring about these episode of racing, pounding beats and skip-beats? I'm afraid to do any strenuous exercise, masturbate or engage in any stressful activities - even ones I used to handle just fine. Any answers would help me greatly. I can't enjoy most of the things I used to love for fear of my heart giving out...
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Avatar universal
Sorry for the late reply, there's been a lot going on lately and I've forgotten to come back and give an update.

After some hectic rescheduling by my doctor AND cardiologist, I finally got to my appointment and got to see "a" cardiologist. I say "a" cardiologist because the one I ended up seeing wasn't the one I was sheduled to see. My previous cardiologist's secretary had to leave work so my appointment was pushed back by a MONTH. So in his absence, I went to see a different cardiologist who ended up being extremely unhelpful.

The new cardiologist was very nonchalant and wasn't particularly forthcoming with answers or reassurance. He looked at the results of my previous 24 hour Holter monitor (which didn't have the chance to record anything of note) and told me what I already knew about them. He said the 24 hour monitor didn't show anything dangerous and told me not to worry. The silver lining is that he did order an echocardiogram, a stress test and after mentioning it as he happened to pass by in the hall, an event monitor.

Unfortunately, the echo and stress tests are scheduled for the 24th of May, so I'll be waiting a while before I can get any definitive answers. In the mean time, I'll be wearing a 21 day event monitor, so hopefully it can record some of my more severe episodes. If the monitor can catch me at my worst and I get the results from both it and the other tests, then maybe I'll finally get some peace of mind or at least some answers.

I'll update later when there's any progress.
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1807132 tn?1318743597
More than likely the pains are from isolated pacs of pvcs and not to worry but do let us know how it goes at the doctors.  
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1807132 tn?1318743597
The fact you are only 24 means odds are pretty strong that your arteries are clean.  It takes quite a while for them to clog up so you would have to have a family history of early cardiac death or early coronary artery disease.  Odds are it isn't clogged arteries.  If you tend to feeling cold often it may be more related to hormones or thyroid issues.  Hypothyroidism can cause a person to feel cold.  But having a sedentary lifestyle may be contributing to that as well.  It mostly sounds though, that you are having simple ectopic beats.  These are extra beats in the atria/pacs or the ventricles/pvcs.  In an otherwise healthy heart they are not a threat.  The more you fret about them the more of them you will feel. As well, as I pointed out in my earlier response, there are lifestyle things that can contribute that you can try to eliminate and see if things get better like caffeine and foods that irritate your stomach or cause acid reflux.

This said, the main issue I see is that you no longer trust your heart and need some sort of absolute assurance that your life is not in jeopardy.  No one can give you either of those things.  None of us is assured of anything in life.  We have to learn to trust and have faith that our bodies will continue to support life for us.  Your heart is a very strong resilient muscle that is designed to handle a lot of things and still keep pumping.  Odds are way more in your favor that your heart will not stop then they are that it will.  So though I understand and support your desire to get your heart fully evaluated I also think that it would serve you well to work on your fear and anxiety.  Maybe try a few sessions with a counselor to work on your fear of death because anxiety in general can wind up spilling into other areas of your life so it may be good to try and get on top of it so it doesn't take over your life.  Maybe hope on the anxiety forum here on MedHelp http://www.medhelp.org/forums/Anxiety/show/71  And talk to others about how they deal with their anxiety.  It's really important that you work through your fear so that you can lead a full happy life.  Take care and keep us posted how it goes with the doctor.
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Thanks again for your reply.

I'm fairly certain that it isn't my arteries (especially considering I don't think I have any family history of it), but I might get them checked out just in case. I've pretty much eliminated caffeine from my diet, but I'm having trouble avoiding reflux inducing food/drink. It seems like everything gives me reflux... I also think I've had my thyroid checked before and it was fine, so no problems there.

I'm trying to get a handle on the anxiety these things cause. I'm having bit of success with it too, if only because I'm getting tired of getting worked up over it so much. I've read up on anxiety and panic attack relaxation techniques, but I'll still be concerned about it until I can get a few tests done. I need to know as certainly as possible that everything is benign so I can relax a bit. I appreciate the link and the kind words.

I've been having some sharp pains every now and then in my lower chest (near the base of the sternum) lately. It comes and goes and It's not a sustained pain. It feels "flickery" if that makes any sense. It comes around during times when my heart feels like it's acting up, but I don't know how related it is. It feels close to the surface, like it's just under the bone.

I'm scheduled to see a cardiologist this Wednesday. I'll post an update when I get back.
Avatar universal
Thank you very much for your kind reply!

The reason I believe the rapid pounding to be tachycardia is because the intensity of the beats is stronger and faster than through usual physical exertion and they do stop almost immediately after the adrenaline jolt passes. My dog actually startled me out of sleep a bit ago and I felt a surge of "fight or flight" adrenaline before I realized it was just the dog. Right after the adrenaline hit, my heart started pounding hard and fast for all of a few seconds then immediately returned to a normal rate.

A few days ago during a bit of solo sexual activity, I chose to power through a few skipped beats and chest discomfort (it was a more prolonged session were I finished multiple times). After finishing for the last time, my heart was really acting up. It felt like the beats were very shallow and interrupted by several small missed beats. The missed beats weren't like the usual hard "skip-thump" and they could be triggered by taking a mildly deep breath or bending over. They felt very weak, but there were a bunch of them over a period of around 4 or 5 minutes before things began to settle down. There was also minor sporatic chest pains (though I have experienced these pains before during longer sessions and tried to not let them bother me).

One concern I have is that my arteries may have some blockage of some kind because of my poor diet and lack of exercise. I haven't had any tests done to see if my circulatory system is healthy so I don't know if everything is alright in there (my limbs do tend to be rather cold and fall asleep fairly easily, though). Do any of my symptoms seem to indicate any clogging in my arteries?

My anxiety has almost entirely been brought about by these recently strong episodes. I'd never had a panic attack before the first bad episode several months ago where I was riding in a car with a friend to go see their new house. I was feeling a little car sick already (something I've had delt with occasionally since childhood) when I had a bad run of PVCs that sent me into a panic. I got the tingling arms and hands, racing heart, dizziness, shortness of breath - the whole nine yards (most of these I realize now were likely from the panic, but I didn't know any better at the time). I was sure that I was going to die.

Ever since then, I've been having palpitations and anxiety while traveling in cars and things that I used to be able to tolerate cause me to freak out because I no longer trust my heart. I used to able to power through most everything that troubled me because I felt like I could always trust my body, but now I feel more frail than I ever have. You can't just will your body live if your heart stops, and that realization hit me like a ton of bricks.

If I knew with 100% certainty that my heart would be fine in these times of extreme duress, I'd have nothing to fear anymore, but not being able rely on my own body has absolutely wrecked my confidence. Being a naturally skeptical person, it'll take some solid evidence to convince me that my heart is healthy when it feels so messed up.

I'm planning to get another event monitor soon, get my circulatory system checked out and try to get an appointment with an electrophysiologist. I need to be absolutely sure, but anything you (or anyone with experience) could tell me would be greatly appreciated.
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1807132 tn?1318743597
Hello Anthony,  Pvcs, in an otherwise healthy heart, are not a threat to you.  Even short runs of them will likely not trigger sudden death.  Most of the danger for both tachycardia and ectopic beats is in relation to those who have had heart attacks or other heart health issues.  Bradycardia is fairly normal while a person is slipping and a rate of 170 can be normal if you were active at that point in time when it was detected.  Anxiety will raise it more than it might otherwise be.  It is hard to say if the pounding is true tachycardia or simply some extra beats.  It is also extremely hard to say if it was tachycardia what kind it was.  When you are exerting yourself in the act of sex we can sometimes bear down and such action can actually cause a vagal response which can trigger pvcs.  This said, if your heart is deemed to be healthy then what you are feeling is really of no concern to a cardilogist.  Certain types of tachycardia are correctable but others are not,  I had one called avnrt that was caused by some extra muscle fibers around the avnode.  The tell tale sign of this kind of tachycardia is that it starts and stops in what feels like one beat.  If your tachycardia does not respond that way then it likely isn't an svt.  In any event, stomach issues like acid reflux are big triggers for pvcs.  The acid irritates the vagus nerve which sends signals to the heart triggering an extra beat.  Work on your stomach issues and you may clear up your extra beats.  But it is important to try and put them into perspective.  Most of the literature on them believes them to be harmless.  A person has to have somewhere near 20,000 or more a day for most cardiologists to deem them a concern in a healthy heart.  Considering you have had your heart evaluated to be structurally normal you really have nothing to worry about.  The worry may actually be contributing to the issue by introducing excess adrenaline into your system that your body doesn't need.  So do try to work on the fear that this is causing not just to feel better but so it doesn't rob you of your life.  Maybe speak with a counselor for a few sessions to work through the fear.  Heart issues can be very scary but your heart is a very strong muscle and it can really handle quite a lot before it gives out so try to trust your heart and your doctors when they say you have nothing to be concerned about.  Avoid caffeine and foods that irritate your stomach,  Cut back on sugar and carbohydrates and drink lots of water.  And just do your best to work through the anxiety.  Take care.    
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Avatar universal
I just called my family doctor to get a detailed breakdown of my recent 24 hour Holter monitor info and the report says that I ranged between both bradycardia and sinus tachycardia. I had a heart rate that bounced between 40 to 170 beats per minute for an average of around 90 and a few PVCs were detected.

The report didn't seem to imply that any of this was concerning, but I don't know what to think. I didn't realize that my heart rate was so sporadic or that I had bradycardia. Is this healthy? Is any of this abnormal or cause for alarm?
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