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Avatar universal

Palpitations

50 year old female.  Have had PVC's and PAC's 20 years.  Stressed to max about having these.  I usually get 10 - 20 a day where I feel a heart zap or a flutter or a pause and a thump.  I had a holter which showed nothing and I had stress test which showed 2mm depression so they did a nuclear stress test with the dye injected which checked out a-okay and was told that lots of people have these irregular beats and not to worry as I have a normal heart and said there are a lot of females that have positive false results.  Should I pursue this further or just forget about all these irregular beats?  Is is normal to feel all sorts of different beats as I say sometimes it feels like a kick from the inside of my chest and sometimes it is a distinct flop flop pause BANG.

Last night, while in bed, I was having a particularly significant time of this, and had my finger to my neck and noticed very clearly that my normal "beat beat beat" pulse was broken up in a "beat beat ..... BEAT beat beat" sort of rhythm (if that makes any sense... hard to describe in plain text) with the heavy spasm feeling being the larger then usual "catchup" beat if you will.  This happened three times in a row.

Is this a normal thing I am experiencing and just my anxious thoughts that are causing these?  As I say they cannot find one thing wrong with my heart but I find that very hard to believe.

10 Responses
Avatar universal
I get episodes of ( B=Beat and P= pause ) - BBBPBPBBPBPBPBPBBBBPBBBBBPBPBP .
You get the idea. This can continue for periods up to 2-4 hours then it disappears and can return whenever.  two trips to ER and sent home after two hours. I have had all the tests - EKG, CTA, thallum stress , echo  and there is no evidence of coronary heart disease.  While I am certainly pleased with that result, frustrated since there is no basis for my random episodes of PAC's/PVC's.  All I know is that benign PVC's will not kill us, even though they feel like they will.   Hang in there.

Avatar universal
Good grief....that is the exact feeling.  I honestly think it is the end every time it does it so I live in CONSTANT fear.  They can't find one thing wrong with my heart either except a trace of mitrl valve reguritation which apparently is normal.  The slightest bit of tension or anxiety brings on the skips.  I just have a hard time accepting that is normal.  Every time I go for testing they say nothing is wrong and send me on my merry way.  Well at least merry for them but not for me as I still have no explanation why I am getting these.  My doctor started me on Cipralex because she says I have anticipatory anxiety.  I say yeah who wouldn't with all these flip and skips.  She says that everyone would get PAC's and PVC's every day but some people just choose to ignore them or can't feel them.  I question who in the right might would not feel it when their heart constantly stops.  I don't know anyone that gets them and believe me I ask everyone.....
Avatar universal

I was happy to see that someone else shared my symptoms but then realized you've been having them for 20 years.  Bummer.... I've only had them for 2.   I guess we are going to have to trust our physicians.... just wish I could give them my symptoms and see if they can live with them.....I agree with you that there doesn't seem to be any explanation for them.
Avatar universal
Oh yeah I kid you not.....20 cotton pickin' years and I still and panicky about every single one of them.

So do they say you have always had these or did you just start noticing them or what?
Avatar universal

I switched blood pressure medication and started taking coreg cr and noticed them shortly thereafter, doc switched me to metoprolol xl and seemed better...they seem to be reduced after increasing metoprolol to 200 mg/day...also on CCB....   doc is now exploring non-reflux GERD and possible esophagitis as an irritant of my vagus...taking prilosec and prevacid with some relief.  willing to try anything that is non-invasive.  given the frequency and randomness of episodes it is hard to determine what is really working or just coincidence.  I've seen references to magnesium supplements and am considering this as well.  There are worse things that could be wrong so I grin (not so much) and bear them.
Avatar universal
I have them for hours at a time ,2 beats then a lonnnnnnnnnnnnnnnnnnnng pause, then a couple of really fast beats, then 3 beats  the stop start stop start, etc etc,
I have them day in day out. If you are have them as seldom as you say nothing at all to worry about.
Avatar universal
I guess it does seem seldom to a lot of other people with their hundreds or thousands per day but I just hate them so much that I just really can't believe they are normal.  I don't know anyone of my normal friends or relatives that has these so I question how normal they really are.
1803629 tn?1323454726
MEDICAL PROFESSIONAL
PVCs (or premature preventricular contractions) and PACs (premature atrial contractions) are frequently benign but can occasionally be so frequent as to cause the heart muscle to become weakened over time.  They can be exacerbated by excessive caffeine or alcohol intake and people usually notice them the most when sitting quietly or lying in bed trying to sleep.  Given that you were symptomatic and the extra beats appear to be frequent, I would recommend that you make an appointment with an electrophysiologist (a subspecialty of cardiology) just to confirm that there is no cause for concern as occasionally they can be from a more dangerous cause.  Make sure to bring all of your previous records with you for your appointment (including images).  Even if it turns out that there is no cause for concern, it can be very reassuring to have an expert physician review your records and given you their recommendations.
967168 tn?1477588089
most of the time, pvc's and pac's are of no real concern and just like hiccups but in the heart - there is no "perfect" heart beat or rhythm we all have irregular ones just some of us are really unlucky and feel them all

I've had some type of arrhythmia for over 35 years since I was 9 years old but didn't find out until I was 42 what they were because dr's told me what I was feeling was nothing to worry about and "normal". In April 2007 an ekg showed I was in bigeminy (pvc every other heartbeat) and pretty much stayed there until June 2009 when a new dr found I had roughly 50,000 pvc's and VT runs.

I tell this often in the heart rhythm forum, but there is a woman in my last cardiologist's office that had 80,000 pvc's daily and was fine on just beta blockers and hasn't developed any problems over them.

process of elimination and finding a cause can be very helpful in treating arrhythmia's and symptoms; also keeping a journal of dates, times and symptoms may help your doctor pinpoint what's causing them...could be as simple as an irritated vagus nerve to something environmental such as caffeine or things in your system such as low magnesium or potatssium.
Avatar universal
For those of you with PAC’s, PVC’s, Atrial Fibrillation, Palpitations, Arrhythmia’s, that happen when you move, bend or sleep, etc, here’s what I’ve discovered after taking notes and experimenting for the last year and a half:

First, about me: I’m a 44 year old male, 5’ 11” and I currently weigh 300lbs. I was 350lbs when my problems started about 2 years ago. I have a full time job as a maintenance person at a school so I’m fairly active. I started having PAC’s, afib (3 to 8 beats at a time based on a 2-week heart monitor test) and arrhythmias (or palpitations), sometimes lasting 45 min to an hour. I can’t say for sure if afib is involved in my arrhythmia episodes or not. I have some acid reflux and I have a sliding hiatal hernia. My evidence suggests that the herniated stomach is sometimes brushing against the heart and that the acid reflux is irritating the vagal nerve in the esophagus/heart area. My arrhythmia episodes are characterized by a rapid irregular pulse that feels like it’s skipping beats from time to time. It feels like someone is knocking on my chest from the inside. No dizziness or arm pain. My chest gets a little sore but I think that’s from tension. I take 40mg of Nexium for reflux in the morning and 50mg of Toprol at bedtime. Even though I have reflux I don’t feel it-but it’s there. I take 3000mg of triple strength fish oil and a few vitamins and baby aspirin. I’ve had 4 stress tests in the last 8 years, all normal.

Body position most definitely plays a role in the PAC’s , which in turn can start an arrhythmia! It seems like a lot of doctors don’t believe this. I have more than enough evidence and I can make the PAC’s happen if I want to. In my case, pressure against my abdomen just to the left of the sternum below the ribs will usually cause a PAC and occasionally a brief bit of afib-although both things are happening less as I lose weight. I’m not sure that I’ve had any afib in the last few months. Pressure against the abdomen and the resulting PAC’s can be caused by bending certain ways, repeatedly bending over to pick things up, arching my back, especially with my arms up in the air, sitting scrunched up in a chair at a desk or in the car (especially with a belt or tight pants on-now I wear suspenders and loose pants). If I watch a funny movie and chuckle repeatedly, the action of my stomach muscles tightening will cause a PAC. I had a bath towel wrapped around my stomach and that caused a PAC. Certain exercises or yard work that cause the stomach muscles to tighten over and over again will do it as well. Sometimes the yard or exercise activities will make the PAC’s happen 5 minutes or so AFTER the activity has ended which I think might have something to do with the herniated part of the stomach getting pushed up during the exercise and then being jammed against the heart for a bit until falling back down after awhile. If I’ve had a meal in the last hour or two then these situations are much more likely to cause a PAC. Most of my daytime PAC’s happen almost 2 hours after eating-though sometimes a little earlier.

I discovered that guzzling an ice cold drink on an empty stomach can put me right into an arrhythmia that will stop as soon as I shift position and kind of hop up and down a bit. In one instance I jumped up from my sitting position as soon as the arrhythmia started and it stopped. I then grabbed my belly and pulled it up and the arrhythmia started again until I let go of my belly. I immediately drank a bunch of warm water and tried again to make the arrhythmia happen but it didn’t. I wonder how many people go into arrhythmia after exercise because they guzzled a cold drink.

I’ve had a PAC occur with a burp when there was a meal in my stomach

My hiatal hernia seems to be involved with putting pressure on the heart because I’ve woken up in the middle of the night and had an arrhythmia stop and start just by changing body positions. Eventually I found that when I start having an arrhythmia, if I IMMEDIATELY jump out of bed and hop around a bit it would stop in less than 30 seconds or so. I guess it could just be my organs in general pushing against the heart but it seems more likely that it’s the herniated stomach.

The arrhythmias generally only happen at night and only between midnight and 3am. Sleeping in a soft bed, on my side, causes my hips and shoulders to sink into the bed, and then pressure is exerted against my belly. Sleeping in the same bed (or a recliner) on my back causes me to arch my back, and either one of these positions generally causes me to wake up in arrhythmia. If I sleep on the hard floor on my side, or sleep on a firm mattress that is on the floor, I don’t sink in so there are almost no problems. I haven’t tried it on my back too much. I haven’t had an arrhythmia in 6 months since I started sleeping on the floor and/or mattress. I had been having 2 to 4 episodes a month for several months before I made the switch to the floor. I had one or two episodes after switching to the floor but there were other circumstances-I had worked for 14 or 16 hours and had really “bad” food (greasy/fatty meals) and was dehydrated. Even when I was having trouble sleeping in the bed, I did find that I never had a problem sleeping in the soft bed after 4am. After sitting up and drinking some water (to dilute any acid) I would stay up waiting for the arrhythmia to stop then get back in bed at 4 am or so, or times when I wasn’t having any problems I would just wake up at 4 or 5 and get in the bed and I could sleep however I wanted and not have any PAC’s or arrhythmias. All I can assume is that less food in the gut at this time means less pressure and acid in the gut.

I experienced an arrhythmia one night after laying on my side on the bed while I was bloated from eating ice cream (apparently I’m a little lactose intolerant). I felt something shift in my belly and then a big thump and I went right into arrhythmia. That was when I finally realized that pressure was the key.

I tried Beano for awhile to help prevent gas but I don’t think that gas in general is a huge problem. I will drink some Maalox with anti gas at night sometimes before I lay down, just in case. I was trying for a long time to only have small meals and to not eat after 5 in order to give my stomach a good 4 or 5 hours to empty out before bed. That doesn’t really seem to matter though because I’m have big meals as late as 8pm and been in bed at 10pm with no problems. I’m not talking about big meals that make you sick but meals that would make you feel a little too full.

My first 2 arrythmias (Feb and March 2010) happened during the day and involved things that irritate the heart. During my first arrhythmia episode I realized that I had had a lot of caffeine and very little food or water, and that was most likely a contributing factor. The second time I had had a decongestant and that again was most likely part of the problem. So I quit drinking caffeine and I no longer take any medicine with a stimulant. I haven’t had any more daytime arrhythmias after that lasted more than 30 seconds,and there have only been a couple of those-from the cold drinks.
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