Premature atrial contractions (PACs) are early atrial beats that originate from cells (foci) in atrium other than the pacemaker cells. Recently it has been demonstrated that these foci are generally around the pulmonary veins. They may be increased by pseudoephedrine which is in Allegra-D but that effect should stop after the drug wears off. It is unknown if menopause increases PACs but it may be possible. Stress (perhaps from lack of sleep) and caffeine do tend to increase PACs and PVCs.
The good news is that PACs are in general benign. For some people however they are very troublesome and treatment is required. The first line therapy is of course avoidance of triggers such as caffeine and lack of sleep. If there are still significant problems then medications such as beta-blockers can be tried. If these fail antiarrhythmic drugs such as flecanide may be effective. Finally if drugs fail then an ablation procedure may be considered. This is an outpatient procedure done by an cardiologist who specializes in heart rhythms (an electrophysiologist) and is effective in stopping PACs in the majority of cases.
I've had pvcs on & off since being a teenager and but when I hit 40 I started getting them at an unbearable level, I felt alive in my chest all the time even when pvcs were not occurring. To cut a long story short just recently I had a hysterectomy and was put on HRT. My pvcs have reduced dramatically and I once again feel normal in my chest. My cardiologist did tell me that I had a focus in the heart but when I told this to my gynaecologist she said something like "we all have focuses in our hearts and that a muscle in our stomach supresses them from being active whilst we are producing estrogen. I always know when I am presented with a lady who is experiencing emotional problems and palpitations that her estrogen levels are diminishing and that she is beginning or in menopause - palpitations are a major sign of menopause". This was quite a revelation to me and I suspect must be true as I can only speak of my own experience where my palpitations whilst still occurring and troubling are NOTHING LIKE what they were before I was put on HRT. I worry of course about being on HRT because of the breast cancer connection - but all I can say is that life is worth living again for me and therefore I try not to dwell on that connection.
Hope this is of help.
Hi, Linda. It helps to know that I'm not alone! I'm hoping the BC pills will have the same effect as your HRT. Too early to tell as it's only been a week. I'm glad you found some relief. That feeling in your chest from the arrhythmia is awful. Thanks for your support, and best wishes. dcmom
It's been two years since I've began experiencing what I call heart palpations or flutters. I've seen a cardiologist on the recommendation from my Ob/Gyn. I had and EKG and an Echo Stress test which all came back fine. At first I wasn't sure why I was having the flutters/palpations. At the time, my Mother was just diagnosed with Bladder Cancer and I thought it could be stress related. But I did notice the palpations only became present from the time I ovulated until the end of my next period. Now at 42 years old, my periods are irregular at times and it's at those times I can experience the palpations for weeks on end. I'm not one for taking medication if it's not necessary, but it is a scary feeling not knowing if this could be a severe problem or not. We've just discovered that my Father has had a silent heart attack in the past and also has an aortic anyerism (sp?). It makes me wonder if something of the same could happen to me. But the bottom line in my opinion is it is definetly hormone related. My next step is to see the cariologist again to do further heart studies.
Thanks for your comments. The timing is the same for me - the palpitations either start or get much worse at ovulation through the end of the next period. No one tells you all this stuff happens at 40! Good luck to you.
i too have the pac/pvc's i have had them now about 3 to 4 years where in the last 2 year's they had gotten to the point where sitting in the chair the whole chair would shake with a pvc so...my cardiologist put me on toperal about a year ago. then in jan i had an eposide that i had to get a ambulance i had chest pain (angina) and was admitted and had a heart cath. i have coronary artery spasms in one artery (which also has a slight blockage, not enough to stent). so i was put on imdur, norvasc and keep the toporal. in the mean time things were going slow i was still getting the spasms but nitro would take them away. i also was suffering with bouts of blood in urine (which has nothing to do with heart) but getting ready for a cystoscope. But wed had another attack at work and nitro didn't work so had to go in ambulance and i just got out sat. now they changed my meds kept me on the imdur and changed the norvasc to cardiezm (spell) and addded another drug for sensitivity to spasms and cut torperal in half. so i don't know what is going on now....i go back to the card. may 17th keeping notes till then. but my gut tells me there is someting else going on with the heart. i wonder if the blockage could have gotten worse? anyone have these problems i sure would like to hear from you. new jersey girl i hope things are well with your mom (do you mind me asking what was her symptoms) that is what i was having cystoscope for but at the hospital they checked my urine and no blood. i had a bad infection at the time when haveing the blood so iam hoping that is the end of that. well have it rechecked in a month. if anyone has cornary artery spasms i would like to hear from you too. iam going crazy i can't keep this up this way. And the dr. says just a matter of getting the right meds.
Hi DCMOM. i was really interested to read your (and others) input. i was diagnosed with frequent PVC (11,ooo+ in 24hrs)in Oct.2000, (i was then 34 yrs old) after a long search (about 20 months!)to find a Doctor who would take me seriously that something was strange and different with my heart beat (my original Dr tried to tell me that my palps, dizzyness, SOB was just parent-fatigue/"toddler-itis" - i no longer go to him!!). I have wondered for ages if there is a hormonal link with some people's PVCs, as no specialists that i have seen, or info i have read seem to be able to list known reasons why these wretched things start in otherwise normal healthy hearts. i reckon that i can pinpoint fairly accurately, that my PVCs started towards the end of 18 months of pretty full-on breastfeeding (when my oestrogen levels would have been quite low). From reading other info, i have been wondering if low calcium and magnesium levels could have contributed, but oestrogen is very interesting, as on other posting sites i have read of a few other women experiencing their first bouts of PVC etc. after pregnancy, and NOW, ...i read of other women with differing oestogen levels experiencing differing PAC/PVC- I WONDER WHY THERE IS SEEMINGLY NO RESEARCH ON THIS STUFF??!! Also alot of males have reported experiencing their first bouts (or worsening bouts) of PAC/PVC after a big weight loss (which i think could also mean that their relative eostogen ratio would drop). Does anyone out there wanna do a research paper?!!
BTW, how are you going these days DCMOM?
Hi, Aussiemom. You are absolutely right that someone should do a research project on this hormone thing! I'm sure there are lots more of us out there being told we're just stressed/tired/nearing menopause! My cardiologist told me that he's never seen the hormonal link written up in any medical book, but he has seen a number of otherwise healthy women come in with PAC's/PVC's right around early 40's, with no previous history of heart problems, so there has to be a link. The birth control pill therapy may be working - I had to switch from Mircette to Loestrin this week due to breakthrough bleeding and abdominal pain on Mircette. I feel much better on the Loestrin and the PAC's seem to be much less noticeable on it as well. Too early to tell, though, as it's only been 2 weeks. Did you ever get rid of your symptoms, Aussiemom? And if so, how? And if not, what do you do to cope with them? Thanks for your comments! Best wishes, dcmom
I would also like to add that after suffering from almost intolerable amounts of Pvcs/pacs, I seem to have gotten some relief from BC pills. the beasts are still there but I now often have days when they are absent all together, whereas before I would get hundreds per day, every single day without fail. My Dr thinks hormone connection is very real and he sees this often in his cardiology practise. Tachycardias and hormone levels have been researched, but as yet no studies have been done into premature beats hormone profiles. hope someone does one soon!
Reading your stories has definitely helped me to put my problem into perspective. I've had an occasional palpitation over the years--always attributed them to "hormones" A few months ago I was diagnosed with high blood pressure and start on RX Diavan. Almost immediately I noticed an increase in the palpitations anywhere from five to twenty a day off and on. The Dr. said that this was not a noted side effect of that drug but happily changed my med to Lotensin. Its only been a few days, but I'm still having the palpitations. I am under stress --who isn't but am still puzzled by the connection to the palpitations to the RX for my blood pressure (if any) I am 49 and still have regular periods but also know perimenopause is upon me. Still tryint to figure all this out!
I was diagnosed with Mitral Valve Prolapse when I was 33, now I'm 47. I have noticed an increase in "extra-missed or whatever you call them beats" as I've gotten older. I will tell you about a week before my period those skips are much worse than usual. This week I was at work and all of a sudden they started missing like crazy. I immediately panicked of course. I took an indural which was prescribed to me last year to take if ever i needed too. I don't like meds but this time there didn't seem to be much choice. It slowed my heart rate down but the extra beats kept up for 3 more hours. The next night I was woken out of my sleep at 2 a.m. No pain, no dizziness, just extra beats. I had them til 8 a.m. I went to my cardio dr. who totally blew me off. He told me extra beats are nothing to worry about, and to forget it. I asked if hormones played a part, he said he didn't know and that it was irrelevant. "They're just nothing don't worry about it". He did an EKG which was normal, but I wasn't having the extra beats at that time. I was really scared and very anxious in his office. He took my blood pressure and it was extremely high l80/ll0. I weight l08, don't drink, smoke, or even drink coffee. He wanted to do a stress test but obviously wouldn't with that kind of pressure. He gave me BP med and i was going to take it, but I recently had surgery and was in the hospital for 3 days. My bp was taken very often, it wasn't high then. I wonder maybe I was just extremely nervous and that;s what raised it? I got my Period the next day. Interesting isnt' it/
Hi, just wondered, can you explain exactly what you're feeling with the PVC/PAC. Mine actually feels like it misses, although dr told me it is actually a premature beat. It almost feels like a vibration when it does that. And did you ever have it for hours at a time. Thanks for any info.
Hi All, Can someone please be more explicit about PVC/PAC and palps. I'm wondering, is a palpitation when you feel your heartbeat in your chest and also feel it missing? I'm not sure if that is a palp or PVC or PAC. I had them 3 times this week, all lasting for hours. Any help I would really appreciate. THanks.
I am a 38yr young woman with PAC's. I just got home from the hospital a few hours ago where the Dr's told me again that I have PAC's and that Im just going to have to live with it! Thats not the answer that I wanted so I decided to get online to find some answers, its terrible that we suffer from this but it was great to hear stories of others and to know that Im not alone! My PAC's just started summer of 2001 after numerous trips to the Dr.s office (they never seemed to happen when I was in his office) 1st trip to the hospital they didnt find anything but sent me home with a Holter monitor which I had to return after 24hrs it showed nothing then more time went by I had a Hystorectomy 10-2001 and in Nov. the PACs were back now my Dr. ordered an event monitor which I wore 24/7. Finally the week before Christmas I went back to the hospital the Dr. on duty called the monitoring company and got all my recordings for that day (all 20 of them) He came back to me and said these are PAC's very normal everyone has them your fine go home. I asked if I could walk or workout he said that was the best thing I could do. OK I started walking everyday I was feeling wonderful that was the best Christmas present my PAC's pretty much went away until tonight 5/16/02 THERE BACK in full force! I have to find a way to cope with this any suggestions? Thanks for listening sorry this is so long it just felt good to tell someone else that knows what it feels like.
Hi, Aussiemom. I enjoyed your comments. It sounds like you have a great attitude, which surely helps you cope with these miserable PVC's! The vits& mins are a good idea. I tried drinking Dasani water, which contains magnesium, potassium, etc. and thought I noticed a slight improvement. Unfortunately I prefer Diet Coke! Maybe I should try the pill form mins. for more of an effect.
I hope your pvc's have quieted down again. I wonder what pregnancy hormones will do to them? Hopefully kick your heart back into normal rhythm! I also was hoping to be pregnant again, but since I've just hit 40 and am now on BC pills, I guess we'll be getting a dog instead of a little brother/sister! I've been on the BC pills now for almost a full month, and I did notice quite an improvement on them. At ovulation when the PAC's are usually the worst for days on end, I only had two days where they were really bad this month. Sleep is the other interesting thing - I also have a snoring husband. He's not a shift worker, but a night owl who falls asleep in front of the TV, then wakes me up by noisily coming to bed at 2 am! Plus, my son has taken a liking to coming into our bed in the middle of the night (to protect us from dragons, he says), a habit which we are trying to break. Coincidentally (?) I do seem to be sleeping better on the BC pills. Perhaps hormones also contribute to insomnia?
You are right that if you can just learn to accept the PAC/PVC's, it does make it easier. I'm finally trusting the doctor's reassurance that I'm not going to drop over dead from them, but it does take a while to get there. And knowing that there are apparently lots of other women out there just like us helps a lot too.
Please do keep me posted on how you're doing both with PVC's and pregnancy! Good luck, and thanks again for your support!
Hi, Michmom. Have you seen your OB/GYN specifically about your PAC's, or have you been seeing the cardiologist/ER docs? My experience with the cardiologist was that once he determined there was nothing wrong with my heart, he sent me on my way to "just live with it". So I went to the OB/GYN, who was much more interested in finding the cause and eliminating the symptoms. He also was very accepting of the hormone connection theory. Did you have your ovaries removed as well when you had your hysterectomy? I don't know how it all works, but I'm guessing that if you still have your ovaries, you would still ovulate, and maybe that is causing or contributing to your problem? With me, ovulation made the PAC's become MUCH worse. I have found a fair amount of relief from taking birth control pills. This is the first month, so hopefully it will be even better next month. I'd suggest seeing your OB/GYN and maybe he can determine if yours could also be hormone related and prescribe something to help. Aussiemom also has some good suggestions in her 5/15 comment.
I had the same question you did about whether I could exercise, because I was afraid I would drop over if I did! But I've started doing Nordic Track 3x per week, and it does help. It is scary to start exercising when your heart is going nuts in your chest, but once you see that you reall don't have a heart attack from it, it feels good.
Good luck Michmom! Please post again and let me know how you're doing!
To answer your question, I believe that palpitation is the general term for abnormal rhythm of the heart, so a PVC or a PAC is a palpitation. My doctor explained that with PVC's or PAC's, it is not actually the early beat you feel, but the one after. Since there is a longer interval between the early beat and the next one, the heart fills with more blood than usual, making the next contraction more forceful, and that is what you feel. Does that make sense? It helped me to hear that explanation and understand exactly what was going on.
That said, you asked what it feels like. I have mostly PAC's, and I describe it like a "flipping" feeling in my chest. It is almost like my heart is bumping up against the front wall of my chest. Hope that helps. Good luck to you!
All of the comments that I've read have been quite interesting. I don't know if my palpitations are PAC's or PVC's or anything else for that matter. I just had an episode and was quite concerned. My question is do any of your palpitations feel like your heart is beating very quickly? I am 33 and I take Norvasc and Toprol for high BP (hereditary) and was a little late in taking it this morning and this was the worse episode I've ever had. Of course, these palpitations all started when I lost 15 pounds and have been going to the gym religiously for a year. Now that I am the fittest and smallest I've been as an adult pre and post-pregnancy, why wouldn't they start? Thanks in advance for any information you can provide about your experience.
I am so glad I hvae found a site where so many of you (us) are having the same sort of symptoms..not glad we all have symptoms, but you know what I mean. My odd beats started about 4 months ago, I'm 45 and perimenopausal. I think there is a definite link between hormone levels and these symptoms. I remember my Mum having the same at about 45 or so. I had an ECG and it showed that the blips were happening every 6 beats or so. GP told me not to worry, but of course I do. It is uncomfortable, it is a damn nuisance and I want to take something now! and get rid of it. I am taking Atenolol as I had atrial fib about 6 years ago and have an erratic beat without it. However, the blips are worse in the run up to a periods and get less toward the end. I am off to GP tomorrow to ask for HRT. It is scary and I wonder when I would need to be getting concerned, as in, is it worse the more blips you have, what is a safe number, if any. Anyone else have them all day for days on end, and the beat feeling like it's in your throat?
Thanks for writing, my episodes started almost 1 year ago I never had them before then. Looking back maybe I was under SOME stress but who isnt? I had my hystorectomy in Oct. they did leave my ovaries. I wore an event monitor for 6wks finally the week before Christmas when I went to the ER for the 4th time in just 5mos all the ekg readings were normal the Dr. called the monitoring company and got all 12 of my readings for that day (thats all that I recorded there were lots more) he came back to my room and said these are PAC's they are non-life threatening everyone has them he said he has them the nurse said she had had them when she was in nursing school. Well that made me feel a little better but I still had lots of ?s but no one to answer them. Oh yea,the DR did say the best thing I could do is exercise that it would help the PACs so the next day I started walking again (I had stopped because I thought it might be bad) I've been walking just about every day since I think it has helped as far as getting healthier. I havnt had any big episodes like 12-01 until 5-16 I really thought I had gotten rid of the big ones so now that sense of security is gone and you wait for it to happen again.. All the times Ive had PACs I seem to make it worse by having panic attacks I get all worked up and sometimes feel like I cant breathe 2mos ago I convinced my family DR that I couldnt breathe so he sent me to a pulmanoligist then that DR sent me for a stress test (that was normal) then I had a pulmanary fuction test which did show a slight asthma problem, but I only had these breathing problems when I either had a PAC or thinking about having one, (the mind is a powerful thing!) SORRY to keep going on To answer your other ? I havnt talked to anyone about the hormones yet. I did see my obgyn 4wks after my surgery and I did have the monitor on then she asked what it was for but didnt have any input. I am going to a cardiologist 6/10/02 I was hoping to get more answers then . thank you for writing and listening to my long sob story I know there are a lot of people worse off then me but its still nerve racking! Im so glad I found this forum. Thanks Again!! may all your days be PAC/PVC free!
Thanks for your answer back. Your explanation does help, a lot.
I feel like my heart is flipping also. Almost like a vibration, when it catches up with the beat. I have an event monitor on right now. I'll have it for 2 weeks. I know this sounds silly, but in a way I hope I get the palps and in a big way I hope I don't if you know what I mean. I would love for them to see exactly what this is doing but on the other hand it's just so scary. It absolutely is horrible waiting for it to happen again. I must say I feel an occasional extra beat about every other day. When I'm getting my period, I feel it often here and there through the day, but what happened 2 weeks ago for 3 different days having it for hours really scared the death out of me. That is an anxiety/panic causing thing. I must say I was feeling anxious (butterflies in my stomach) for days before the first big episode started. The panic came after it started. Hopefully they find just what all of you have and I learn to deal with it. THanks again. Let me know how you are.
I was diagnosed with PVCs several years ago. I went through several recurring episodes, and after investigation was told they could be due to a slight prolapse of my mitral valve. After understanding what was happening, I relaxed and the episodes were less frequent. I continued to monitor myself and found that any occurence was only during PMS. I thought it was due to the emotional stress that I felt at those times. But now that I'm 49 and quite sure I'm in peri-menopause, I'm having very frequent occurences again. But there seems to be a pattern with my monthly cycles, and I'm sure my hormones are surging and fluctuating. I am very interested to see that they are related to hormone levels. Dusty111
I too am in perimenopause. I've been for 5 years. I also notice the extra beats during PMS much more. The weird thing is I was diagnosed with Mitral valve prolapse 15 years ago and just went to a new cardio dr. and he did an echogram and told me my heart was perfectly normal. He said I did not have mvp and there was no sign of reguritation which I was also diagnosed with. My question was why did I have 4 bouts of extra beats that lasted for hours within 6 days. I was never so scared. He told me hormones are a definite cause along with stress of course. Hmmmm, it's a little disturbing not knowing for sure even though 2 other drs. did diagnose me with MVP. Oh well I like this one's answer so I'm really going to try and just deal with the PVc's and hope they don't come to often. Take care.