Strange heart ryhthm

[nonamist]

Hello,
I'm 17 years old,male. Don't drink or smoke.About six month ago, I had very strange feeling in chest but can't explain into English what it is. [Sorry, English is my second language and I'm not good at it]  It lasted few seconds. In my PE class, I played badminton (only 1-2 min) and then I felt like something jerk(maybe skip) in my heart so I can't play any longer. [It happened 4 times]. I sometimes get cough when I stand up or sit in bad posture. I think it is PAC or PVC so I ignore them.Unfortunately, one day in my chemistry class, I had very strange heart rhythm and I’m sure that it is not a Single PAC or PVC. It just like my heart beat 2 steps, normal one and followed by slightly lighter one every beat. It lasted for 10 second and then disappeared .No other symtomps during that episode. I had it again 1 time after that day so I went to see cardiologist. I had holter moniter test for 24 hours and I had only 7 PAC and 3 late beat. [I didn’t have that weird episode during holter test]. I don’t have that episode again in the past 6 month but I do have skipped beats every day. The doctor put me on echo test and the result is redundancy Mitral valve prolapse, mild MVP with trace MR.The others are normal.Yesterday I had that episode again and it lasted for 10 second s after I had stood up.
My question is
1.Can this weired episode be bigeminy? or Gallop rhythm?
It’s regular and beat in same pattern, beat-beat, beat-beat, beat-beat [it beats in different area, sometimes is on the top one and lower one(the second one is slightly lighter)The rate is nor fast(don't include second beat).
2.Having pac or pvc during exercise is strange or it can be a serious underlying heart problem?
3. Does redundancy MV, trivial mitral valve prolapse, trace MR is bad condition and progress with age? My heart don't have murmur sound too.
Thank you

[nonamist]

I'm going to see cardiologist soon about my symptoms to ease my mind. After reading your post, I feel more relax. My Qtc on my 2 EKG are 426 428. My first cardiologist  didn't say anything about it. The second cardiologist said something but I'm not sure it is the QTc. He said a little high but in normal limit.

Thank you very much again

[nonamist]

Thank you very much

[Marie M Gleason, M.D.]

Dear nonamist:  you are describing several different issues.  First you can feel occasional skipped heart beats.  You have seen a cardiologist and had a thorough cardiac evaluation including a  holter monitor and echocardiogram.  Mitral valve prolapse is generally a mild heart valve condition, but some patients do experience some palpitations as you describe.  Single premature beats from the atria (PACs) or ventricles (PVCs) may be annoying but are not going to alter the cardiac output.  Even bigeminy is not going to alter your cardiac output significantly.  You should check with your cardiologist to make sure that your corrected QT interval is normal on your baseline electrocardiogram (ECG).  Some patients with mitral valve prolapse have a prolonged QT interval that can predispose to potentially dangerous rhythm problems that need medication and /or defibrillators.  Your cardiologist would be aware of this condition, and likely would have told you about it if there were concerns on your ECG.  
As far as the chest pain is concerned, it sounds non-cardiac in nature.  When pain occurs at rest, it is usually not cardiac in nature.  If it is worsened with taking deep breaths, it is also unlikely of a cardiac nature.   The fact that your Emergency Dept visit showed a normal ECG and chest x-ray also supports that your pain was not heart related.  A tiny spontaneous pneumothorax would be just that- tiny.  And of no major consequence.  
It sounds like the cardiac work up so far has been reassuring. If you feel that exercise is difficult due to your palpitations, then an exercise stress test might provide further information. You should keep yourself well hydrated (at least 40 ounces of fluid daily) and avoid caffeine. It sounds like you are getting very anxious about your symptoms, and reading about many different causes of such symptoms.  Anxiety can only make your symptoms worse.   Please discuss your concerns with your cardiologist so that you can get your questions answered.

[nonamist]

Sorry,
There have something I want to ask more.

I have 3 times experiencing bad chest pain on the left side. First is one after my military class( I don't know in English [Where I'm live, teenage boys have this class crawl with my left arms and then I have severe pain in my left chest pain. After the sharp pain in chest I have pain on my shoulder and arm ( it's not the same kind of pain). I don't go to hospital in first time. After that 4-5 months, I sat in my school and then I had pain in chest again for no reason. The pain increase when I breath in so I can't take a deep breath.(I don't know if it is the same as shortness of breath). I think I can take a deep breath but it too pain so I don't deeply breath in by myself. This time I decided to go to hospital and I did an EKG. The first doctor said that normal but my second ( maybe third or fourth)  cardiologist said it's not all normal. He said I had sinus arrhythmia but nothing to do with it.
Last one, I had pain(not sharp at all) on my left arm and back for no reason in morning and afternoon. In evening the pain disappeared but when I lie down or bend ,I have very chest discomfort ,my heart doesn't beat in proper sound and the pain come back suddenly. This happen only when I'm lying down and it is very strange. I went to hospital and do EKG the doctor said it was fine and chest X ray was normal too. He listen my chest while I was sitting and I'm sure that he can't find nothing wrong if I don't lying down. It lasted for 3 days and then disappeared.I had to sleep on my right side when I had it.

Can this chest pain be a spontaneous pneumothorax? If the hole is too small ,chest X-ray can be miss to find it out?
Does this relate to my skipped beat or MVP? All of this happen( include skip beat) in last year. It really brings my life depressed. Although I see many cardiologists , but I don't know even what I'm experiencing. I get only the same answer that I was fine or normal.

Thank in advance again