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14991338 tn?1447193706

do i need to see a different E.P?

I have seen one E.P in the last year at a very credible heart specialist hospital.
I understand I have seen the best type of cardiologist for my symptoms, however I feel they are somewhat rushed and I leave without asking all my questions.

I had a 24 hr holter monitor - revelaed PACs and a supraventricular beat
Followed by a 48hr holter 8 months later due to ongoing symptoms - revealed minimal pvcs
I then had an echocardiogram - showed nothing dangerous and no sign of MVP
I then had a stress test on the treadmill, and blood pressure seemed good and heart rhythm was good

I STILL get the exact same symptoms that brought me there in the first place, and I'm still worried!
I believe somewhere that not enough time has gone into explaining to me what's going on.

Do I re book an appointment.
9 Responses
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1807132 tn?1318743597
Based on what you have described I don't suspect anything will come of it but if it makes you feel better you have the right.  Unfortunately finding out why we have these extra beats can be a fruitless pursuit and to some degree I am not totally sure the medical community really knows.  It seems as though once a spot in the heart has flared off an extra beat then it is sensitive enough to do it again for really no good reason.  I would say work on stomach issues, avoid caffeine and manage stress and anxiety and see if that helps.  The more you obsess about them the more you will notice them and they will take over your thoughts leading you into fear.  Your heart has been fully evaluated to be very sound and healthy which means what is going on is of no consequence to your well being.  You are not in danger due to the extra beats.  They feel disconcerting but they are not a danger in an otherwise healthy heart.  That is the main thing to keep in mind.  If it makes you feel better maybe keep a journal of what is going on to see if you can uncover a pattern, maybe a certain food that seems to coincide with you getting the extra beats or times when you feel stressed.  This might help you start to feel like you are taking control of them instead of them controlling you but it is important that you take steps at not letting them take over your emotional well being.  It won't help the situation.  Stay strong and I do hope that they go away.  For some they just disappear as randomly as they came.  Take care.
Helpful - 0
1124887 tn?1313754891
Of course you experience the same symptoms. Normal test results doesn't help your anxiety in the long run. You can't expect your symptoms to disappear until you get your anxiety treated.

You can't expect your cardiologists/EPs to treat your anxiety. The only thing they can do is to tell you that your risk of sudden cardiac death is extremely low (though not zero, it never is) - probably the same as the normal population. What you need to learn, is to accept the very slight risk that you, like everyone else, suddenly can die, without letting it ruin your life quality. I bet that you accept that you will die at some point, you just don't want it to be now or the next years. Most people suffering from health anxiety (including myself) do.

My advice:
No, don't re-book any appointments.
No, don't see another cardiologist. Stop wasting time and money on more cardiac tests. Your heart is fine, and no reassurance will work for long.
Yes, get your anxiety (and fear of sudden death) treated.

Take care :-)
Helpful - 0
1423357 tn?1511085442
....and that's GOOD advice!
Helpful - 0
14991338 tn?1447193706
thanks for the post michelle. at the moment medhelp community is really helping me, and as close to a cardiologists view as possible due to so many people having a similar problem.

michelle AND is_something_wrong, lets say i threw my anxious history in a bag and binned it, that still leaves a good question as to what to do if one still has symptoms that are alarming, even though the tests say theres nothing wrong.

arent there clear examples of situations where these advanced tests have failed before, and on individuals that dont even report symptoms unlike me.

bill clinton - nuclear test a few weeks before his death
fabrice muamba - at least 4 ecg's and 1 echocardiogram in 4 year span.

Now, i understand what you guys are saying but what i have said to my GP is, just because i suffer with anxiety doesnt mean it makes me immune to a hidden cardiac issue. Not all chest aches i have or ectopics are a result of anxiety.

ive had so much therapy so far. CBT. exposure therapy. relaxation techniques and a shed load of meds.

i do not suffer any other form of anxiety, social, heights or other health worries, just heart
Helpful - 0
1124887 tn?1313754891
My point is, even though you have symptoms, you don't need to worry about them. You do have some ectopic beats and rapid heart rate, but probably everyone does. The problem is that when focus is drawn towards the heart, you will feel (and fear) what others ignore or just don't notice. Most people with health anxiety focus on one part of the body. I've never feared cancer, lung diseases or kidney failure. I focus on the heart too, and sometimes on mental health (fear of going crazy, fear of harming myself, etc.). The latter started in 2012 and more or less replaced the heart fears for a couple of years.

CBT should be focused on the fear of sudden death and accepting your own mortality. Relaxation techniques may be a useful add on but it doesn't treat anything.
Helpful - 0
14991338 tn?1447193706
once again , thank you for the response

i understand what you mean. for example i could of been having these abnormal beats for years through exercise but because mentally i haven't ever noticed them i wouldnt of thought i ever had them!

its so frustrating. when they occur at rest i completely ignore them! they dont ever worry me! but when they occur during exercise they really concern me!

where do these stories of mis diagnosis stem from?

for instance long qt is a biggy in my anxiety at the moment. with having recovery pvcs or pacs whatever they are, they worry me. the rational side of me understands that if the stress test showed nothing then its very very unliekly that if i did suffer a abnormal rhythm that it would show and tell when it wants. it would of shown
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Avatar universal
Go and re read over again the post  Is Something Wrong made. Best to deal with your anxiety issues.
Helpful - 0
1124887 tn?1313754891
I think, during my time on MedHelp, that I've discussed with hundreds of people experiencing that PACs or PVCs occur during exercise. Everyone worry because "the rule" is that benign ecopics occur during rest and the "dangerous ectopics" occur during exercise. Yes, it is true that some PVCs during exercise could be caused by lack of blood supply in the setting of CAD, which is why doctors do stress testing. However, your PACs and PVCs during exercise (I think those you get during exercise are mostly PACs) follow another mechanism.

During exercise, plasma adrenaline usually increases tenfolds. Which alone can provoke ectopics. In your case, you expect the ectopics to occur, which probably increase plasma adrenaline way more, probably thirty to fifty times the resting levels. You are simply afraid during exercise but you don't notice the panic symptoms as they merge with the normal symptoms of exercise. Also, during exercise the atria are dilating way more, they are responsible for 40% of ventricular filling, during rest only 10-20%. This stretching of the atria can, together with adrenaline, cause ectopic beats.
Helpful - 0
2 Comments
thanks for explaining things. i will be addressing my anxiety once again with some more therapy. the issue i have now is that i have looked online so much at symptoms of HCM or LONG QT or ARVD that im stuck with this information in my head. so now when something abnormal happens i access the part of my brain that remembers the symptoms related to them. what i find really really difficult is the fact of athletes being screened and something still happening. as for you explanation on the plasma adrenaline, i agree completely on the fact i do pre-precipitate them to happen before exercise, but why do they happen in runs or very close together when my exercise is more intense. To me, its my heart screaming its under strain and isnt happy.  
all anxiety aside, i dont think they have ever ever happened at rest like they do during exercise sometimes. during exercise i mean within 10-60 seconds of stopping the movement involved.
1807132 tn?1318743597
Bill Clinton, the former president of the United States or a different guy??  The former president isn't dead as far as I know.  Is Something Wrong has way more knowledge on these things than I do but in general from what I have learned, a missed diagnosis is pretty rare.  
Helpful - 0
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