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Avatar universal

PVC

Dear Doctor:

I understand some PVC's are more dangerous than others. With a normal heart structure and normal echo's, ekg etc ... the incidence of PVC's are rarely a problem or considered benign?

Second, I read last night that depending upon depolarization of the PVC's can be a predictor for VT or V-fib? In a normal heart without no underlying heart disease is this still valid? Meaning that the person is still at risk of Vtach should his PVC occur on the T wave also known as the vulnerable period of ventricular repolarization may precipitate into VT or VF? Does this still mean people with normal hearts have high risks should this occurr?

I was told I have benign PVC's even though they sometimes ocurr in couplets but 99% of the time they are isolated. Am I reading too much into this? I have been told to ignore them ..not so easy to do. My cousin is a top cardiac surgeon at Sunnybrook hospital in Canada and he says its not your heart that will kill you but your mind thinking of this.

Does PVC's increase with age always? My father has LVH due to high BP, and he has PVC's does this mean I would get LVH without having High BP- I am 38 now? I am just worried about how predisposed I am to all of this because my PVC's came after our first child and they never went away after that although the frequency is not very high. Usually, every 4 months I get 200 or so and then the odd thump here are there.  All tests normal each yr. Finally, my cardiologist is saying that I really dont need to see him yearly ? Should I insist? Many thanks.







32 Responses
Avatar universal
medking,

Thanks for the post, your highness.

Q1:"the incidence of PVC's are rarely a problem or considered benign?"

In a general population of persons with structurally normal hearts, there is no good epidemiologic evidence to suggest that PVCs affect the longevity of the populace.  Individuals, however, with PVCs may feel badly from them due to palpitations.

Q2:"Second, I read last night that depending upon depolarization of the PVC's can be a predictor for VT or V-fib?"

Some PVCs may indicate that a person has ARVD, a very rare condition.

I think that you would agree that a cough is a fairly benign symptom? However, uncommonly it may indicate cancer or TB.  Similarly, PVCs can indicate essentially nothing, like a cough, or rarely may indicate something wrong, like a cough.

Q3:" Am I reading too much into this?"

All I can say, is that in a population as a whole with structurally normal hearts, PVCs have not been shown to increase mortality.

Q4:"Does PVC's increase with age always?"

No.

Q5:"Finally, my cardiologist is saying that I really dont need to see him yearly ? Should I insist? "

Most patients with PVCs don't need to see a cardiologist.

Best of luck.



Avatar universal
Sorry about the post, I just remembered not to post for 2 months. I will stay away re: posting after this last one.  I will comment but not post. Thanks and sorry!!
Avatar universal
Just looking at one of my past ECG's and it showed the following:

Vent, rate 118 BPM
PR interval  164 ms
QRS duration 104 ms
QT/QTc 328/459 ms
P-R-T axes 47  - 16 - 18

Sinus Tachycardia
NonSpecific T wave abnormality
Abnormal ECG

What does this mean??
Avatar universal
I have another ECG on hand:

Vent Rate 117 BPM
PR Interval 160ms
QRS Duration 100 ms
QT/QTc 288/398 ms
P-R-T axes 51-42-36

Whats up with this. The cardio never eluded to any abnormality re: Prolonged QT?
Avatar universal
Can you comment on the two ecg data provided?

Thanks,
Avatar universal
Just spoke a cardiologist out of NY- he was a cheif of staff at one the majors in NYC. Actually, he is my best friends father. I faxed him everything I had and he said: I have no R on T, no Long QT syndrome, just unifocal PVC's and probably most predisposed to this due to an adrenogenic response (anxiety) causing much of this.  In any case, all is normal nothing to be concerned about.  Told me to take the atenenol for a while till I feel better - he said 12.5 mg per day is less than a childs dose and even suggested going to 25 mg to have any real impact. In any case, I feel much better and thanks for your support. Much appreciated !!!!!!!!!!!!!

Thanks Friend,

Abe
Avatar universal
Hey my friend,

I need a little of your input as regards the results of my last echo which I just got (done 9th May 2002):

All that was measured were as follows:

Left Ventricular Diastole 42mm as against range 37-56mm

LV posterior wall (diastole) 12mm as against normal range 6-11mm

Intraventricular septum (diastole) 14mm as against normal range 6-11mm.

I'm a big (6'4" 220LB) and quite fit and healthy 43 yr-old white male. The echo report also stated normal LV cavity size with good contraction, and LVH. My GP says he'd expect LVH in a big fella like myself: I favour agreeing with him, but am nonetheless left wondering why the LV diastole is quite low in range.......... my HR is quite slow whilst at rest and maybe the contractile force is - in the setting of a 'fit' heart - quite low (low LVD) even with LVH???

I'd REALLY appreciate your views on the above.

Best wishes,

Mike F.
Avatar universal
Hi Hankstar: I am significantly smaller than BigMick (5'7", 135 lbs - female), but have almost identical LVH values (13 mm for both septum and posterior wall). Given that men's hearts are bigger than women's, are there any gender-related norms that are used to quantify the degree of LVH? I mean, do my values also suggest mild LVH? Probably should have asked my doctor, but I obtained a copy of my echo independently and have never discussed with it her. Do you have any information?
Would appreciate your input,
Nancy
Avatar universal
I have to say that I'm concerned (& I hope I'm not alone but fear that I am) at some of the threads on this board.  I have been reading some responses, in particular, those from a "Hankstar." It seems that Hankstar dispenses what appears to be "credible" sounding medical advice (in fact, seemingly close to practicing medicine) to clearly concerned "patients" after "patients."  In this recent thread, someone types out some details of an ekg and it gets immediately interpreted as a possible Long QT Int Syndrome on the basis of "number!"  I'm sure the brief anxiety that was created on the "over reading" of a "portion" of one's ekg (without the benefit of knowing if there were other factors such as electrolyte imbalance or even seeing the actual strip)was anything but helpful--and in my opinion, dangerous.  In fact, it was even neccessary to have a physician contacted as a precaution. This is not helpful and a waste of medical resources, and at a minimum, totaly avoidable.  Additionally, blurting out medical mubo jumbo and then trying to balance it with "By the way, I'm not a doctor" is not appropriate fair balance.

There are plenty of doctors today that over read ekg's for LVH and other begnin findings, the world doesn't need more.

Hankstar, you may already know this but you seem to have a very unhealthy preoccupation not only with your own health, but with this board and, in my opinion again, "practicing" medicine.  I also don't think your a doctor as a doctor wouldn't reach conclusions you seem to do so quickly without first seeing their patient.  In the future, if your not able to keep yourself from reading every thread, try to think about the possible anxiety you may cause before resonding--and the implications of that anxiety (possible increased medical costs and second guessing qualified physicians)--in the long run even though "patients" may appreciate your responses in the short run.
Translation: before scaring a person to death by telling them they may have Prolonged QT based on partial reading of an ekg, try to resist writing your interpretations until you do rec' your med degree.  And pls discard your copy of Dubins EKG Interpretation..it's not healthy.  I can't say that I blame the forum staff as they don't monitor the patient-to-patient comments.
Avatar universal
hi,
if you were to red thru many of the posts in this forum, u would see that more often than not hankstar is asked for his opinion by others on here.  
pandora

p.s.  to medking,
normal heart rate is between 60-100 bpm so anything below or above this will read abnormal on computerized ekg.  if its 59 or 101 bpm, simply because its not within the range, it says abnormal, thats what i was told by my doc.
pan
Avatar universal
like you may not have noticed, the doctors throw here and there comments in after they read what we write. that shows that the comments are overlooked. i am sure if someone would write something totally wrong it would be corrected. the forum is a support for all of us and i am sure a lot of us feel reassured either way. if you get better informed about your problems you can give helpfull tips etc. and that is all what hank is doing.
Avatar universal
I agree 110% with your comments.
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