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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?
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Avatar universal
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.




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Avatar universal
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?
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Avatar universal
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?
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Avatar universal
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.)
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Avatar universal
Im new here but have been reading the PVC posts for about a month now and I sure wish this site had been available back in 1979 when my first PVC's started.Ive been through just about everything posted here.Emergency room trips,several doctors,EKG's,stress tests,monitors,echo's,xrays,bio feedback,medication,etc.,only to find out other than a slight MVP that all is well. You guys know all about the blank stares you get when your trying to explain the feelings we get to someone who just doesnt understand right?? Well its been one hell of a road and after 33 years of this,what I call "demons dancing on my soul",Im still here! What I have learned is that after all the tests, most of us are physically sound but its our electrical system thats screwed up. I also believe that,depression,anxiety,and panic attacks are related to this.Medication and relaxation helps but the skips,pauses,thumps,flutters always return and until someone discovers a miracle cure for us we are told its nothing to worry about and to just go on with our lives.Easier said than done!! Sometimes I can ignore it and sometimes its like every skip releases a drop of panic or fear in me.Anyway for me I stay very busy planning way more than I can actually do everyday to keep my mind off of ME,take my medication,and finally just get mad as hell at it and tell myself it will not ruin my life! So just remember as bad as it is there are thousands of people out there that would trade their illness for our "dancing demons"!!! "My armor is weathered and dented yet I still draw my sword for the battle within".
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Avatar universal
Well put Luke.  It's nice to know that others actually know how these things feel.  Doctors sure don't.
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Avatar universal
I have been cruising this forum for about a week and am confused as can be - even frightened - by some of the conflicting information I see. Maybe someone can help...

I am a 46 year old healthy female except for (what I now know to be) PVCs/PACs that cropped up in March and diagnosed via Holter and stress echo in April. When I went for my stress echo I grilled the tech - he said a positive sign is when, during excercise, the frequency of PVCs/PACs decrease. Mine did - I felt relief. I was told that PVCs/PACs are benign and to exercise daily. So, once every day (I haven't missed a day since my diagnosis) I lace up my tennies and go for a brisk 2 mile walk (~4mph) for about 30 minutes. It is refreshing as well as helps to decrease the PVC/PAC activity. Some days when the PVCs/PACs are every couple of beats I will even go for an extra walk just to slow them down. Some days though I spend a lot of time on the couch as they sort of take my breath away and make me feel out of sorts. Having PVCs/PACs every couple of beats for hours on end feels exhausting.

I recently read in one of these forums that excercising with PVCs/PACs is bad! ACK!! I was told it was OK and that these were benign!!! What is the real truth about PVCs/PACs & exercise?

I was also at my chiropractor's office last week and on my way out the door, the other chiropractor in his office said, "too bad about the arrythmias Debi - now you'll have to watch out for throwing a clot!" No one at my cardiologists told me this! Is this true??? Are PVCs/PACs synonomous with arrythmias?

I just want to get back to living a normal life! Just don't know what the facts are, and now I am afraid to lace up and go for my walk! What to do???

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Avatar universal
Please read post on palpitations I posted earlier under nikl on 6/26, maybe this will help someone with these.
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Avatar universal
First off what is quad???? My understanding is that a run of three pvcs in a row with normal beats inbetween or more is v-tach!!! theres only singles or couplets then v-tach. My electrophisyologist is very adament about this isnt quad four or five?
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21064 tn?1309308733
From what I understand, bigeminy is when every 2nd beat is irregular; trigeminy is when every 3rd beat is irregular; and quadrigeminy is when every 4th beat is irregular.  A couplet is when 2 beats in a row are irregular and a triplet is when 3 beats in a row are irregular.  I believe 3 or more is termed a "run".  hope that helps
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Avatar universal
Emi
This is my first time on this site and I've read quite a bit about the PVC's. I don't have them nearly as much as some of you but I do have some. It started for me I think when I was 21, I was moving boxes and my heart started pounding faster and faster and skipping and just doing the jig for itself. Well I went to the emergency room and the doctor there gave me two shots of adenosine before it calmed everything down. He said I had SVT and that it would come and go for the rest of my life. But that it was harmless. Well ever since then I have skips all the time. My doctor said cut down on salt things like that but I still have them. I don't drink, I stopped smoking, I stopped caffeine. The works. But I'm a little nervous reading that they are supposed to stop with exercise. Lately they have increased with exercise. I was riding my bike and I had a few when I reached the top of the hill. No matter how many times you have one it still makes you stop for a second and readjust yourself. I'd love to find out what this means. There are so many questions. Are we more at risk for heart disease later? Is it hereditary? My biggest concern now is, is this going to cause me problems while I exercise? I've just started running in races and it scares me to think something will happen to me. Should I not be doing the extensive exercise that I'm doing? I have so many questions and nobody to answer them. Should these not be happening while I exercise?
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Avatar universal
HOW CAN YOU TELL IF IT IS BI'S TRI'S ETC WHEN YOUR HEART JUST FLUTTERS.  I WAS VERY ILL ONE DAY WITH STOMACH FLU AND RIGHT BEFORE I THREW UP I HAD QUITE A FLUTTER BUT DON'T KNOW IF IT WAS BI'S ETC AFTER THIS WNEVER HAD UPSET STOMACH HAD A SERIES.  IS THIS BAD? I'VE DONE ALL HEART TEST AND EVERYTHING NORMAL.
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Avatar universal
PVC'S are very scary!!! maybe my story can help those with the same problems. i am a 36 year old female. not in too bad shape, but over weight.it started two years ago having a few palpitation . one or two a week. went to family doctor feeling my bp might be high. he put me on tizac180 for the high bp. he sent me to a cardio doc to check the palps. had a stress test,eco,blood work, 24 hr urine test,also wore two types of holters. one i wore longer than the other. all test came back ok.doc said i had no heart problems. over the last year the palps have gotten worse, and now having some chest pain. 4 months ago had the palps so bad i went to the hospital for help. they said i was anxious and was in a state of panic. of course this is what they saw,i was scared to death. my heart was racing 130bts and palping like crazy. they gave me a downer and sent me home. 6/28/03 i was back at the hospital. i was having alot of palps. 5-6 per min. some chest pain. the chest pain is what made me go to hospital. docs gave me toprol 25ml said my palps were benign. this new med. is not helping. still having alot of palps all day long. they do seem to let up when i go to bed, but they are waiting for me when i get up.told dont worry about them, but its hard when your heart wants to jump right out of your chest. docs said the chest pain may be from all the palps. feel like i have the flu. cold chills, head ache,eyes feel funny, just plain wore out. go to heart doc on 07/10/03. I have no stress in my life . the only meds i'm on are tizac 180, asprin 81ml, and toprol. i'm just wondering could the tizac be causing all the extra palps? guess i'll find out soon. with the help from god and doc i plan to put an end to these palps.
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Avatar universal
Hi mary,
Your story sounds alot like mine. I cherish the days i am pvc free to some extent. Not a day goes by without having at least a few. i think its more scarey when I have to tell someone that has no idea about pvc and watch there face turn to horror. WHAT! Your heart is skipping beats?? Thats crazy deb you should go to the er. O thats what I need to hear all right.. I have chest pain to when i have my episodes of pvc. I hate it and would some times like a choice that if it want to cut off my left arm my pvc's would leave for good.. LOL.. Sometimes my pvc run together. Thats what scares me the most. I have been taking magnesium, and calcium. I alse take 25mg of zoloft. This has helped so so much, I can't begin to tell you. I also started eatting better too. I am fit physically and to am 37 female. No blood pressure problem, but high on the cholesterol. I figure i work out every day why not eat what i want.. HMM... No deal my body says. So now i eat better and have always exercised. I really hope for you the best. Dont give up ever on this. Something will work for you.
take care   Deb  : )
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Avatar universal
Today was the day... I found out that I too am a PVCer.  Finally I know what is going on in there.  How many nights have I laid awake listening to that odd and disconcerting rapid beat followed by an all-too-long pause.  I'm simply glad to know what it is all about... it is also encouraging to know that I am not alone in the world of PVC.  Let us press on.  Your fellow PVCer.
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Avatar universal
Today was the day... I found out that I too am a PVCer.  Finally I know what is going on in there.  How many nights have I laid awake listening to that odd and disconcerting rapid beat followed by an all-too-long pause.  I'm simply glad to know what it is all about... it is also encouraging to know that I am not alone in the world of PVC.  Let us press on.  Your fellow PVCer.
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Avatar universal
Glad I read these comments.  I am an unwilling PVCer since January 1990. The first time I noticed a PVC was after exercising, and I thought, "What the?  OMG, what is going on?  Oh no, is 1990 my final year?"  I was only 38. (male) It was gratifying to find out later that this condition is benign.

The last time I saw a Dr. for this condition was 1990 when he told me everything was within normal limits, so I took him at his word and stopped running to doctors since them. Hey I'm still alive and in good health.    

The worst experience with these things is driving long distances and having them in a car, because there is no way to shift position or walk around which often "cures" them temporarily.  

Not only cars, but airplanes.  In 1993 I took a plane from Chicago to Paris (via Belgium) and had a real horrid experience with PVC the entire way (8 solid hours).  It was only when I reached Europe that they went away completely for two weeks.  As I walked around the Brussels airport at 4AM local time, I hoped and prayed the PVCs would go away.  Luckily, they did, and while in France I do not remember getting one PVC.  Why not?  I was enjoying myself too much to worry about them!  

If you have a few thousand PVCs per month, take "heart."  Since 1990 I have experienced several million PVCs, a very rough estimate for me would be 9 or 10 million total, with particularly bad years in 1990 &1991,  1993, 1995-1997, and 2002 into this year, yet in every other way I couldn't feel healthier.  I can jog further and longer than my teenager.  

Oddly, in August 1997 my PVC attacks suddenly vanished for a full three years.  Now they are back and hope they "subside" soon.  They seem to be at their worst when I'm lying down in bed reading, or after a meal.
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Avatar universal
My wife was just recently diagnosed with PVC.  I have done the research to find out what I can bout this condition and what I can do to help.  It's comforting to hear that some of you have lived with this condition for quite some time.  However, at the same time I'm sorry to hear that anyone has to live with this.  Prior to my wife being diagnosed it was painful for me to sit there and watch the pain she would have in her chest during these contractions.  Not knowing what is going on, is it serious......am I going to loose my wife.  Unfortunately it's a condition that at this time has no cure.  Because of the entries that I have read on this site, I now have a more positive outlook and know that my wife will be with me for many more years to come.  Thank you for sharing your thoughts and stories.
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Avatar universal
OK I am new here. I'm 30 years old and in OK shape. Last week I started running again. I went on a 4 mile run, and had no problem at all. The day after that I went for a 3 mile run again no problem...until later that day. I started to get this skipping feeling in my chest. I kept running a few days after that thinking it would just go away, but no such luck. I hope this problem is just the result of an out of shape guy starting to run again, and the problem fades away. Has anyone ever had this same problem. I know all of you know the feeling I'm talking about, but is this the result of my new running program or am I stuck with this.... I have been to the doctor for a full medical exam no problems. Hope one of you can give me some friendly advice
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Avatar universal
OK I am new here. I'm 30 years old and in OK shape. Last week I started running again. I went on a 4 mile run, and had no problem at all. The day after that I went for a 3 mile run again no problem...until later that day. I started to get this skipping feeling in my chest. I kept running a few days after that thinking it would just go away, but no such luck. I hope this problem is just the result of an out of shape guy starting to run again, and the problem fades away. Has anyone ever had this same problem. I know all of you know the feeling I'm talking about, but is this the result of my new running program or am I stuck with this.... I have been to the doctor for a full medical exam no problems.
Helpful - 0
Avatar universal
OK I am new here. I'm 30 years old and in OK shape. Last week I started running again. I went on a 4 mile run, and had no problem at all. The day after that I went for a 3 mile run again no problem...until later that day. I started to get this skipping feeling in my chest. I kept running a few days after that thinking it would just go away, but no such luck. I hope this problem is just the result of an out of shape guy starting to run again, and the problem fades away. Has anyone ever had this same problem. I know all of you know the feeling I'm talking about, but is this the result of my new running program or am I stuck with this.
Helpful - 0
Avatar universal
I'm 30 years old and in OK shape. Last week I started running again. I went on a 4 mile run, and had no problem at all. The day after that I went for a 3 mile run again no problem...until later that day. I started to get this skipping feeling in my chest. I kept running a few days after that thinking it would just go away, but no such luck. I hope this problem is just the result of an out of shape guy starting to run again, and the problem fades away. Has anyone ever had this same problem. I know all of you know the feeling I'm talking about, but is this the result of my new running program or am I stuck with this.
Helpful - 0
Avatar universal
I'm 30 years old and in OK shape. Last week I started running again. I went on a 4 mile run, and had no problem at all. The day after that I went for a 3 mile run again no problem...until later that day. I started to get this skipping feeling in my chest. I kept running a few days after that thinking it would just go away, but no such luck. I hope this problem is just the result of an out of shape guy starting to run again, and the problem fades away. Has anyone ever had this same problem. I know all of you know the feeling I'm talking about, but is this the result of my new running program or am I stuck with this.
Helpful - 0
Avatar universal
GES
I get skipped beats for hours after running and doing groundfighting (Gracie Jui Jitsui).  I guess it will not hurt you. I have been to three different Cardiologists and I have all the standard tests.  They tell me to have at it and not to worry.  Good luck and keep training.  I am 34yers old, 602, 208lbs and in excellent shape.
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