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Avatar universal

HELP! Pressure Build up before PVC and more questions

I have been having PVCS off and on for over 10 years. I have several questions but first, let me explain what I am feeling, have had done and maybe you can help with comments.

I have been to ER multiple times and sent home, pcp countless times (concerned and talk about medicines and feelings...sent home), cardiologist (ekg, echo-heart structure fine, monitor confirmed PVCs), vegas nerve doc and all results are fine. Thyroid checked-fine. Bloodwork checked---fine. I do take potassium and magnesium vitamins daily just to possibly help PVCs. PVC feeling leads to anxiety and take medicine to help that. On Beta Blocker and Nexium for heartburn/acid.

Now, the issue is this.... before I feel a lot of the PVCs I have a strange pressure/build up feeling at the base of my heart area. Not sure if it's stomach/esophageal or my heart. Then I have the extra strong beat and I don't like it. It's strong and I have my wife check my pulse and listen to my heart and she can hear the strong extra beat but can't feel the build up. My blood pressure and HR are normal, so nothing odd there either. It's the EXTRA feeling that bothers me. If I could distinguish between heart/stomach that would help. If I knew it was not my heart, I think that would help with anxiety.

So, the pressure, almost twisting feeling--it's not fluttering. It's not butterflies. It's not an electric feeling. it's pressure and sometimes I don't have a PVC with it--but most times I do. Is this the heart? Is this the stomach?

This feeling is so distracting and makes it hard to concentrate.

I can't exercise--I'm concerned it might make it flare up because exertion makes me feel the PVCs more and I don't like that.

PCP says that it might be esophageal spasms but upon research I see that they are painful...and I don't feel pain. So, I don't think that's it. Can you have spasms without pain?

Please, if you have any thoughts or leads or ideas as to what this could possibly be--or have similar experiences, please post! I need any and all help. Thanks.
6 Responses
Avatar universal
I feel the same thing! the feeling is usually stronger the longer I've been having them
20748650 tn?1521032211
Pvc's present differently in every patient.

Different sensations associated with pvc's could indicate a pvc of a different origin then normal, changes in sympathetic tone (nervous influence on the heart). It could also be irritation of the phrenic nerve, which runs close to the heart, or an esophageal spasm as described by your doctor.

In any case the likelyhood is that the problem is benign im nature.
So I'm wondering if the funny feeling before the strong heartbeat is the actual pvc? The strong beat being after the pvc. Somtimes if feels lower than others; closer to my stomach. Most of the time a strong heartbeat afterwards but not always.
Difficult to say, everyones interpretation of what a pvc feels like is different.

That said, yes i feel like its highly probable all these feelings you are having are related to the pvc and subsequent compensatory pause.
What's interesting is the pvc's seem to lessen or go away with a ppi.  So my doctor was thinking esophageal spasms but there is not pain. Plus the strong heart beat feeling would be hard to explain another way I think.  
Avatar universal
I know this is an old post.. But i was really surpriesd to find someone who feels exactly what i feel. I don't know what this pressure means.. As you say, it is not always followed by a pvc.. But sometimes i just can tell the pvcs are coming, i just feel the pressure building up and i know.. I suppose it has something to do with the muscular tonus.. You may say i'm crazy, but sometimes it has to do with the weather, if it's rainy i usually feel it.. And also in the late autumn or early spring the feeling is more often.. Or under stress.. I don't know..but if you are still here and you have an answer i would like to know it
Check out the answer given below by : FloridianMustache   Hope all is well.
Avatar universal
I have inappropriate sinus tachycardia, so my hearts baseline is in the 130s-150s range. I've had 2 ablations for SVT and AVNRT. But I have experienced the same as you. I haven't been to my cardiologist yet for it though so I'm not sure what causes it.
The whole thing lasts no more than a minute.
I feel an intense pressure in my head neck and chest. I feel as if my brain will burst and my eyes will pop out. I feel as if someone is grabbing me by the neck on both sides near the carotid artery. Vision goes dark around the borders of view. I have a "sense of impending doom " while everything goes dark.
The pressure will continue while my heart  feels like it's quivering and the rate drops drastically (and so does my blood pressure) and feels like it is going to stop. When on a monitor it shows that it slows down to around 20-40bpm. I feel like I will faint as well. After slowing down it shoots right back up to 150bpm as usual in a manner of seconds. I get a pulsing all over my body and both see it (grey flickering in sides of my eyes) and hear it(pulsing in my ears with tinnitus)I even feel it in my tongue and teeth where the roots are.
It releases all the pressure and then I have to take one big gasp of air and have to let it out long and slowly. My whole body relaxes. I turn all red then my chest feels hollow and my heart feels like it is sinking or melting away into my stomach. Just a very light airy feeling.
I could compare it to having to get Adenosine but adenosine stops your heart for a split second. That's why this is so scary because when given adenosine you basically die but not truly. I suggest you look up how adenosine works or maybe some vagus nerve disorders and maybe you can gather info from there.
Avatar universal
You're experiencing what is known as a compensatory pause. During a PVC, an ectopic impulse elicits a depolarization (contraction signal) in the ventricle too early. Basically, when this happens, the ventricle is not adequately filled with blood. So when it contracts, it ejects a lower-than-normal volume of blood, and as the SA node fires another sinus impulse, there is a slightly longer refractory period (resting interval) between the PVC and the normal sinus beat. As this pause happens, the ventricle now gets a little over-filled and stretches harder than it does during a sinus beat. This overstretch is what makes the "THUD" characteristic of a PVC. The pause in between the sinus beat and the PVC is normal. You actually don't feel the PVC...you feel the after-effects. Interesting, ain't it?

Now, keep in mind that some beta blockers or acid reducers (omeprazole is one of them) can cause some magnesium wasting. So even if you're supplementing with it, you may be wasting more than you're absorbing. Also, the type of magnesium (the compound the Mg is bound with) is important as it can determine how much you absorb. For example, its most common to find magnesium oxide, found everywhere. But, its bioavailabity when taken by mouth is pretty awful. Its around 5% or so. Meaning if you're taking 200mg, you're only really getting ~10mg of magnesium. Find a good compound with optimal absorbtion like magnesium glycinate or taurate. Typically, unless you have severe kidney disease, magnesium is very well tolerated and safe, and if you are deficient (decent odds you are) you need more than the RDA of 350-450mg. More like 800-1200 mg per day. If it causes you the runs, back the dosage down. I had an horrible deficiency that caused me severe debilitating arrythmias and PVC's on the daily and magnesium resolved the issue. Took around 1200 mg per day and the worst faded within weeks.

Exercise may exacerbate the PVC's or reduce them...with me it was paradoxical, usually they would let up a bit. Still would happen, but not as bad when it rest. Then other times there would be no change. Catecholamines (stress hormones) will and do irritate the heart. Makes the likelihood of them to occur greater. No surprise there.
Great answer! Thanks!
Avatar universal
Original poster.   Have you ever been tested for sleep apnea?  If you have not i suggest you talk to your doctor about it.

After many many many many years of fighting a difficult mental battle with frequent pvcs, a dr recommended I have a sleep study done to determine if i have sleep apnea as there are multiple studies that show sleep apnea contributes greatly to heart rhythm disturbances.

I found out I stopped breathing between 18-20 times per hour.

I started cpap therapy and the frequency of pvcs reduced by 80% early.

If I get cocky and stopcpap they're back in days.

Google "sleep apnea and pvcs"
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