usually at rest

The PAC's just started getting alot more frequent. My normal BP is 118/70. Resting pulse in the 60's. I eat well, exercise and in very good weight. Female 57, parents both had heart issues. My PAC's started about a month ago, just sitting doing paper work. Skip a beat, do 4 skip one do 27 do one more skip. The next day I walked up four steps into a hot building and the heart was skipping every other beat for about 4 minutes. It has not done that since then. Now every four or five days i will beging to feel the flutter and then for about 10 minutes I have the PAC's. My HDL is good my LDL is a little high 147 my triglicerides (triglycerides) are 61, I regulate my blood sugar with diet. So do I deal with these or should I get a stress test with the IV dye???They also sometimes happen just after I work out and my heart is almost down to normal

[Michael J. McWilliams, M.D.]

My approach to a patient with PACs would not include a stress test unless you described other symptoms like chest pains, chest pressures, shortness of breath at rest or with exertion, swelling in the legs, waking up in the middle of the night short of breath.  PACs are usually not a sign of coronary artery disease.  If you had PVCs, my threshold for a stress test is much lower.

I will sometimes check an echocardiogram, especially if there are any other cardiac symptoms or a murmur on exam.  Otherwise, the best approach is often to do nothing and live with them.  PACs do not increase your risk of cardiac events.

I hope this helps.  Thanks for posting.