Pregnancy and PVCs

[dodgybeats]

Thanks for taking my question.  I am an otherwise healthy 32 yr old female with pvcs/pacs and suspected SVT episodes (rare and never documented).  I have had the ectopic beats for about 10 years and have had echos (last one in 1999), ECG and an EP study - all normal.  I am now 4 months pregnant and have noticed a quite dramatic increase in ectopics including short runs of ectopic beats which can be terminated if I cough or change positions.  My OB and GP are not concerned about these.  My questions are: in your opinion is this "normal" in pregnancy? I lost my brother to dilated cardiomyopathy at 17 yrs of age and am a bit worried about peri/postpartum cardiomyopathy.  Should I push for another echo?  Thank-you for your input.

[Carolina03]

Whoops -- my apologies, Hank. I was in a hurry when I posted!

Best,
Caroline

[mbimom]

The previous post was TO Hankster FROM jkf. I think you mistook the advice from jfk as being from Hank, it seems a lot of people ask him questions as well as the doctors, he does have a lot of good knowledge to share.

[Carolina03]

First, Hankstar, with all due respect, you're not a doctor; your reassurances are inappropriate.

I can only speak from my own experience while recently pregnant with my third child at age 37. I experienced more frequent, some sustained PVCs/PACs as recorded by an event monitor. I also had chest pain -- rising, constricting pressure from the middle of my chest into my neck. I also had phlebitis, and was diagnosed with aortic insufficiency per echos during the pregnancy and postpartum.

I have no other serious health problems, and as a result, my OB and GP said I was experiencing GERD!

Flash forward seven months postpartum. I have a permanent perfusion defect, meaning part of my heart is ischemic, i.e., damaged, as per a recent thallium stress test.  

Be assertive in your care, especially during labor. Demand oxygen during push time, and regular checks of your vitals. This is the most vulnerable time of your life, and cardiac symptoms, especially from someone with a family history of cardiomyopathy, should be TAKEN SERIOUSLY in my humble, non-medical opinion. Your symptoms could be benign or not.

The normal hemodynamic pressures of pregnancy do NOT include tolerating extreme cardic-related symptoms. If you don't feel like your doctor is taking you seriously, or your symptoms include chest pain, then find a cardio who will listen and make decisions, including prescribing medication or testing if indicated.

Your presentation of the symptoms is key. Be calm, direct and rational. Doctors are human and will base their decisions and diagnosis partly on the basis of your presentation.

I now wish I would've been taking medication but cannot suggest what if any is safe during pregnancy. It is a very, very personal and difficult choice to make along with your trusted doctor. Even low-dose beta blockers aren't proven safe during pregnancy, but may be the right choice, if not taking them means your son or daughter won't have you around 10 years from now.

My intent is not to make anyone anxious in the already difficult state of pregnancy. I have been there, I know how hard it is emotionally and physically.

My prayers are with you.

Caroline

[jkf]

When I was pregnant I got PVC's and was very tachy.  To the point that they put a holter on me.  Everything was fine.  They said not to worry.  Don't worry about her.  The additional blood intensifies the already exsisting "nuisance" of those darn pacs etc.  She will be fine.

[sheryl1945]

When I was pregnant I got a lot of PAC's/PVC's.  I don't know why.  I was fine; please try not to worry.

[heartdancer]

I am interested in the pregnancy-palpitation connection also. My 20 year old daughter, who was having frequent but short episodes of tachycardia, has just found out she is about six weeks pregnant. Back in October a holter was done and it showed a couple of runs of her pulse being up to 160, plus a rare PVC and PAC...Cardiologist was not concerned and did not feel any further testing was necessary. Said the primary care doc can put her on a low dose beta blocker if the episodes bother her. My daughter told me that since after Christmas she has not had any more episodes...but now that she is pregnant I am concerned they will start up again. Will the tachycardia during pregnancy damage her heart? Hurt the baby in any way? I hope the dr. can answer me because I am very worried about her and the baby. I feel an echo should have been done on my daughter since she does have an innocent murmur, but she gets her care at a military hospital...you can't make them give you a test if they don't choose to....thanks to all who answer...heartdancer

[CCF-M.D.-RCJ]

dodgybeats,

Thanks for the post.

Q1:"including short runs of ectopic beats which can be terminated if I cough or change positions."

Pregnancy can lead to increased frequency of SVT episodes, and the episodes you briefly describe could be consistent with SVT.  Evaluation of pregnant women with episodes as you describe might include an event monitor.  Talk to your doctor about your spells.

Q2:"Should I push for another echo?

I can't really intelligently answer this question without more information (and maybe not even then ...).  From what you have told me, I think trying to get to the bottom of what are these spells would be a good first step.

Best of luck.