PVC?

[jerl]

Doctor, I am in distress. I am 21 years old, 5' 7" 175 lbs. I was 220 lbs in December so I have lost a lot of weight. I have been having this sensation in my chest for a few weeks now. It happens all day, everyday. It is as if my heart stops and then there is a very hard thump that catches me off guard every time it happens. It takes my breath away. I kind of want to call it a spasm or hiccup in my heart. There is sometimes a little pain around the chest area. It is scaring me so much. The doctors all say I am too young to have heart problems. But it is there and I am not making it up.

Please Doctor, what is this? I have been to the ER twice because of them in the last week. They never catch them on the ECG. I am having an echocardiogram today.  Could this be what they call a PVC? Am I in danger of this developing into an arrhythmia? They happen all day, sometimes harder than others.

I have had a chest CT due to doctor's orders from a chest X-ray. The results read I have a abnormal left mediastinal and hilar lymphadenopathy with nodular infiltrate in the left upper lobe. The doctors suspect its a minor fungal infection and are watching it. Could this have anything to do with my heart though? Is it a coincidence that I am having heart palpitations like these and this lung thing at the same time or are these related?

I appreciate your help doctor. Thank you for reading.

[yoopertom]

It sounds very much like a PVC. A premature ventricular contraction (PVC) is not a skipped beat but a beat initiated in ventricular area of the heart as opposed to where it should originate from the sinus node area. The heart senses the origination of the beat as incorrect, cancels it and initiates a signal from the proper, sinus node, area. The cancelation may feel like a pause, and the proper beat may feel stronger than normal thereby the so called pulsing sensation.

Doctors will tell you that everyone has an irregular heartbeat. For some reason we become sensitive to them and they can cause us anxiety. The best thing to do is have your regular doctor set up an appointment with a cardiologist and have the situation checked out. The most common means of finding out the situation is to wear a Holter monitor that will record your heart over 24 hour period. Rest assurred, there are plenty of us "irregulars" out here, and we have learned that if there is NO underlying heart damage from disease or a heart attack the irregular beat is benign. In other words it will cause you no harm. That said, depending on your emotional make up you may find that sufficient, others may suffer from some anxiety or even panic attacks. You do NOT have an arrhythmya problem. Some doctors may initially prescribe a beta blocker as it tends to slow the heart rate and quiet the PVCs, however they are not dangerous. The fist step is however, to check it out. Ask your doctor to refer you to a cardiologist who is aware of the anxiety irregular heartbeats can cause a person. How do you know, ask, call several cardiologists and discuss it with their nurse then have your doctor refer you to one you are comfortable with.

Good luck.

Tom

Good Luck

[Michael J. McWilliams, M.D.]

BTW, the fungal infection is probably histoplasmosis depending on where in the country/world you live.  It often does not require immediate therapy depending on whether it looks acute or chronic.

[Michael J. McWilliams, M.D.]

It sounds like a PVC but the only way to know is to catch it on a monitor and correlate it with symptoms.  Your doctor can order a Holter 24 heart monitor to answer the question.  If you have a normal heart on echo and a normal EKG, extra beats are not dangerous but can cause significant symptoms.  Heart problems that are dangerous are very rare in your age group.  The EKG, echo, monitor and history and physical evaluation should answer the question.

Fungal lung infections are pretty rare.  I think I would ask your doctor more questions about why you would have one.

I hope this helps.