PVC's - Heart evaluation needed? By whom?

[KLT]

I have always had what I now know are frequent but harmless PVC's. Usually fairly isolated but occasionally in short runs. I had never seen a doctor for them, but had raised the issue in other exams and been reassured they're normal.  Last week they settled in as a completely irregular heartbeat, with the feeling of no regular rhythm at all for two days. On the third day, Saturday, I went to the nearby immediate care clinic for evaluation. By the time I got to the clinic the pattern had returned to normal with only occasional palpitations. The doctor did catch a few runs of irregular beats when he first listened to my heart, so ordered a EKG.  Most of the time I was there, I had a normal heart rhythm, although they did catch a few runs of PVC's (just minutes long)after I attempted to raise my heart rate.  The doctor said I had random patterns of bigeminy, trigeminy and quadgeminy.  He said that was harmless but a bit unusual -- he thought most people who have long runs of PVC's, usually settle into one pattern or another (bi- tri- or quad-geminy.) He ordered tests of my electrolytes, magnesium, calcium, postassium - all normal.  He, of course, suggested follow up this week with my doctor. My questions: 1)Is that really necessary if I'm a healthy athletic 40-yr old? 2)If so, should it be directly with a cardiologist? (I hate to pay for a visit with my regular doctor only to be referred on.) 3) Should I wait for another irreglar pattern? 4) My BP was 102/70, down from 120/70 a week earlier when I had my annual exam. Is that just a normal variation or could it be related?

[CLM]

Hi -- just so you know you are not alone, my most recent Holter (Monday) came back with 10,197 pvcs.  I, too, have tried it all and I think I may just go for an ablation.  No one should underestimate the toll these can take.  Hang in there!  (Female hormone shifts make them way worse, by the way, as does stress.)

[Barbara]

I too have been bothered with pvc's for years.  Believe me, if something could be done, I would have had it done years ago.  I have been to different hospitals for different opinions.  I am going to an electophysiologist right now.  I have been from emergency rooms to counseling for this problem.  Stayed off of spicy foods, quit smoking, stayed off of chocolate, tried yoga.  There isn't much I haven't done.  They have ruined my life, and every doctor says they are benign.  Well ask you doctor if they ever felt them.  I have gone from singles to bigeminys to God knows what.  Holter monitors, thalium stress test, x-rays, blood work, echocardiograms, etc.  Been here and done it.  In fact my family calls me skippy.  I just wonder if they ever stop.  There isn't a day when I don't have these.  Does anyone know that?

[Quackbust]

I have read that trigemities are not good (warning signs).  I too have had them, but all the doctors say you fine.  Its scary to see one thing written and hear another thing spoken.  Maybe we have to have lots of them in a row?

[CCF-M.D.-RCJ]

KLT,

Thanks for the post.

Most internists can handle PVCs just fine -- I would start there.  It is a rare patient with PVCs who needs to see a cardiologist.

What might need to be looked into is whether or not the irregular rhythm you experienced prior to going to the urgent care facility was atrial fibrillation.  A holter monitor or event recorder might help in this regard.

Hope that helps.