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PVCs, Bradycardia, and Diastolic Hypotension

23 y/o M, insignificant cardiac history, family history unkown.

Well, the title does a good bit of explaining. A couple of weeks ago, I was sitting right here, screwing around on my computer, and I felt a fluttering kick in my chest. I sat up and thought to myself, "That felt like a PVC." A few seconds later, I felt another one, and another after that. They were irregular. To give a background, I've been known to throw PACs due to stress, caffeine, nicotine, and the like, but I've never had noticeable bouts of PVCs. This continued on for a while, and since it was of such rapid onset, and there was mid-sternal discomfort, I decided to go to the ER. When they put me on the 12 lead, I was looking at the monitor. Most of it was normal sinus, but then I started seeing irregular PVCs show up (They looked odd though, almost like they were sitting on top of a QRS). I believe they were unifocal, but I couldn't get much of a detailed glance at anything but the 3 lead because these brilliant people don't like printing strips. I also noticed I was quite bradycardic. My RR was hanging around in the low 40's for quite some time, and I was hypotensive with a diastolic in the mid to low 50's. It seemed I would brady down, throw a PVC, come back to a rate in the low 60's or so, then brady down again, ad nauseum. I also felt what could be regarded as sinus pause, and a few times I thought I caught it on the monitor, but I certainly felt it. The doctor copped it up to nothing more than palpitations and an athletic heart, but I have yet to buy that. My resting rate is usually 70 something. This was an acute onset that has continual persistence, it wasn't asymptomatic due to the angina, and later on, fatigue and occasional mild dizziness, and not to mention, I'm not a marathon runner, but am somewhat sedentary, so his diagnosis seems more like CYA mixed with end of shift syndrome.

Anyways, I had a 48/hr Holter done, and have yet to get anything back from these people, despite having called quite a few times. (They're well known for procrastination)

Until recently, I was consuming large amounts of caffeine via energy drinks, and was a moderately heavy drinker. I still smoke, but am working on quitting. I'm thinking this could either be some manner of node issue, or, heaven forbid, HCM. Either way, the last thing I want to deal with is the worst case scenario due to complacency by the doctors. I have a tendency to like living.
4 Responses
1807132 tn?1318743597
The first thing I will say is there was any risk of danger on your holter they would not wait so it is a good sign they are being less urgent at getting back to you.  The other thing I will ask is if you gave up the caffeine prior to the episodes?   If you use to consume large amounts of caffeine and now don't that can affect the heart rate.  It may just need a bit of time to adjust to not having the caffeine crutch.  A sinus pause is typical with a pvc as well mine can come with some chest pain but angina from what I understand is an squeezing chest pain and I believe it is quite strong.  Is that what you feel?  My pvcs feel more like a stabbing pain or sharp pain as opposed to a squeezing.  I assume you got the holter from a cardiologist.  I would just be persistent with them about your symptoms if they persist.  In an otherwise healthy heart ectopic beats are no danger unless we have upwards of 20,000 or more a day.  But if our heart is structurally normal then we really just have to learn to live with them.  Watch the biggest triggers which are caffeine, stomach issues like acid reflux and stress.  Well best of luck getting a handle on them and keep us posted on how you are doing.
Avatar universal
My results came back. Apparently they didn't feel like telling me that they gave them to my doctor. I also flip flop between hyper and hypotension. Like between 150/85 to 110/48, however i stay bradycardic. My doctor said he'd run some tests, which he forgot to do, and after hearing a few pvcs when ausscultating, he gave me propranolol 60mg. My concern with that is that the main contraindication is sinus bradycardia. I have sinus bradycardia. I dont like that prospect. He's either right, and I'll be ok, or he's wrong and best case scenario is I'll wake up in the hospital.
Avatar universal
Bradycardia is a side effect of taurine. New studies out. My heart rate has been low. Doctors don't seem to like to read new studies. Saw a cardiologist and an endocrinologist. I have no blockages in my heart and I used to work out regularly until this. I'm quitting the energy drinks this weekend. Will let you know how it goes. Google taurine, reflexive bradycardia. Lots of ittnfo out there.
Avatar universal
Since all your electrocardiograms seem to look fine i don't think there is anything wrong with your heart. I assume the auscultations have been fine too.

It more seems like there is something wrong with the signals to the heart. I mean the heart only does what the nerves tell it to do, right?

You could perhaps benifit from seeing a neurologist specialized in the autonomic nervous system.

It could also be that something is wrong with your baro reflexors for example.

Or systemic, like hormonal, hypothyroidosis, low cortisol, pheocromocytoma, etc. A good doctor specialized in internal medicine might be good to consult for this.

Sometimes the body does strange things. A thourough check up will at least exclude the most dangerous causes.

Take care
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