Heart Palpitations

[TSquaredUA]

I was diagnosed with heart palpitations a year ago. I'm 22, in great shape and normal BP. My dad has arrythmias in which his pulse increases and he has been diagnosed with an enlarged heart and was born with a heart murmur. He is overweight and has high blood pressure.

I've had 2 EKGs, a chest X-ray, blood tests, and an echocardiogram done. The EKG showed I was having PVCs. All the other testing came back normal. I was officially diagnosed with benign PVCs. They occur about twice a week. They can occur when I'm stressed, after a night of heavy drinking, or after working out. I assume the triggers of my PVCs are increased adrenaline levels (which explain 2/3 of my PVCs) and a low level of magnesium (which explains why I get them after heavy drinking).

I recently have been afraid to workout after reading about HCM and sudden cardiac arrest in players after or during exercise.

I also have really bad allergies. I have been diagnosed with asthma, but I've never experienced weezing, so I'm wondering if I was misdiagnosed. I also have heart burn on a weekly basis, which goes away when I take Tums.

My diet is pretty healthy, I try to exercise regularly, and I don't smoke. I am in college so I drink often.

I am worried there is something severe wrong with me despite what my cardiologist says and the fact that my echocardiogram came back normal.

What are the chances I have a heart condition that went undetected after EKGs, blood tests, and an echocardiogram?

Are there any other tests I should have done?

[Mom2four85]

wow sorry for all the typo's...I need sleep and some coffee :P

[Mom2four85]

To rule out HCM your dad or you should go to a HCM specialist just to be safe - I've read the genetics testing is not that reliable so I wouldn't do it

I've been told that an echo will rule out HCM, but I've alsy read later on HCM will show up in an echo that wasn't there previously, that's why it's important to see an HCM specialist

arrythmia's can happen for many different reasons but often because of adrenaline and if you drink alcohol - because alcohol dehydrates your body - so either keep in check how much you drink and/or drink water (yeah pretty gross after alcohol) after and see if that helps - each of us are different with what triggers and the amount of anything we can withstand before symptoms occur so keep track and see what yours are

if magnesium is the problem ask your doctor about supplements or if you have anything else that's causing the low mag. - alot of us suffer low potassium also and eat bananas or take mag supplements or fish oil

get a copy of your results if you didn't - sometimes dr's will not tell you stuff that shows up; and yes they can miss things or just skim over results and not really read them

another thing is to get an exercise stress test - which can be a common problem with HCM patients

[itdood]

If you want you could have a nuclear stress test that will check for blockages or a basic stress test.  Those are nice to load up your heart and watch the EKG.  If you wanted to really push it you could get a cardiac MRI to rule out any muscle wall abnormalities.

If the PVCs were caught on an EKG the doc will know where they came from, what type they are, etc.  That is key information that would point to a more worrisome type of PVCs and warrant more testing.

The things you have going for you:

Young
No symptoms
No worrisome types of rhythms
No family history of sudden cardiac death
PVCs were caught on an EKG so the docs know which type, where they are coming from

I disagree with your take on heavy drinking / magnesium relationship.  Alcohol is a stimulant to cardiac muscle.  It sounds to me like you probably have the run-of-the-mill type of PVCs.  These usually originate in the right ventricular outflow tract (RVOT).  They are the result of something called "enhanced automaticity" in the cardiac muscle cells.  The alcohol stimulates cells that are already prone to being hyper.

Keep this in mind too, cells in the ventricles can fire a beat for a good reason.  This is a backup mechanism in case the ventricles don't receive a signal to beat (which can happen for many reasons).  You won't remain standing too long if the ventricles miss any beats.  This backup beat is called an escape beat.  A side effect to this is that they sometimes do this when not needed and you get a PVC.

Say you could take a drug that would prevent PVCs from ever happening.  Would you take it?  This means that you've disabled your hearts backup by taking the drug...

I can remember getting PVCs as far back as 4 or 5 years old.  I would get very rare fluttery thump in my chest which I eventually learned was a PVC when I finally caught them on tape during a stress test when I was 35.  I'm 42 now.  I've had recent periods with ~4,000 PVCs per day.  Had every test under the sun.  They haven't changed my heart at all.  I keep in decent health.  My advice is to keep taking care of yourself and get checked out every year.