I am a casually athletic female, age 49, nonsmoker, bp averaging 130/80, total cholesterol 126. Diagnosed with mild MVP/minimal MR 1985 by 2-d echo, nadolol 40 mg qd, down to 10 last year. No change on yearly echoes, asymptomatic from '87 til this year. No family history of arrhythmia.
Late February had mild afebrile illness, malaise without URI symptoms. Once sudden tachycardia on minimal exertion, then twice prolonged severe chest tightness (4+ hours) radiating into arms. All labs normal (incl ESR and C-RP, cardiac enzymes not checked), no ECG changes. Mild chest discomfort persisted for 3 weeks but returned to brisk walks 3-4 hrs/week. Echo in mid-March unchanged, LVEF 62%. Frequent pvcs started late March, referred to university cardio, 8445 pvcs/24 hours on Holter, no couplets or runs, echo mid April showed normal MV, mild MR, mild TR, mildly dilated left atrium, LVEF 60%. Referred to EP, diagnosed polymorphic pvcs of idiopathic RVOT origin, switched from nadolol to verapamil 80 mg tid, helps but getting some breakthrough. Last week mibi stress test normal at 98% maximal HR, MRI scheduled next week to rule out ARVD.
1. What would be the significance of latest echo findings, if any? EP is unconcerned, should I be?
2. Does this sound like it could be the aftermath of myocarditis? With my history how likely is ARVD?
3. EP has recommended ablation, how likely is this to be successful (assuming no ARVD).
Any other comments or advice would be welcome. Thank you and sorry for the lengthy post.