PVC's

[canadianwithquestion]

Would 10 to 15 pvcs a day in a normal heart be normal.  I feel skips, flutters and bangs about 10 to 15 times and day and my doctor says that if she was hooked up to a holter she would have the same amount.  I have only had documented pvcs and pacs and they are not concerned.  I am very worried about these though.  I have had them for years and I still hate feeling them.  At times they feel like a zap in my heart and other times a couple of quick beats and a bang and other times just a bang.  There seems to be so many different feelings I have with them.  My doctor says that everyone gets them and some people are just overly sensitive to them.  I have a very high anxiety level about them though.  I do take an antidepressent because of my stress over my heart.  Should I pusue this further or should I really just drop it and not worry.  I just don't want to drop dead from these things and feel they are missing something.  They also gave me an echo test and a thallium test.  40 year old female in good health.  These are really controlling my life and I just want to drop my worry over them.  Could my doctor be missing something or what are you feelings on this.  Thank you.

Connie

[Michael J. McWilliams, M.D.]

there was an article in JAMA that showed an increased risk of cardiovascular events with faster heart rates.  Academic physicians study everything.  That is what they do and how they make their careers.  They will always be coming up with conditions that are associated with increased cardiovascular risk. The problem is that heart rate and PVCs are objective information that you can focus on, quantitate.  My advice is always to focus on the things you can change rather the ones you can't.  Diet, exercise, no tobacco, moderate alcohol, control diabetes, hypertension and cholesterol.

It is safe to say that you are not a significantly increased risk but there is a statistical increased risk.   I try to answer them honestly and do not think there is any reason for alarm.  

Happy holidays

[Michael J. McWilliams, M.D.]

Correction, the JAMA article was about increased heart rates.  The PVC data is older than that.

[tickertock]

I understand the way people feel, but HTN, diabetes and high cholestrol are probably associated with a much more increased risks for cardiovascular events than PVCs, while some studies show that persons with PVCs are STATISTICALLY  at a slightly increased risk for cardiovascular events it doesn't necessarily mean that the PVCs themselves are dangerous but could be used a marker for  slight increased risks, bottomline just about everyone has PVCs at sometime or another so no one is without risk PVCs or no PVCs, yet the finding has to be acknowledged even though long terms studies suggest no "significant" risks for having PVCs with a otherwise normal cardiac evaluation. Its a kind of "grey" area and most doctors don't even want to speculate Dr. MJM was just being frank and honest, this is abosultely nothing to worry about in my opinion. Happy Holidays everyone.

[jkfrench]

Boy, I agree with finetilthree.  We have seen posts with people saying they have thousands of skips a day and every doctor that ever responded said it will not hurt our heart.  This person says she only has 15 or so and you are saying there is an increased risk of cardiovascular events.   For people like use, you may have just said we will HAVE a serious event because of the skips.  
UGH

[finetilthree]

Wow, after reading this forum for a year and a half now, this is the first time I have read that there actually IS an increased risk of cardiovascular events.  Seems that there will always be conflicting information if you read long enough.

[Michael J. McWilliams, M.D.]

This is a very common question.  If you have a structurally normal heart, normal EKG and other wise normal history and physical exam, there is only a slight increased risk of cardiovascular events.  I agree that you are more likely to ruin your life by worrying that something is going to happen than to actually have something happen.  You need to find a way to move on. Consider a second opinion, if the second opinion agrees, you need to move it before it ruins your life.

Good luck and happy holidays.