very confused- PVC- PAC - Extrasystoles.

[sleepsleep]

Yeah we are legion, and we fear it. I myself find it silly. but i fear them too. Atm they control me.
Anyways. Ive written before. Waiting for a letter to get here to tell me when i have to show up for a stress test.
Now i know there are many ways we can feel these damn things and some dont feel them at all.
But getting more confused about how mine feels, since others report something different.
Now first of. . .
when i get them when "resting"- Watching tv . . Washing the dishes and stuff thats pretty slow paced, , , It just like a quick light tap inside the chest. (i dont feel missed beat so to speak, i rather feel the larger/extra ones)- but these im kinda okay with. I can get like a 1-3 second panic attack then move on.

But when doing something at a greater pace. . . workout at home. . . Fast walk up town. . . Even sex O.o -
Its much more violent. . . And best way i can describe it is like getting hit from the inside out with a tennisball fired from one of those automatic machines. (not the pain, but the force behind it. )-
These i dont trust.
Also for the reason that they feel like they will continue until i slow down. (jup at recovery i really dont feel anything. . . Only during the "chosen event".- )
So while doing some workout as an example. . .  5-10 minutes in. ..  BAM- Then i stop for a few seconds. . . Decide to try and continue. .  so start again. . .And BAM. . .
Ive tried doing this once a maximum of 4 "BAMS" hehe. But yeah. . . In my mind this cant be right. . .
I mean. . . . it really seams like if i decide to continue, then they will too. . . And while my doc says :" continue! " - i dont really trust it to work out to well in the end. Also. . . im not really winded or tired when it happens. . I feel like I could go on much longer- - - Except for that factor.

But yeah. . .Anyone recognize this?
Cause from what ive read, the most normal thing is to get them at recovery. . .


BTW:
25 male.
EKG done no signs of anything incl extra beats.
HOLTER which for some reason no one can find the results off. but was a long time ago.
Resting heart rate in the morning about 60-70
Mid day  80-90

[is_something_wrong]

Sending you a message in Norwegian, because you are Danish ;) Easier to explain then

[sleepsleep]

hi both of you- Thx for the replies. Yeah this bugs me allot- And know many have this issue (lack of trust in these "BAM"s )- But yet again people (you two) seam confident its nothing serious. That first of all helps calm my mind a bit... How long i dont know, but always counts for something.

Yarrow- thx for the link- Actually had it bookmarked from a search earlier in the past. But yeah. He explains them well. He explains allot about them. So thx anyway for the link.
About getting professional help. well ill admit i think i need it. (im diagnosed with anxiety)- And its kept me out of a job for about 2 years now. But the system is kinda funky here. . .
Ill explain.
I live in denmark- We pay about 40% in taxes (and thats fine so far)- Those 40% go to healthcare and other public services.
But first of it took about 5 years before anyone even suggested I might suffer from anxiety.
Then they gave me access to a professional in the area, who gave me 10 appointments then kick me out the door. Told my doc that really wasnt enough, (not sure if its the average a person needs to get over it, or start to see changes.... but 10x40 minutes really didnt do much here)
So he gave me a new place to start up. . . Got 2 appointments and then got kicked out again. So now all I get is "we tried, so no more options left"- So only options now are - Get over it by myself (sure not impossible i guess)- Or pay for the service myself.
Now I cant complain too much- I get "paid" by the state, cause im currently listed as unfit for work.
But heres how things work for "anxiety diagnosed" people in this country.
You get the standard payout as anyone on welfare (thats really the right name aint it?) -
If I was diagnosed with depression (like one of my friends) - id get about 30% more-
(now he has no interest in getting back to work due to his conditions, so he is actually pursuing the right to get "retired" completely and then get paid about 50-60% more.

So we are really short of possibilities to move on as a anxiety struck person.
Instead if your depressed you get paid more, and even more if you decide to completely give up.  (sure this is just my view, but I really want to get back out there- Work, earn, buy)-
But just feel like its as im running into a tornado, I can run run run, but ill never reach the damn thing.
Also the first guy I had those 10 appointments at, was a real jerk-
First off after the 10 appointments he mailed a statement to my doc(like they always do to tell them how it all worked out)- where it said i didnt take i seriously and often didnt show up.
I showed up to every single appointment, and the proof was my driver- (dont have a license myself. )
+ one time we arrive and sit in the waiting room for about 20 minutes before we knock on his door to hear if hes ready soon- - - He then gets all surprised and confused cause he was suppose to cancel that appointment, while i notice he just filled my appointment in for a other "client". - Thats just wrong.

Anyways. . .haha enough about that rant- Just seams that Anxiety doesnt get the real attention it should.- (sure not saying its nearly as critical as many other diagnoses)- but one major difference mostly is that we "anxiety patients" - Really want to do what we cant,. And really do want to get back out on the streets and work.

Back to the original topic.
Yeah ive figures so much as it doesnt really matter how many show up and such- just bugs me when i hear/read that its a better sign when they show up during recovery then during the actual workout.  But who am I to say who is right and wrong there.

And Is_something_wrong.-  hi again.
Well sorry to say I was never really good at math (math classes i was drawing Manga Babes instead haha)-
So not getting the full picture there.
But i understand the logic in this :
You rest your heart beats slower and calmer.
You do something that requires allot of oxygen (running, weightlifting and so on)- You heart needs to pump more blood around to deliver more oxygen, this it beats faster and harder. So when the usually small "bam's" would show up they would follow the general heart cycle and this be larger and harder.
Still just puts doubt in my mind when they maybe haven't been there a whole day until I start doing a workout and they then show up many times. I dont know. . . .
I myself know its silly. . . just cant really trust them enough to put the to the real test. (like keep going for a full hour when they start just after 10 minutes. . . )

But yeah i know. . .My mind might also make them worse or even help cause them. Dont doubt that.
Lately ive been getting a kinda rush/tickle in the chest. . . Which id mostly feel in the stomach. Feels like a quick release of adrenalin that just rushes through for a quick second. Just bugs the hell out of me.-
Also one thing you guys might be able to help with.

I often think in this particular pattern. . .  If i get over this and move on- how long should one wait between checkups ?
Cause like. . Lately there have been some events where fairly you people have been victims to some extreme things.
A young kid 13- Got a heart attack - (he was resurrected. and this must have been a condition he was born with. )
Then we have the Icelandic singer who had stroke at 29 (no idea if he had some condition)-
Then my guitar teacher who had a heart attack about a year ago age 40-. (Lives but. now he lived kinda with a bad life style. Lived just above a pizzeria, across the street he had a MCDonalds. And he wasnt a drunk of course. But you know, playing concerts, watching concerts go hand in hand with drinking. . . So yeah.- . . Not the most healthy lifestyle.)

What im thinking is. . .Well people say, : well you have nothing to worry about, you have been checked. "-
But how long does such a check make good for?

Like had my teacher had a check up 1 month before, be able to avoid that event?
Or could it be a half a year before the event? ? ?
Yep this is a point 10 on the silly score. . . But this is the way i think unfortunately- think this is like my minds fail-save, where logic fight anxiety.

Anyways,. . .ill try stop writing now haha.
Have it the best, and hope you might have some extra words on this.
S.

[is_something_wrong]

Just so you know; extrasystoles at rest are the most common.

Extrasystoles with activity can be caused by a lot of things, but it's important to differ between PVCs and PACs here. PACs during exercise (which I suspect you have, I'll explain afterwards) are almost always caused by the elevated adrenaline levels caused by exercise, plus, what seems to be your problem, you are anxiously waiting for them while you walk or run or having sex (I did too at one point, result was a really upset girlfriend :p I guess it's a bit of a turnoff that her boyfriend checked the pulse constantly during sex). Poor condition level may also cause PACs during exercise.

PVCs can also have the same mechanisms, but from what I know, doctors get a little more suspicious if you have a lot of PVCs when you exercise. "A lot" means in this setting >10% of all heartbeats.

You notice the extrasystoles better when exercising. That is easy to explain. It's caused by two things, one for extrasystoles in general and one for PACs specificly.

1) Exercise elevates cardiac output and stroke volume. When you get an extrasystole, the heart will fill up even more and next beat feels like an explosion in the chest.

2) This concerns PACs only. After a PAC, the sinus node resets, but before it does, it shakes its head for a short while, like "what was that I just got hit by?" This is the so-called "sinus node recovery time" and the reason you feel a pause after a PAC, and a hard beat after the pause.

To illustrate with numbers (they are just an illustration, not exact numbers):

If your heart rate is, say 60, the heart beats once every second. Then a PAC fires at say 0,6 seconds. Next beat is supposed to occur at 1,6 seconds, but due to the sinus node recovery time, which is, say 0,4 seconds, it occur at 2 seconds. The next heartbeat is 1,4 seconds after the PAC, not 1 second (40% longer)

Problem is, this recovery time isn't decreased proportionally with the heart rate. If you are running, your heart rate is, say 180. (one beat every 0,33 seconds). Let's say a PAC fires after 0,25 seconds. Next beat is supposed to occur at (0,25 + 0,33 = 0,58 seconds) but the recovery time may still be 0,4 seconds, so next beat occurs at 0,98 seconds. The delay / pause is (0,33 + 0,4 = 0,73 seconds) which is 121% longer, and during that time, the heart is really filled up with blood, causing a huge BAM!!!! in the chest.

I hope this was somewhat explaining. Great answer by the way, yarrow, and John Kenyon seems like a really helpful person. Just a shame he doesn't work there anymore.

Good luck on the stress test!

[yarrow]

Unfortunately, you are going to have to do two things:

One is to research the heck out of PVCs and extrasystoles, because no one can do this for you.  We can give you links and so on, but you have to read them (often repeatedly), and come to understand them.  Unless you want to be left at sea, this is going to lead you to some pretty complicated stuff about the anatomy and physiology of the heart.  It's not rocket science, and it can be understood by regular people, which leads me to:

The second item, which is that it's going to take time--lots of time--to experience your odd heartbeats and understand and accept--at your very core--that in the absence of heart/vascular disease, what you're feeling is NOT dangerous.  This is the hardest part, because of the emotional component.

If you're brave and forthright and are willing to entertain the idea that emotions are involved, a good psychiatrist can help enormously, but this is a concept that is very difficult for those of us who feel these beats and in a sense would prefer them to be a dangerous physiological phenomenon rather than an emotional problem.  

In the meantime, type this into your google search box:

cardiology/forums/backup/topic-24286.html

It will lead to you to a description of PVCs by John Kenyon, a cardiac tech who writes about cardiac problems in a way that is user-friendly.  He posts at a site that we cannot link directly to here at medhelp.  One of the things he emphasizes is this:

"There's little correlation between the perceived force, number, etc., of them, and the actual characteristics of a given PVC."  

In other words, particularly if you're young and if your heart has been tested and found normal, the special details of what you feel with your unusual beats is, incredibly enough, not very important.