I haven't posted in a while on a MedHelp forum but with my recent onset of very frequent PVCs (have had phases of them for over 30 years) and knowing without doubt that mine were triggered, sustained, increased in frequency...etc... by anxiety and stress, I wanted to add some comments regarding these devilish palpitations, that might hopefully help others.
Before I get to my main comments, I’ll mention that a heart murmur was detected in me in my teens and a referral to a cardiologist found that I had a healthy, normal size heart. Twenty years later (now about 10 years ago), I had an EKG/Stress test because of a phase of PVCs I was going through and again, my heart was normal, with no arrhythmias found (my PVCs seldom occur with exercise). Even though my last check up was 10 years ago, it would be silly for me to go the expense of renewed heart tests because if the PVCs were benign then, they are still benign now, especially with the fact that I have no chest pain with mine, or shortness of breath and I’ve never fainted due to one or noticed any dizziness with them. I’ve had as much as several years go by without attacks of PVCs.
First, I agree with the many cardiologists, MDs and medical people who point-out the harmlessness of PVCs, in people with structurally sound hearts but as we who experience episodes of frequency with them know, they are not harmless to one's quality-of-life and emotional well-being. We therefore must develop coping skills and if-needed, take medications that help us deal with them.
The reason I can tie my PVCs directly to my anxiety, is due to the fact that I've suffered generalized anxiety and occasional panic attacks since my teens (over 30 years). My palps have occurred at times in my life of severe stress and anxiety, since youth. Amazingly, I have actually gone years at time, not noticing anything other than a very occasional PVC. Afterward, a phase of them might show up and last for weeks or months.
I feel that people who have posted, saying that stress and anxiety was not involved in their PVCs, have the type personalities that deal better with stress/anxiety than some of the rest of us. In other words they can have significant stress but don't perceive it as others do. I say this because if they had no stress/anxiety, their posts of concern regarding their PVCs would not be appearing on forums. They likely felt a PVC or two and began to subtly anticipate them and also likely experience little adrenaline surges when they occur, that causes succeeding ones or even runs of them. They are fueling them more than they may realize.
I also feel that the fight or flight response becomes so touchy in those of us whose anxiety increases with PVCs, that adrenaline is released in lightning-fast spurts, with each heart skip. This adds not only to the perception of them (palpitation/felt) but also to the strength and frequency of them. While we can at times convince ourselves, saying "this is just part of my anxiety/stress disorder", the unpleasantness of them works in the back of our minds, saying to us "this is going to lead to a serious heart problem or arrhythmia for you if they keep happening like this". This is why I referred to them as “devilish” at the start of my post. They are in-essence "thorns in the flesh" -- little reminders of our mortality, while we try to live life and enjoy it.
Some of the heart specialists I've read on the PVC subject, state that "about half of us have them" (PVCs and PACs). This is why when people post about the "potential deadliness of them" or the "potential for them to evolve into life-threatening arrhythmias, they should not do so, without adding the fact that this is only true in people who've suffered serious heart damage or have significant heart defects. If this were generally true of healthy people, that would mean that 50% -- half of the entire population is at risk for dropping dead at any moment but common sense says this is not true.
My mother for example made trips to the emergency room, 25 years ago when she began having frequent PVCs and runs of them, after a period of severe stress and anxiety (I inherited her anxiety disorder). She is now 75 years old and has kept the PVCs controlled via daily Xanax for all of that time. Amazingly, this same benzo drug is what controls/reduces mine and so I too have begun to take it regularly at low to moderate dose. I was reluctant toward the drug at first, due to information warning of it's potential for dependency however, dependency is exactly what SSRI antidepressants require, as do beta-blockers, neither of which can be abruptly stopped but must be weaned-off of (if situations merit), slowly, under Dr.-supervision.
I was originally placed on a beta-blocker but the fatigue I experienced with it is was far worse than that I experience with Xanax. Additionally the beta blocker causes me sexual dysfunction and worse dizziness when first standing from seated. The Xanax causes none of these issues for me. Please understand this IS NOT a plug for Xanax or any benzo for that matter; I'm simply saying this has been my experience but may not be the case with other PVCers and PACers.
In conclusion: I do feel anxiety is a very common trigger for PVCs and likely the number one trigger. Add to stress/anxiety, some caffeine or other stimulant or even digestive problems (especially hiatal hernia and GERD) or hormonal/electrolyte imbalances and these little devils can really flare and feel nasty. Amazingly, you can have far-less adrenaline in your body when anxiety is reduced and the PVCs are far-less noticeable. The hard thumps for example, feel more like gentle blips (if felt at all) and the head-rush or mild chest discomfort/pain that follows them might not be there at all when a person is relaxed. Of course this varies among us but I suspect this to be true in most cases.
I mentioned my mother but my uncle who recently passed at age 80 from a brain aneurysm (not heart related), was at one of his last Dr. visits when they mentioned that he had lots of PVCs when they monitored his pulse. He was surprised because he said he never felt them. They told him that he likely has always had them. Here again, an example of how relaxed people have them but are not aware of them but anxious, highly-tuned-in people will feel every flipping one of them. Anxiety simply adds to the strength and frequency of them, as mentioned.
In conclusion: Find things through cautious and responsible experimentation that will help you cope with your PVCs (i.e. potassium, magnesium, lots of water, essential fish oil, CoQ10, eliminating stimulants, reducing stress). If you can do-so without prescribed drugs, this is the preferred way to avoid side-effects or possible long-term problems from them. If however, a person needs at-least short term pharmaceutical help; this is nothing to be ashamed of in my opinion. In my case for example, a situation developed in my son’s family, that terribly increased my anxiety/stress level, plus I struggle with other non-heart related health disorders (thyroid disease and mild peripheral neuropathy) and I saw the medication alternative, at least for the time-being, to be the best one for me. At the same time, I exercise regularly (daily walks) and I do work on stress reducing and anxiety self-therapy, every chance I get and at times, I’m pretty good at it.
I hope my comments are helpful to my fellow PVCers – God Bless you all!