You didn't say why you before age 24 had undergone two echocardiograms and echo stress. Why was that done? That may be an indication.
There is no way anyone reading your post can provide a diagnostic for you, see your doctor if the problem repeats. I read you should continue to exercise and reestablish you can work at the old level, and if so move up more slowly to a next level. Think too about what you are eating, drinking, and your general life style, is it a healthy one? Do you drink any of the high energy drinks... that sort of thing.
Hey Jerry they were both done for similiar palpitations but nothing was found. I also did a 24 hr holter monitor, pvcs only.
Did you have any runs of the "continuous irregular..." when wearing the Holter? If not you should discuss wearing a longer term monitor with your doctor, I've worn one 24/7 (off for showers and too old for sex) for about two weeks to monitor my Atrial Fibrillation and to monitor the introduction of a stronger anti arrhythmic drug Rythmol at 425 mg twice a day. Just for the record the Rythmol did stop my AFib,nor cold it hold me after an electrocardioversion... so much for drugs for some of us. .
If the Holter showed the irregular periods to be runs of benign PVC I guess the path forward is suggested by how much discomfort and loss of quality of life it causes. I believe many who have benign PVC with an structurally healthy heart live with it aided by beta blocker or similar meds. At age 24 I think you'd want to avoid a life time of beta blocker and discuss with your doctor what options for other treatment might be available.
There are many participants on the Community who have personal experience with PVC and may respond.. or you can get the history by searching on PVC, there is a load threads on that subject.
Sounds like it was probably an ectopic beat(s) of some sort, or could have been some other conduction issue. Almost always these are benign.
Unless it's caught on an EKG we can only guess what happened.
I've lived with PVCs since my early 20s. Actually, I can remember getting the feeling of them as early as 5 or 6 years old riding my bike but it was very infrequent. I used to be a top 2% physical fitness freak. I'm now 45. Back in 2009 I had a really bad flare up that lasted 10 months, averaging about 6,000 PVCs per day. I would flare at about 2:30 am every night, like clock work from a sound sleep and be up the rest of the night. It's was pure, F^&!ing torture. I lived through it, though at times I wanted take my heart out of my chest and stomp on it, still here. No damage to my heart. I had many tests done including a rather extensive MRI. CAD runs in my family and I didn't have any blockages at all, not even any detectable calcium in my arteries which for my age is rather good.
My Grandmother (who I probably got this from) had it too. She died dude. when she was 96. from dementia. Toward the end we WISHED her heart would mercifully let her go. PVCs, in a healthy heart, don't predict anything. I've seen NO studies that correlate PVCs to the risk of CAD or MI, except for PVCs called recovery PVCs but even that study is debatable.
Then there's my Dad. Great shape, slim, handsome guy, pack a day marlboro man. Never a hint of any issues, had a widow maker heart attack when he was 42. He somehow survived it and needed a heart transplant. This was back in 1988. He's still here, 25 years late. Amazing right? Stopped smoking, no blockages since.
If you've had an MI, PVCs can predict certain things but you haven't had an MI, there's no concern there.
Keep an eye on it, any changes in symptoms see a doctor. Don't smoke. Caffeine, even small amounts, will make it worse. Lifestyle choices can also make it worse (drug use, poor diet, not enough electrolytes).