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Avatar universal

Palpitations

I am really worried.  I have palpitations daily but nothing like I had last night.  I have been checked out by a cariologist and they say nothing is wrong with my heart other than skipped beats. I was feeling really anxious when this happened.  

I was watching TV feeling anxious thinking about my heart when it skipped a beat.  It then skipped again the next minute and then again.  This happened every minute for so for 5 minutes.

I have a stethascope and I went to get it and laid back down on the couch.  I listened to it skip every other beat for 10 minutes!  It would beat normal, then do a little skip then a hard one.  I counted it 30 times per minute.  This went on for 10 minutes until I stood up.

I started to calm down and just laid there and listed to it skip.  I was going to get my husband to take me to the hospital but it seemed to stop and go back to its normal beating after 10 minutes.  Needless to say I slept in my clothes because I was so worried it would do it during the night and I would have to go to emergency.

Could an anxiety or panic attack bring this on for it to continue skipping like that every other beat for 10 minutes even after I had calmed down?  I am just absolutely horrified!  Now I see the single skips are not big deal compared to what happened to me last night with this irregular rythum for 10 full minutes.
53 Responses
Avatar universal
crl,

thanks for the post.

Everything really depends on what has been discovered in your previous evaluation.  

Overall, from what you state, it really sounds like the familiar situation many of the other posters have suffered from with their PACs and PVCs. Many people see a wax and wane and even a frank change in the quality of their symptoms over time.

I realize it can be quite scary though. Sometimes, dealing with the underlying anxiety issues associated with palpitations can be more effective than actually treating the palipitations.

good luck
84483 tn?1289941537
When I had PVCs real bad this would happen several times a day all day long for weeks, a PVC every other beat(bigeminy)It's the nastiest feeling of all. I was checked while having them by cardiologist  and he told me not worry, they'd probably come and go like that all my life. Its been over 5 years since my last bad episode. I rarely have them anymore, maybe its the atenolol and cozaar I take to control hypertension.Hope you feel better soon. I know how distressing this can be.
Avatar universal
I can't imagine this happening again!  It was the nastiest feeling I have ever had.  I thought for sure I was a goner!  I don't think I can go through another bout of those.
Avatar universal
I'm a professional athlete and i know that my left ventricul is very little dilated (it disappears when i have one month rest). Do i still have a structurally normal heart with this?  And are my pvc's still benign?
21064 tn?1309312333
I've actually been in the doctor's office in bigeminy and her comment was, "it's only bigeminy."  Don't worry - you may never find a reason.  These pesky skips appear and disappear at the strangest times, often for no reason whatsoever.  

There was a time when I pretty much lived in bigeminy.  Seriously, with a structually normal heart, it's really no more significant than single skips.  Not to worry.
21064 tn?1309312333
Have you been checked out by a cardio?  If so, is he/she the one that told you about the slightly enlarged ventricle?  With a doctor's stamp of approval, I wouldn't let it worry you.  Just another of life's mysteries : )
Avatar universal
The best thing to do is go to a cardiologist and get a heart work up done.

Because the most frequent response you'll here on this forum and others is that with a structurally normal heart - PVC's/PAC's (skipped beats, including Bigeminy) are all harmless.

It's not that you will feel a total reflief right away, but it will be the facts that you will always be able to revert to, when in doubt...

There were some pretty good responses from another doctor in a recent post of mine:

http://www.medhelp.org/forums/cardio/messages/36251.html
Avatar universal
Hey everyone! I've been observing this forum for a long time, but I can't ever seem to get through to post a new question, so I thought I'd just ask the rest of you: do all of your palpitations feel like strong beats, or could they feel different as well? I get strange intermittent sensations in the center of my chest, but instead of feeling like my heart is pounding, they feel like my heart is contracting, or pushing inward, if that makes sense.
     I did have an echo, EKG and holter in August, but back then I was feeling just general chest tightness, not palpitations. I have been diagnosed with GAD, which mostly manifests itself in health anxiety. I am not currently taking meds, but I am planning on starting on Zoloft or Lexapro within the month. My cardio did say I might have MVP, but the tests weren't conclusive. The palpitations come most frequently when I am walking outside. They started during a week of extremely cold weather, but the last two days have been warmer and they are still happening. They occasionally happen inside or when I am at rest as well. I would say I get between 5-10 a day, and frequently a few of those will come shortly after the others, i.e I get three walking to one class, two walking back, and one randomly when I'm reading in my dorm ( I'm a female approaching my 20th birthday, by the way). Sometimes they come when I am not thinking about them, or worrying about anything at all, which makes me doubtful when people tell me it is probably anxiety.
     Any advice or reassurance would be greatly appreciated! Reading this forum has been very comforting to me so far!
Avatar universal
There are a lot of theories that we all have...

But, again, the general statement from the medical community seems to be that if your heart is otherwise healthy - the skipped beats are harmless...

Very frequent PVC's can lead to Cardio Myopathy in rare cases - we're talking like 20,000+ daily.

Most people have skipped beats and just don't notice or pay attention to it.

I have some health anxiety as well. And when this is the case, as soon as you notice one odd beat - your mind is in tune to most of them.

The possibility exists that you may have always had what you feel, just that your noticing them now because you happened to catch one and didn't mistake it for something else.

The medical community also states that anxiety can induce the skipped beats, but doesn't clearly indicate why. There are many possible triggers for them but anxiety is said to be one of the more popular ones, especially considering that most of us become anxious when we feel them.

Consider the fact that some skips feel mild while others feel forcful.  It's possible that this is due to the timing of the skipped beat and maybe even if your anxious or panicky at the time of the skipped beat.

Also, stress hormones may gather up, which may explain why some of these happen out of the blue...

Again, some of this is just theory.

But all the Dr.'s seem to say the same thing. If your heart is healthy, your really at no more risk for anything bad, than anyone else with a healthy heart.

Hope you found this helpful.
Avatar universal
It sounds like you know a lot about hearts!  Are you a doctor by chance?

So you don't think a person should worry when they are feeling anxious and they get one skip after another for 5 minutes or so?  I will get one skip then get panicky and I think it sets it up for another and another.
Avatar universal
Of course some people, like myself, are not so much bothered by the forceful compensatory beat as they are by the PVC itself.  In my case, even though it is pumping less blood, the PVC itself has a all sorts of sensations, ranging from an abrupt kick in the chest to a painful ripping feeling.
Avatar universal
Can someone just explain why (how?) these won't kill me?  I had a rough week with these things.  Such hard and forceful ones.  They suck.  This is the worst week I've ever had, and I still probably only get about 20 per day.  They are so unnerving b/c they had almost gone away, I was feeling like 2 or 3 a day.  Now I am feeling 20 per day.  Why do they happen?  Why do they wax and wane?  I am only 35 and I am really afraid to get too active, if you know what I mean! I was a wild child before and now I am like an old person!
Avatar universal
Palpitations or "premature ventricular contractions" occur in 100% of the population.
Why?
In easy to understand terms, it's because every cell of the heart wants to be a pacemaker. So every now and then, a cell depolarizes early and that spreads like a wave across the heart from cell to cell causing the ventricle to contract early.
Well since it's early, it hasnt had a chance to fill up much with blood so a person may not feel the beat or if its very faint.
Hence why people call it a skipped beat.

Now that the PVC has occured, it doesnt stop there. The regular pacemaker is still keeping time and it isnt going to change it's timing b/c of this. So what happens is that you have an 'extended' filling period of the heart (remember, blood is still coming into the left ventricle from the lungs). So now you have this left ventricle with more blood than it had b/c of this long filling period.
NOW, here is the key concept. There is a mechanism of the heart called the "Frank Starling Mechanism" where the 'more' the heart muscle is stretched, the 'more forceful' the contraction.
So what does a person feel. A so-called missed beat (it was there just very weak) and then a big 'thump' in their chest b/c of the Frank Starling Mechanism.

Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign.

Of course there are always exceptions to the rule.
Also, limit things that may get your little cardiac cells feeling independent and feisty and firing off early.
21064 tn?1309312333
Sorry the pvcs are still bugging you.  With a normal cardiac workup, I'd say go back to being a wild child (within healthy limits)....lol.

Don't worry about the pvcs - they are harmless in the setting of a structurally normal heart.

Think of them in the context of a migraine.  Surely, you think you will die b/c the headache is paralyzing.  But, it's found to be a migraine and nothing more.  I'm always thankful that pvcs got me instead of migraines.  Those of us who have one one will be happy to never experience another.

Have a great weekend!
Avatar universal
I wish you were my doctor!  You have said a lot of things in here that no doctor has ever told me.  

Can you please tell me why then I had wicked palpitations on Tuesday night.  I was feeling really stressed laying on the couch and my heart skipped a beat every minute or so and I started getting more and more anxious and i went to get my stethascope and laid back down and it skipped every other beat for about 10 minutes.  I started calming down listening to it and it still skipped.  I was going to go to ER but I then when I stood up it stopped skipping.  Needless to say I am back in panic mode and can't stop thinking about it happening again.

I have started taking 10mg Ciprilex.  I have been on it for three weeks and am still stressing about my heart. Can you please get back to me with your comments?  I feel so much better when I read your comments.
Avatar universal
I enjoyed reading your explainations...
First off, I've had a normal echo and Thallium stress test with the past 6 months. EKG's were aslo normal. My 24 hour halter showed some PVC's and PAC's.
PVC's were mostly during sexual activity.

You mentioned that PVC's are overridden by Adrenaline?

I do experience PVC's during sexual activity - I think sometimes - bigeminy. More so if I feel fear set in if I feel a few... I thought my brief periods of seconds/minutes were long until I heard of people with days/weeks of it...

If Adrenaline overides them, can you explain why them might happen during sexual activity and worsen if I fear them at that time? Does this have to do with stress hormones and/or other hormones?

My cardiologist also mentioned that they are less likely to occur when your heart rate is higher.

I have felt thuds during exercise and especially if I had a panic attack while exercising, but they may have been PAC's.

I mostly get occaisional PAC's/PVC's. I think mine are primarily stress driven since I started having panic attacks 6 months ago...

You say that PVC's are a natural occurance and compare them to farting. I hope I can get to that point where I can compare them to that!

In layman's terms, why do they naturally occur? What's the purpose? My primary physician stated that skipped beats reset your heart/heart \rate?

As I've posted before, I always fear that if I'm in bigeminy and I continue doing what I'm doing, that it may turn into couplets, etc. and become dangerous.

I always get concerned about being sick and vomitting - that it will cause some sort of Electrolyte imbalance and I will get a harmful arythmia. Would this take a major amount of vomitting?

What are your thoughts on some of the idea's behind magnesium helping to eliminate bigeminy. And/or suppliments that may help a hypersensitive auto-immune system?

And lastly, would you agree with the other explainations I've gotten, that with my work up, there is no danger when they occur and simply continue doing what I'm doing?

Thanks!
Avatar universal
You said "Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign."
Why are the doctors worried about them when they are right in a row????  Because the doctors on this forum are telling that pvc's in a row are benign!!!
Avatar universal
Carrie, some people are more in tune with their body and when they have one PVC, they are likely to 'pay more attention' and worry when they get another. Some people have them all the time and do not notice them whatsoever. I have seen patients with every other beat is a pvc (bigemingy) or every third heartbeat is a pvc (trigeminy) and you ask them "do you feel that?" and they are like "feel what?"
They just dont notice. Usually that is with older people for some reason, maybe they are old enough that they just dont care. Younger people, many times women, tend to stress and worry and ruminate about these. So often times, just for peace of mind, an echocardiogram is performed to show them that their heart is 'structurally normal', although there is a cost to this test which may not be warranted. It may actually limit medical expenses such as ER visits and improve their peace of mind. It is not limited of course to just young women though, if someone can tell me how to not notice when I get them, even though I know what they are, Id appreciate it, they can still be startling ;)
As far as the older people not feeling PVCs, they are also dont alot of times feel atrial fibrillation unfortunately.
While young people who get it, notice their heartbeat is irregular, older folks commonly do not realize it until they get a regular ekg at their doctors. Not recognizing atrial fibrillation can lead to stretching out of the atrium making it more likely that the condition will be chronic, rather than treatable with cardioversion. So it cuts both ways.

Jeff, I have no clear idea why you would have a painful feeling from a PVC or even if it is coming from the heart. The heart does not have pain nerve endings. So when you get for example, ischemia from lack of blood flow, you dont feel it in your heart. You get 'referred pain' elsewhere. Like arm,neck, this that.
It's actually somewhat of an odd thing about the thoracic cavity in general. That if I was to take a hammer out, hit your toe. You could tell me exactly which one I hit. Not true with the thoracic cavity. I could take a pair of needle nose pliers, reach inside you and squeeze something. You probably would feel it in a different location in your chest area. Just the way it works.
As far as what you are describing, I dont know what mechanism is at work. Check with your physician if it continues to bother you.

Finetilthree: Why are they going to kill you? Well the vast majority of these are benign, in fact, they are a natural physiological occurence. You could just as easily ask why farting doesnt kill you, but I digress.
To understand this a bit. Lets look at the heart's pacemakers.
First there is the Sino-atrial node which is a group of cells on the top of the heart that fire in a rhythmic manner to initiate the heart depolarization which stimulates the muscle to contract.
That group of cells fires and like dropping a pebble in a pond the ripples spread out across the atria. The top chambers of the heart. That is the 'p-wave' on an ECG. Then there is a slight delay at the Atrio-ventricular node. This is a safety valve of sorts, you see, there is a non-conductive sheath of tissue separating the top (atria) and bottom (ventricles) of the heart. This safety mechanism prevents things like atrial fibrillation (more of an annoyance) from becoming ventricular fibrillation (sudden cardiac death).

From the AV node, it then shoots down to the apex of the heart where the muscle contracts and squeezes to eject blood from the ventricles out of the heart. Simplified, yes I know, but for the brevity purposes I have described three  pacemakers of the heart. Not clear about all three?

First there is the SA node, the 'primary' pacemaker.
Second, there is the AV node, the 'backup' pacemaker. If the SA node fails and does happen with sick people*, the AV node will fire when the heartbeat becomes too slow.
Finally, the trickiest to spot as a pacemaker in my explanation, is the muscle itself, now I am not going to go into ion channel physiological explanations of this. But, the heart muscle itself is a backup pacemaker. You dont often see this except in the final stages  of death where the muscle itself is trying to keep a person alive.

*Interesting factoid is that Alberto Salazar, a champion marathon runner in the Eighties was in such great shape (and the better shape you are in, the lower your pulse typically) that it was so low that his AV node tookover as his pacemaker, it had taken over because his heart was so slow at rest.

Also, as far as exercise. PVCs by and large go "away" with exercise, they are overridden by adrenaline. So lets say you went for a stress test and you had numerous PVCs to start. By the time you were a few minutes in, most likely they would go away. But, lets say you were normal to begin with, then as someone gets winded they start getting PVCs then that may be taken as to be more substantial.
You have to realize that PVCs in and of themselves occur in everyone.
Depending on the timing and occurence of them, they can also be a symptom. Diagnosing heart problems you have to look at a "constellation" of symptoms in order to ascertain whether or not they fall into a likely category requiring further followup with very expensive testing.

Short answer: If I were you, which I aint, but if I was, I wouldnt use PVCs as an excuse to not exercise, you would be doing more harm than good with that reasoning since exercise staves off many heart problems later on down the road. Nice try though :O)
Avatar universal
Can you please tell me why then I had wicked palpitations on Tuesday night. I was feeling really stressed laying on the couch and my heart skipped a beat every minute or so and I started getting more and more anxious and i went to get my stethascope and laid back down and it skipped every other beat for about 10 minutes. I started calming down listening to it and it still skipped. I was going to go to ER but I then when I stood up it stopped skipping. Needless to say I am back in panic mode and can't stop thinking about it happening again.

Carrie, I could never tell you why or even if you had palpitations over the internet. I am glad to offer a little more than basic explanation to help you understand a PVC as I know the worry is the worst part of these. Not knowing what it is can lead to issues, from personal experience, I was convinced I had lymphoma when I was 16 because I found one of my lymph nodes. Then I talked myself out of it and thought I had Ebstein-Barr virus. Of course, it was normal.
The problem is that without 'knowing' what exactly is going on with some objective evidence, there would be know why to say whether you are experiencing another rhythm (although I do believe you that they are PVCs, just know way to know for sure over the internet)
That is why they have event recorders that you can wear to document when that happens, its alot cheaper than going to the ER.
I had to chuckle at the stethescope and listening to your PVCs, first time I heard that ;)
I would suggest that you go for a walk rather than sitting down waiting for the next PVC. That will help take your mind off the PVCs and will in all likelihood 'overide' the PVCs. Although, you may experience some PVCs after exercise as adrenaline is still high and your heartrate has fallen.
As you can see palpitations are difficult to explain and one can make it a very complex explanation. I used to have a professor and we would ask a question and he had a famous response that made us cross our eyes, his answer was for example if we were students asking a question about the heart he would say: "...always, sometimes and never"
As soon as you tell a patient 'always', it wont happen and as soon as you say it will 'never happen', it will happen.
Leading to the trap of people saying "...but you said..." So, the wisest course of action is say "in relative percentages, your risk stratification having a cardiac event yada yada yada".
Which in of itself gives the patient a  bit of annoyance b/c people like clearcut answers, yes or no.
And with the palpitations which can in some settings be used as an indicator but the vast majority are just normal, but because of things like LongQT syndrome where I have seen patients have brief runs of ventricular tachycardia (do not google that please, its just an example of one rare thing not specific to you) a person just cant say for certain without some sort of clinical evidence and again, cannot be done on the internet.

If it bothers you where it interferes with your quality of life and you just want to find out what it is. Talk your physician into an event monitor. Extra piece of mind may be an echo to see if your heart is structurally normal but probably not necessary b/c of the cost can be several hundred dollars for the echo.

Short answer: If I were you, which I aint, but if I was and it was bothering me. I'd eliminate things which may make the heart muscle 'jumpy' like caffeine or other stimulants, alcohol the byproducts of which can irritate the cardiac cells causing PVCs or other rhythms known as 'Holiday Heart', limit stress, eat a healthy diet with some potassium rich foods such as a banana or even better; canteloupe which has twice the amount of a banana per amount.
If all dietary and exercise changes do not work AND you find yourself still stressing, then you might consider a low dose beta-blocker to see if that can ease your mind* and help reduce the occurence of palpitations. Although I wouldnt do that.
*interesting factoid: Many concert pianists before important performances take a beta-blocker to help reduce their nerves and performance anxiety.

I have started taking 10mg Ciprilex. I have been on it for three weeks and am still stressing about my heart. Can you please get back to me with your comments? I feel so much better when I read your comments.

If you are having problems with anxiety, the cipralex may help with your worries and ruminating about health or any other issues.



Rag123
2/23/2007
C16 Luciasbrown I enjoyed reading your explainations...
First off, I've had a normal echo and Thallium stress test with the past 6 months. EKG's were aslo normal. My 24 hour halter showed some PVC's and PAC's.
PVC's were mostly during sexual activity.

You mentioned that PVC's are overridden by Adrenaline?

Well, I simplified it to a large extent. The SA node stimulated by exercise and adrenaline actually overrides with a higher rate. Adrenaline can actually cause PVCs at low heart rates b/c it is a stimulant to the muscle cells. I dont mean to confuse you.



I do experience PVC's during sexual activity - I think sometimes - bigeminy. More so if I feel fear set in if I feel a few... I thought my brief periods of seconds/minutes were long until I heard of people with days/weeks of it...

If Adrenaline overides them, can you explain why them might happen during sexual activity and worsen if I fear them at that time? Does this have to do with stress hormones and/or other hormones?


##### Well if we compare sex to a stress test using the bruce protocol where first three minutes are the easiest and PVCs are usually still present. I was taught, although I dont have a scientific study to back this up, that Stage One is equivalent to having sex with your wife. Stage three is equivalent to having sex with someone other than your wife.
I have no gauge really to know how much your heart rate is and how much adrenaline you have released during sex.



My cardiologist also mentioned that they are less likely to occur when your heart rate is higher.
I have felt thuds during exercise and especially if I had a panic attack while exercising, but they may have been PAC's.
I mostly get occaisional PAC's/PVC's. I think mine are primarily stress driven since I started having panic attacks 6 months ago...
You say that PVC's are a natural occurance and compare them to farting. I hope I can get to that point where I can compare them to that!



##### Well with increasing knowledge of what they are and the length of time you have them, you will probably eventually tire of worrying about them. Like I said before, if someone can tell me how to not get startled now and again by them myself, then I'd appreciate it. The release of methane gas is natural biological process, so is a PVC, that was the parallel I was trying to draw.


In layman's terms, why do they naturally occur? What's the purpose? My primary physician stated that skipped beats reset your heart/heart \rate?

##### My best answer for why is; 'because they can'
The purpose of them is as I mentioned that your cardiac muscle is actually the third pacemaker of the heart. Sometimes, a cell just depolarizes. When that happens, it spreads from cell to cell causing a PVC. Same in the atria causing PACs.
*Interesting factiod: Before pacemakers became common, people used to hit the chest to break a lethal ventricular rhythm b/c the force would cause ventricular cells to depolarize. This was called a 'precordial thump'. People may have seen it on the TV show MASH and wondering why they are hitting the chest trying to restart the heart. Not that it is restarting. Its trying to depolarize ALL of the ventricle cells at once. Then while all the cells are repolarizing, the pacemaker can take over and maintain a normal rhythm, fibrillation rhythms in atria or ventricle is like an electrical dragon chasing its tail preventing proper contraction. Also, getting hit in the chest during the T-wave can cause v-fib, we've heard stories of kids getting hit in the chest with soccer balls going into v-tac or v-fib. There is some truth to that, although very very rare, not enough to stop playing soccer.


As I've posted before, I always fear that if I'm in bigeminy and I continue doing what I'm doing, that it may turn into couplets, etc. and become dangerous.

I always get concerned about being sick and vomitting - that it will cause some sort of Electrolyte imbalance and I will get a harmful arythmia. Would this take a major amount of vomitting?

What are your thoughts on some of the idea's behind magnesium helping to eliminate bigeminy. And/or supplements that may help a hypersensitive auto-immune system?

##### Since I believe in evidence-based medicine, I rarely believe marketing hype of so many supplements and the companies who profit from them. It's hard enough to believe the claims of some of the pharmaceutical reps, let alone someone who bottles an herb and promises to alleviate an ailment at a profit.
Magnesium however is a mineral and if you are deficient can cause PVCs and is used as an antiarrhythmic when there are no contraindications.
You may speak with your physician on testing if you have low levels of magnesium especially if you also have low potassium levels.
The vomiting question is hard to answer b/c it just depends. An otherwise normal healthy adult who eats a nutritious balanced healthy diet, it would not be something to worry about.


And lastly, would you agree with the other explanations I've gotten, that with my work up, there is no danger when they occur and simply continue doing what I'm doing?



##### I would be very pleased if I had a normal echocardiogram coupled with a normal thallium stress test. If you think of your heart as a house. You know that the structure of your heart is normal (echo shows the foundation is good and doors open and close and all rooms are the right size) and the plumbing is good with no plugs(stress thallium). Your ekg was normal with no evidence of long QT I take it. And if all you have is PVC's and PACs. You can be confident that the wiring is good as well. I think all the bases have been pretty well covered. Again, if you have continued anxiety AND after you have eliminated alcohol, stimulants and certain foods like chocolate which can contain caffeine, ate a well balanced diet and all of your bloodwork is normal. Then I would consider a beta-blocker and perhaps something to help turn your brain off for a bit such as an anti-anxiety med.

Thanks!

Your welcome and stop worrying
Avatar universal
Sorry to keep bombarding you with questions...

I just read your reply to someone else...

In regards to the vtach thing, my fear as I tried to explain in my prior reply is that bigeminy may turn into couplets or salvo's (back to back with no normal beats in between).

Could this happen withing a normal heart? And if so, would it still be harmless?

And lastly, can you explain what vtach is and if back to back PVC's could lead to it in a normal heart?

As you can see I'm always worried about things progressing, especially if I have skipped beats and I become terrified, panic, etc.

Or am sexually active while having them and continue...

Thank you very much!
Avatar universal
I'll have to come back to you on your questions a little bit later.

The sex and the stress test levels was a bit of cardiac humor.

I think I am going to stop saying 'its overridden by adrenaline' from here on out. It's making it too confusing b/c adrenaline can 'stimulate' cardiac cells, just like caffeine or the byproducts of alcohol can stimulate a cardiac cell to depolarize and cause the PVC.

I am just going to say that it is 'overridden by exercise' from now on because adrenaline after exercise can cause PVCs while the heart is slowing. So forget I said adrenaline.


Avatar universal
I had a run of 10 pvc's without one normal beat between (=nsvt).  My cardio told me that this is benign in a normal heart.  The doctors on this forum are also telling that nsvt is benign in a normal heart and that nsvt does not go into Vtach or Vfib (in a normal heart).  Why are you telling the opposite? (maybe i did not understand you well?)
Avatar universal
Wow do you ever know a lot!  Are you a heart doctor?  You make total sense about what you are saying.  I am really going to take some of your comments "to heart".  

My only other question to you is that when a person has a panic attack could my heart still be skipping 10 minutes after I had calmed down?  I have never had a run of them for so long like I did on Tuesday.  I am still freaked at it.

I just started counselling with a therapist becuase of my anxiety about my PVC's.  She is trying to get me to focus on other things than my heart and told me to get rid of my stethoscope.  I know I should but I just don't think I can!  

So Lucasbrown if you could just tell me if that is a bad thing to have my heart going into the funky rhythum every second beat for 10 minutes after just having a panic attack what?

I have had an EP study as well becuase of my cronic complaining about my heart.  They caught something called salvos or something like that and it really freaked me out.  They do say that I have a structurally normal heart though and don't worry about the skips but I really do.
Avatar universal
You said "Doctors are not too worried about them since they occur in everyone unless they are right in a row. A good rule of thumb is that if they occur less than six per minute then they are usually benign."
Why are the doctors worried about them when they are right in a row???? Because the doctors on this forum are telling that pvc's in a row are benign!!!

Well without reading what they may have said, I guess it all depends on how you define "...right in a row" and also how you define "worried"
I do not know what they are saying with different words, but I am trying to say is if they are runs of non-sustained vtac. Which what I meant by saying 'right in a row' or R on T phenomenon.
I just had a patient yesterday who had a non-sustained vtac on the treadmill but he reported no symptoms and was on the proper medication already and it occured only twice.
So, yes we pay more attention to non-sustained vtac b/c a patient may be at higher risk of developing sustained vtac which can lead to ventricular fibrillation.
Without symptoms it does raise an eyebrow when you see it.
Far more than seeing a PVC or bigeminy or several PVCs in a short period of time.
When I say 'right in a row' it means no normal beats in between.
Hope that makes it more clear.
PVCs are for the most part benign and no treatment except reassurance is needed. But what I also touched on is that they can be an indicator as well but a poor one.
So what I am saying is that PVCs are benign if they occur in a normal heart :P
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