PVCs

[KungFuKao]

Hi, I'm a 28 y/o male morbidly obese @363lbs (have lost 42lbs in past 4 months!) non-smoker, don't drink, etc.  I take 3mg of Ativan daily for anxiety (also seeing a therapist) and 8-9mg of warfarin to keep my PT/INR in the 2-3 range.  I was perfectly healthy (minus being fat :D) my entire life until I was hospitalized after having pneumonia for bi-lateral pulmonary embolisms which thankfully cleared up after a heparin drip & coumadin.  Major lifestyle changes have happened since then.  After I was released from the hospital, had my first panic attack; I honestly thought I was having a heart attack, ER doctor said it was panic/anxiety & sent me home.  After having about 4 more panic attacks & constant terrible thoughts of dying, I brought up all my concerns to the doctor and he wanted me to see a cardiologist.  I did the 24hr Holter, 30 day event monitor & heart sonogram & nothing showed any abnormalities at all, perfectly normal heart/rhythm, except for tachycardia during panic attacks, go figure.  Literally two days after I took the 30 day monitor off & returned it, I started having PVCs, which I once again thought were going to kill me.  Doctor checked things out, caught one on a 12-second EKG rhythm strip & said nothing to worry about, and that my heart was probably just irritated at having to try & push blood through all the clots I had.  I've had PVCs as many as 5-7 times per minute for 3 days straight (which my doctor wasn't concerned about), and as little as 1-2 in a day, but they keep coming back.  4 months later, I'm still having palpitations (normally when I stand up, but random for the most part) and the PVCs seem to have mutated into the pause/thump but then it feels like I'm being shocked, and it radiates out into my hands & feet & makes me feel like I'm going to pass out.  This is new to me, and I haven't seen anybody have the same symptoms, so I'm curious as to whether or not this is 'normal', or something to be concerned about

[CCF HeartMD5]

Hello, it sounds as if your symptoms have progressed. I agree that occasional PVCs are typically not concerning. However, if you are having new sympoms which include palpitations and feeling as if your are about to pass out, you should be seen again by your doctor. A repeat EKG and possibly a Holter monitor should be considered in order to rule out the possibility of any concerning heart rhythm.

[KungFuKao]

I've discussed this with my doctor, and the EKG strip came out normal once again.  He still isn't concerned about any of it.  He thinks I'm in a sensitized state from the anxiety & the PVCs are more intense because I'm focusing on them.  He said the passing out sensation is also anxiety related.  The day after I saw him, I had another 'episode' where I was watching TV, lying with my head against the windowsill, and my earlobe was pushed against my ear & I could hear my heartbeat very clearly.  Sharp thumps, over & over & over.  Then the thumps got very dull & weak 3 times in a row, and I had the passing out feeling again.  Then, since I was freaking out, I had a panic attack, but was able to keep it from blowing up with the CBT tricks I've been learning from my therapist.  If you had to take a guess, would you say this is actually just anxiety, or potentially something else?