Palpitations

[Diane]

I'm a runner and I run 4-5 times a week about 30 minutes a
workout. The palpitations have never happened during a workout.

I have been experiencing palpitations off and on
for the past 6 years or so.  I never know when the palpitations are going to happen.  I get them once every couple of weeks and they usually last around 10-20 seconds.  Yesterday, I had one that lasted for about 3 minutes and it really scared me.  Normally if I lay down flat on my stomach and breath slow I can get it to stop in 10-20 seconds, but yesterday was very weird.

About 5 years ago, I went to the doctor and had them run all
the tests.  He could find nothing wrong.  In fact, he sent me
to have an ultrasound done on my heart and that checked out fine.  

Lately the palpitations haven't been bothering me, but yesterday's scared me because it lasted a lot longer than I'm used to.  I believe part of it has to do with stress.  

What can I do to relieve the palpitations when I'm having the palpitations and should I be worried that yesterday's lasted longer than normal?

[Cleveland Clinic, MD]

One may be serious (NSVT) and the other is not (multiple PVCs).

[Richard]

Dear Doctor, What is the difference between a run of Non-sustained V.T. and a run of pvc's?  Thank you for your time!

[sylvia]

I had a 48 hour Holter monitor performed which showed four beats of monomorphic ventricular tachycardia at 200 beats/minute which self-terminated and only a single pvc. Does this mean that I have VT.? I was told that it was just a run of pvc', benign. Now after reading this I'm very nervous!

[Cleveland Clinic, MD]

No,not VT. As you were told only 4 beats of PVC.

[Cleveland Clinic, MD]

No, multiple PVCs are not dangerous.

[marie]

What's this about 8 pvc or more in a row being considered a different more dangerous arythmia??  If this is true, then I know I've experienced such an arythmia in the past.  I have not been able to catch such an episode on a monitor though.  Is there any truth to multiple pvc's being a more dangerous arythmia?

Marie

[Cleveland Clinic, MD]

Although a PVC and ventricular tachycardia both come from the ventricle they are different animals alltogether.  The one is serious and the other benign.  The presence of PVCs does not increase the risk for VT.

[Martie to Marie]

I went for a second opinion years ago about my heart malady---pvc's, pac's and the doctor did the exact same thing that you described. He sat by me and read my records from the first doctor and said the records are probably on target. What kind of second opinion is that? He didn't even listen to my chest! We are always told that we are entitled to a second opinion but try to get one. I went because the first doctor told me for years that I had Mitral Valve Prolapse but when he did an Echo several years later it came back negative and when I questioned him about it, he just said "sometimes it doesn't show up"! When I went to the second doctor he just agreed with the first. I thought he would want to see the Echo or do his own Echo or give his own opinion. I was under the impression that if someone has mitral valve prolapse, it would always be visible on an echo. I've been told since then that I never had mitral valve prolapse. I believe this sooner than believe that the mvp comes and goes on Echocardiagrams.Anyway I think if someone really wants a genuine second opinion, he/she would have to go to a different city than the first opinion where the doctors aren't acquaintances. My doctors were friends, both cardiologists in the same small town. Martie

[CCF I Don't understand??? About PVC's]

I thought if you had more then 3-8 (#'s I've seen vary) PVC'S in a row it was considered a different, more dangerous rhythm called ventricular tachycardia, that can cause different symptoms and potentially turn into life threatening ventricular fibrillation. Please explain this to everyone, as I believe this is what most PVC sufferers fear. Thank You.
Also, I thought PVC's were dangerous, or could cause worse symptoms if you had unknown underlying valvular heart troubles.

I have really bad PVC's, and my cardiologist is evaluating them with an event recorder. Sometimes they are bad enough to make me dizzy, or even faint. Does this make sense? I think I have up to 30 seconds of skipped beats at a time. That's a guess, based on putting my hand to my chest. My PVC's are already well documented on previous holters, then became more severe over time, in terms of symptoms. Funny, since I'd stopped paying the PVC sensation any mind long ago. But the dizzy spells started in. So, I am confused about all this info, or what my deal is. I am young, in good health, normal weight, echocardiogram normal, terrible amount of PVC's induced by exercise.

Stress test showed PVC's and unusual tachycardia. Beta blocker has not reduced the amount of PVC's much, or the symptoms. I am so baffled at what's happening, and frustrated, because I know there's an arrhythmia going on, and can only speculate it's this V-tach thing??? It puts me in bed some days, dizzy and out of breath feeling, irregular heart beat feeling, but not necessarily too fast. It will go up and down, so that it's hard to take my pulse, it will be 70, then 100, then 130, then 60... then feels like something buzzes in my chest.

Please explain this PVC's are always unsymptomatic/benign thing further. I really am lost, and think everyone else is too. If they are so benign, why do cardiologists bother to check for them with holters? Thanks. BTW, I don't doubt they are "benign," just know that they can cause symptoms, esp. when they turn into long runs of a half skipping heart beat that knocks you over, makes you dizzy, makes you pass out, then feels like your heart comes back with a serious kick.

[Cleveland Clinic, MD]

PVCs are never serious and never become serious.  If this is the only finding there is probably no reason to pursue additional testing.  The only reason to check other things would be if new or different symptoms (such as passing out) develop.

[marie]

I too am curious about when to become concerned about the PVC's.  I've had them for years and I too am a runner.  I also get them while I'm running though...that's when they scare me the most!

I've had all the test done and my doc. say's they are PVC's and not to worry about them.  In the last year and half however I've been experienceing these in runs, which I never used to before. My doc. has not been able to catch one of these episode on an event monitor, so it worries me that these episodes have yet to be reallys seen by anyone.  

I live in Oregon, and our University President was recently hospitalized with a heart arrhthmia.  That's all they've said, just that he passed out due to an irregular heart rhythm.  I'm so afraid that when my PVC's occur in these runs that they might too turn into an irregular heart rhthym and something terrible will happen.

I've asked my doc. for an echo stress since I'm a long distance runner and I have these episodes with ruuning, but she doesn't seem to think that's necessary.  I even went for a second opinion, but I felt like all he did was look over my old records and read what the last doc. said and then said he agreed.  How do you really get a second opion..with all new tests etc??  Do you have to tell them that you haven't had the tests done before so they will go ahead and do them?  I've heard from other doc.'s on this forum that an echo stress is a good idea.  

Can PVC's turn into a dangerous heart rhythm if there are too many too close together??  When they talk about someone have arrythmia what does this mean??

Thanks in advance for your help.

Marie

[Cleveland Clinic, MD]

Most likely these episodes are benign however these is a small chance they could be something more serious.  I would recommend seeing your doctor and asking about a Holter monitor test.  Once serious things have been excluded you can try things like slow deep breathing, coughing, lying down, etc.  Good luck.