mulitfocal couplets

[bbxx]

I just want to know if anyone else has multifocal couplets. I see in june 4, 2010 in the heart disease section (but I dont think the girl had heart disease) that the doctor said multiform pvcs are more dangerous. I am confused as to why my doctor didnt even mention it to me if the fact they are muiltiform is so much more dangerous. Does anyone else have this? I really would feel better if others had it (I dont wish it on you, I just want to know if you are ok). I was told I did not have to take meds if I didnt want to.

[sleepyVT]

My understanding of some multi-focal PVCs and ectopic rhythms is that the danger comes when the ectopic beat falls in the cardiac cycle.  Depending on when the QRS complex falls,(or when the ectopic beat is occuring) it could lead to VT instead of a stable extraventricular rhythm.  Some things to consider regarding the progression of these events is other health factors. Things like sleep apnea can cause extra stress on the heart during sleep leading to reduced oxygen, reduced cardiac output, and increased blood pressures. Over time the cardiac muscle will lose elasticity due to these problems. Also, sleep apnea can be very problematic if you also suffer from COPD  and CHF.  Then not only are you not breathing because of the apnea, but as well the lungs are having a harder time with exhalation leading to CO2 retention.  If you suffer from CAD it is definitely worth seeking a referral for a sleep study to assess and treat OSA. It is necessary to treat OSA to keep it from further damaging the heart.

[bbxx]

Yes to both of you. Then a guy drops dead from a heart issues after passing every test available, eating right his whole life and everyone is left shaking their heads feeling suddenly very vulnerble. (sorry, my spelling stinks)

[RNRita]

I think we are just ON base.  One person with PVCs lives to be 90 so they can't kill you....one person dies because of them ......and we'll never know.  How would they even KNOW that?  UGH....on a rant.

[Mom2four85]

it's just like every other aspect of research, side A wants to prove side B that X=Y so they set up a research team with patients who meet their "criteria" for that research program...using patients as their guinea pigs for their purpose...and doctors use this research as gold standards of diagnosis and care

maybe I'm way off base?

[bbxx]

But they said that it was "rare" for someone with 20,000 pvcs to get cardiomyopathy, so how come they now say 4,000 pvcs can  lead to it. You know why? Because the more research people do, the more they realize they dont know as much as they thought they did. Remember crib death? They told our grandparents to sleep kids on the their backs. Then they told our parents to sleep them them on their tummys. Then they told us to sleep them on their sides. Do they know? Or is it simply there are spells where each happens. Maybe they studied pvc induced cardiomyopathy for 10 years and one person with 20,000 pvcs got it, but years later same study 2 with 4,000 got it. You know, like it always seems things come in bunches. Just my opinion for the little its worth.

[Mom2four85]

I'm right there with you, I've had it with dr's and some have no clue what's going on...when will more research be done and we patients be treated differently? I went from age 9 (back then it was for attention I fainted and made my heart flipflop lol) to 42 being told "nothing" was wrong.

If I had no broken my foot I would have died at 42 and been one more "unknown" case because of some uncaring unfeeling bafoon who didn't know a pvc from a hole in the ground....now I have to deal with major issues because 5 different dr's chalked something dangerous up to something else. Why, when, how did my heart just "morph" into something dangerous when nothing had changed? I still have no answers and no clue what caused my problem.

if pvc's are benign then why ablate them? why not just leave them alone? another question is..new data comes out all the time...why don't all dr's follow this - like march 2010 data about pvc induced cardiomyopathy - instead of >15% of pvc's the new data says >4,000 CAN cause CM - I've tried to find a set standard for echo's yet patients are diagnosed via this method...how outdated is it? what set standard of parameters do ALL dr's use in echo's? where is that info...

I have to see my pcp's cardiologist Friday before she will refer me out, if I don't get any answers, I'll be making an appt with Cleveland or Mayo Clinic.

[RNRita]

Everything I've read doing research says that multi focal PVCs are more dangerous, yet I hear people saying that their doctors tell them they are not except with a structurally abnormal heart.  If they can't get on the same page, how are these supposed to ever be fixed?  When are they going to do a weekend marathon and get donations and grants to help OUR situation?  We could be....um...Medhelp's Kids!  

AND I would like to know how they know that PVCs are benign in the first place.  How do they know that when young people die for no apparent reason, it wasn't just an undiagnosed arrhythmia?  Ain't I fun tonight?  Can you tell I've had a bad day?

[Mom2four85]

I've read the lown rating system is flawed and contradicted by some dr's, yet others swear by it...just too much to think about - too much conflicting things I've heard/read about arrhythmia's it makes my head spin even more...

the one that answered nurse2b1982 has the expert symbol beside his name; not sure how he could get that but it's a good question - any moderators know if this guy's legit since it does say member's comment yet most of his answers are in the expert forum and some places it says Doctor's Answer?  I really hope something is incorrect with the member's comment showing up and it's a glitch...he has 131 pages of 10 answers on a page, he even answered one of my questions [shudders]

the other one - by CCF Cardio MD - MTR, Mar 03, 1999 doesn't have the expert symbol [scratches my head] even more confusing...

[bbxx]

Jodie, I thought the same thing about that--wondering if he was a real doctor and I too was hoping he wasnt. I did ask a cardio on another site today abou the lown rating thing and he said he is almost certain that is only for eople that have had a heart attack. He went on to say someting about it being from like 1955 or something like that--I am terrible with dates, so maybe I have that wrong.

[jkfrench]

Interesting, that one post responding that multi focals are more dangerous doesn't indicate who the doctor is.  If you put your cursor over the cleveland clinic icon, it just says male, 35 years old, member since 2007.    Don't most of the responses from the doctors tell us who they are?   Just hoping that somebody jumped in pretending he was with Cleveland Clinic.
If you do ask the expert, please let us know what they say.  I'm going to ask my doctor again.
Jodie

[jkfrench]

Yep, lucky us.  We can feel every one.

[bbxx]

Well that would be awsome if you found a good doctor!
I think more people feel them than dont. (pvcs) When I was hooked up I did the same thing (theres one, theres one, etc...) they were like-"an unlucky one, she feels them"
lol

[Mom2four85]

I'm glad you get my humor :P  

I went to my appt with a new pcp and saw the NP there and she questioned things like some of my meds & treatments; that i've been questioning...she listened to what I had to say even it felt like I was complaining.  Maybe I've finally found an office I can stick with and find some answers =) She's even redoing some bloodwork the others did just in case things have changed and gave me some meds to see if it helps with my back pain.  Got a referral to a new cardiologist & EP =) also.

Oh wow about the other site...no way someone really said it's not possible to feel pvc's? every monitor and ekg they've hooked me up to; they ask can you feel that? yup, and I tick off when I feel it to them - all pvc's and I've had chest pressure and pains with them...but eh I'm not a nurse or dr what do I know?

[bbxx]

Lisa, I really appreciate all the information you share! I wish you would find a cure while you are looking! :) Seriuosly though, thank you, and do not stop researching! Even the doctors that care dont have the time to invest in the research needed for some cases, as you have learned. I am a firm believer in questioning, studying, researching, and not putting my hope and trust in someone just because they have a degree. Sort of off topic, but  I was on another site when someone asked if it was normal to have chest pressure and pain with pvcs cause they were scared and some woman touting a nursing degree told her its simply not possible to feel pvcs, therefore she was feeling "palpitations" which is strictly anxiety and she needs treatment for anxiety!  I mean, what if that person took the advice and was actually having something related not just to pvcs but worse? UGH!

[Mom2four85]

fine...I'll go back to my corner and stick my head in the sand again...I know nothing!

[bbxx]

Thankyou Jodie, it would help except for Lisas reminder lol --Lisa, if you post and get an answer let us know--or maybe we dont want to know? lol

[Mom2four85]

Jodie; that's the post I use also, but here's one that makes me wonder if even dr's know wth is going on - bbxx found this - http://www.medhelp.org/posts/Heart-Disease/Pvc-question/show/1256410?personal_page_id=1104413#post_5756071

"Multifocal PVCs are more dangerous.  It basically means that various regions in your heart are irritable."

"Multifocal PVC's can be worrisome in the setting of underlying heart disease." http://www.medhelp.org/posts/Heart-Disease/multifocal-pvcs/show/869489?forums=forums

"The good news is it doesn't matter if they are unifocal or multifocal PVCs--if you have a structurally normal heart, there is no need to worry about them."

These are all from MH/CC dr's, really leaves me wondering - I've been told for 18mths unifocal/multifocal doesn't make a difference...except in underlying heart disease - define "heart disease" or structural problems dr's!  I think I'm going to ask in the expert forum to get an answer.

[jkfrench]

My pvc's are multi focal.  I worried about that too.  I just saw my doctor on Monday and asked him about it and he said not to worry, my heart was structurally normal.  He went on to tell me that the reason he has me come in once a year for an echo and stress test is so that he can tell me with the upmost confidence that my heart is fine and to not worry about my pvc's.
I sometimes wonder if that is why they feel so different when they decide to increase from a few a day to hundreds a day.
Then go on like yours, for months.  I hate that extra long pause to.  
So, to answer your question..I am okay with multifocal pvc's.  Hope that helps.
Here is a link to one of the doctors responses on this forum regarding multi focal pvcs.
http://www.medhelp.org/posts/Heart-Disease/Signaficance-of-unifocal-vs-multifocal-PVCs-in-a-normal-heart-structure/show/253854?forums=forums

Jodie

[bbxx]

Wow. Talk about creepy! All those doctors saying your echo was normal when it wasnt? I dont know how I would know if I have couplets a lot or not. It feels like I do every once in a while, but when I feel the exta long pause when taking my pulse I assume those are couplets and they happen kind of often. Low blood pressure is something all my family has on both sides, sooooo I guess I have no idea unless I start passing out or buy my own heart monitor. Meanwhile  I cant even move, cough, walk, sit, bend etc.. without feeling them. I recorded 8 or more a minute when I first woke up. Its been over a year of no normal pulse. It use to be that I would feel an occasional skip. I miss that. I am sorry you have such a rotten deal. I hope you get the help you need.

[Mom2four85]

********** what in the world? now we can't post the word h e a l t h b o a r d s???

[Mom2four85]

My case is very complex and complicated to understand even for me and I've lived it.

When I first went to dr's in June & July 2009, they told me through testing I had a "structurally" normal heart which was NOT true, somehow the echo wasn't exactly accurate enough to pick up some things it should have and the parameters were off a bit.  I specifically asked about this after I got my echo in July.

I was told all of this was "structurally" normal:
Mild Tricuspid insufficency
Trace Mitral valve in sufficency  
Mild Concentric left ventricular hypertropy  with EF rate of 55 - 60%
Dilated left atrium with normal left atrial pressures
LV diastolic function: E/A 1.0, DT a140 msec, E' 10/cm/sec E/E' 8

How true or accurate that is; I don't know.   I still do not have an answer if this echo really was "normal".  When I posted on allexperts, drs lounge, ************, medhelp they ALL agreed with my cardiologist - this echo was "normal" and nothing for me to worry about - I had no structural heart problems!

No one has any clue how I went from the middle of July 2009 - August 2009 and suddenly I had a 40% EF, severe cardiomyopathy that was damaging my heart, mild systemic hypertension and moderately elevated LVEDP (34 which is technically heart failure) and parts of my heart were in bad shape - cardiac output was greatly reduced; although no CAD - all of this was non - ischemic.

Then the real clincher....my pvc's/vt were malignant and dangerous where I had been told they weren't because I had no structural heart problems... Polymorphic Ventricular Tachycardia is what I was diagnosed with.

I don't think an isolated incident of pvc couplets are anything to worry about, BUT if you're having them alot or very frequent pvc's - over 15,000 pvc's daily, symptoms such as fainting, low blood pressure etc that you should worry.  Worry, stress and anxiety can and will make your symptoms worse and make you feel worse...eh I'm not a doctor, what do I know...:P

[bbxx]

Thank you. I cant go back to the cardiologist till spring, so I was hoping to find others with them. Your heart is not structurally normal? Did it show in a echo? I read your story, its terrible! What is the sructure part thats not normal, is it valves? I have mild mvp. The last couple days I have been having so many pvcs I swear I will have gray hair by the end of the week! Short of living at the cardioloist and living on a monitor theres no other way to see if I have gotten worse or not, so its freaky.

[Mom2four85]

I found the post...she was on my friends list and I haven't heard from her in awhile.  

If i remember correctly, she had a lot of pvc's (30,000 or so she thought for awhile) then she had a EP Study and got her paperwork and found only 4k pvc's, not the high amount she thought she was having - and she did have a lot of continual multifocal couplets.

I see the Dr told her multi focal was something to worry about, yet other MH/CC dr's say just the opposite - depending on structural heart problems.

If you're still in doubt make an appt with another dr and get to the bottom of your issues just in case; it's better to be safe and make sure nothing has changed or it hasn't worsened.

[Mom2four85]

yes I have them - can you post a link to the post you're talking about?

I was told by several dr's - cardiologists & ep's (as well as all experts, dr's lounge and here on MH) that if you have a normally structural heart; then it doesn't matter which you have; with the exception of polymorphic VT - which I was dx with after my EP study

I didn't have  normally structural heart as they first told me and ended up with a list of things wrong...no clue why and no answers so I'm as clueless as the next person WTH happened or why I was so "lucky" to be saddled with what's wrong me :P