skipped beats while exercising

[carrieky]

I'm 31, female, 120lbs. I exercise very regularly (~30km per week of running).  My resting heart rate is ~50 bpm and my BP is ~110/60.  Recently, I've been getting stabbing chest pains. Nothing too painful, but otherwise just annoying.  In fact i would say on a scale of 1-10, the chest pains would rate about a 1 or 2.  In addition to this, I've been noticing some skipped beats while exercising - not too often, maybe 4 skipped beats in the past 3 months - 2 while exercising and 2 at rest.  I did the full cardio set of tests - ECG, echo, stress ECG, blood tests, and all came back perfectly normal except for highish cholesterol.  Dr says that i'm perfectly healthy and should live a long life, and that my slow heartbeat is natural for an athlete/ runner.  He says chest pain is not cardiac in nature due to it being stabbing (versus dull pressure /crushing), fleeting, and localized (ie. i can pinpoint the location of the chest pain).  I never got to mention the skipped heartbeats to him, until i was reminded off them after my visit while I was going all out on a run to celebrate that nothing was in fact wrong with me.  Should i be concerned about the skipped heartbeats?  It was terrifying whne it happened!! Please help.  Should i consult with doctor again?  I have a marathon coming up soon, and now don't know what to do.

[carrieky]

Just an update.  I have gone back to the cardiologist to explain to him about the skipped beats I had been having.  He put me on a 6 minute ECG, and found a single Premature Atrial Contraction in the 6 minute ECG.  He told me that I have nothing to worry about, it could have been caused by extreme stress (I had been so stressed recently), or even a flu (I had the flu 12 weeks ago).  However, when I asked him if I could still join the half marathon (21km) a week from now, he told me to cancel and just rest.  

Is that the right recommendation?  He said that even with PACs i can still run, but he'd rather i not run in my current state (stressed and anxious about everything that's been happening).  What do you guys think?

[carrieky]

Thanks! It's reassuring to hear.  The feeling is just so weird and annoying when it had happened a couple of times, so I had been constantly thinking about it.

[itdood]

It's always a good idea to get your medical advise from a doctor.  4 skips in a 3 months is not many, I can't think of anything you could possibly do to prevent these skips, as they are just too fleeting to identify any triggers. They are probably PVCs and completely normal.  Hook up 10 healthy adults to holter monitors, and 6 of them will have isolated PVCs.  It's very common.

The skips intrinsically are not harmful.    They sometimes can mean something else is going on with the structure of your heart.  You've had the proper tests done to rule those out.  If your doctor gives you the all clear to run your marathon, do it.