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Are My Ectopic Heart Beats A Cause For Concern?
Question: Hi there. I have a long history of palpitations. I have been having them since I was 19 and am now 36. I have had them checked out 3 times and it always comes back as begnin skipped beats (PACS I believe). I also have a severe health anxiety disorder which makes it hard for me to accept the benign nature of these palpitations. I recently am going through a bout of health anxiety and had them checked out again. I had an ekg, Echo both normal. I wore a loop monitor for two weeks and it just picked up occasional skipped beats. My cardiologist said to ignore them and carry on. I also felt one while exercising and again my cardiologist said to ignore it unless there was an obvious increase in them upon exertion. I am finding myself scared to exercise. Is it normal in my situation if I feel an occasional skipped beat during or upon recovery from exercise. My cardio says it's fine but I've read some scary things online about feeling them upon recovery being dangerous. I feel completely fine while exercising. I had a stress test four years ago and it was completely normal. My cardio is more concerned about my anxiety than my heart as I having a hard time accepting this begnin nature of it all. Can I truely stop worrying and continue on with exercise. He said I didn't need a stress test again unless I feel a lot of them. What would a lot be? Thanks XXXXXXX
Brief Answer:
Your ectopic heart beats are quite insignificant.
Detailed Answer:
Hi XXXX!
I am returning again to answer your question, as I believe that the most important part of dealing with your persistent fears (regarding ectopic beats during exertion), is to build a solid and coherent judgement on the clinical importance of extra-systolic events in young adults.
In clinically normal young adults (asymptomatic, normal resting ECG, normal heart structure (confirmed by echo), ectopic beats are found in nearly half of exercising individuals. These ectopic beats (mainly PACS) could not be a reason for limiting physical exercise, nor represent they a harbinger of a more complex life-threatening cardiac arrhythmia. So, by several clinical studies, when an organic basis (carduiomyopathy) doesn't exist, ectopic beats lack clinical significance and should be ignored.
If more frequent ectopic beats are found during exertion (more than an average of 6-10 PACs/min, then a systematic investigation of responsible endogenous or exogenous triggering factors should be ruled in/out.
First, some exogenous stimulants, like alcohol, caffeine, smoking (even passively), illicit drugs, etc should be avoided if they are confirmed.
From the other part a catecholaminergic over-stimulation of cardiac receptors should be sought by confirming excessive blood levels of circulating catecholamines during exertion; or other possible endocrine disorders, like abnormally increased thyroid function, etc.
Stress and anxiety may be classified as both endogenous and exogenous arrhythmia triggering factor with a considerably importance of driving such a frequent extrasystolic arrhythmia.
Regarding your so feared ischemic heart disease, I definitely exclude form being part of your cardiac physiology intrusion, as there are no minimal medically based evidence to support it. I spend a lot of my clinically daily practice caring for ischemic cardiac patients, and I declare with a firm determination, you absolutely have no chances of being part of such a unlovable club (cardiac ischemic disease). So, just relax! I would not like to complicate our discussion with technical term regarding what is a really important arrhythmia to consider, but you have t believe me.
Hope to have been helpful! Greetings!
Your everlasting,
Dr. Iliri
Your ectopic heart beats are quite insignificant.
Detailed Answer:
Hi XXXX!
I am returning again to answer your question, as I believe that the most important part of dealing with your persistent fears (regarding ectopic beats during exertion), is to build a solid and coherent judgement on the clinical importance of extra-systolic events in young adults.
In clinically normal young adults (asymptomatic, normal resting ECG, normal heart structure (confirmed by echo), ectopic beats are found in nearly half of exercising individuals. These ectopic beats (mainly PACS) could not be a reason for limiting physical exercise, nor represent they a harbinger of a more complex life-threatening cardiac arrhythmia. So, by several clinical studies, when an organic basis (carduiomyopathy) doesn't exist, ectopic beats lack clinical significance and should be ignored.
If more frequent ectopic beats are found during exertion (more than an average of 6-10 PACs/min, then a systematic investigation of responsible endogenous or exogenous triggering factors should be ruled in/out.
First, some exogenous stimulants, like alcohol, caffeine, smoking (even passively), illicit drugs, etc should be avoided if they are confirmed.
From the other part a catecholaminergic over-stimulation of cardiac receptors should be sought by confirming excessive blood levels of circulating catecholamines during exertion; or other possible endocrine disorders, like abnormally increased thyroid function, etc.
Stress and anxiety may be classified as both endogenous and exogenous arrhythmia triggering factor with a considerably importance of driving such a frequent extrasystolic arrhythmia.
Regarding your so feared ischemic heart disease, I definitely exclude form being part of your cardiac physiology intrusion, as there are no minimal medically based evidence to support it. I spend a lot of my clinically daily practice caring for ischemic cardiac patients, and I declare with a firm determination, you absolutely have no chances of being part of such a unlovable club (cardiac ischemic disease). So, just relax! I would not like to complicate our discussion with technical term regarding what is a really important arrhythmia to consider, but you have t believe me.
Hope to have been helpful! Greetings!
Your everlasting,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr ilir. I'm sorry I'm just having a super bad anxiety day where my fears are overtaking rationale thought.
Is that 6-10/ minute only when at rest, exercising or on recovery. Also would that be if it were persistently like that all the time after or during exercise. Say one day I have 2-3 / minute and then a week later have 8/ minute is that ok. Does it have to be persistent and frequent. I've never had that many in a minute ever. Today I've had I palps at rest. I exercised and had none during or on recover. I guess I want to know if it were a problem associated with exercise would it happen most likely all the time and not sporadically. If it happens sporadically is that ok?
Is that 6-10/ minute only when at rest, exercising or on recovery. Also would that be if it were persistently like that all the time after or during exercise. Say one day I have 2-3 / minute and then a week later have 8/ minute is that ok. Does it have to be persistent and frequent. I've never had that many in a minute ever. Today I've had I palps at rest. I exercised and had none during or on recover. I guess I want to know if it were a problem associated with exercise would it happen most likely all the time and not sporadically. If it happens sporadically is that ok?
Brief Answer:
Your scarce PACs are not going to harm you.
Detailed Answer:
XXXX!
When ectopic beats keep appearing so frequent, it would be necessary to consider a diagnostic as well as a therapeutic option.
But as you are experiencing very scarce PACs time after time, and also any when exercising, it's not worth to consider them as dangerous. Just relax!
I still believe that your scarce PACs are generated by increases anxiety.
So, anxiety is making more complex, exacerbating those ectopic beats and associated fears.
Those sporadic unpleasant feelings do not impose a dangerous threat to your life.
You just need to get used to this idea.
Wish you a pleasant evening,
Dr. Iliri
Your scarce PACs are not going to harm you.
Detailed Answer:
XXXX!
When ectopic beats keep appearing so frequent, it would be necessary to consider a diagnostic as well as a therapeutic option.
But as you are experiencing very scarce PACs time after time, and also any when exercising, it's not worth to consider them as dangerous. Just relax!
I still believe that your scarce PACs are generated by increases anxiety.
So, anxiety is making more complex, exacerbating those ectopic beats and associated fears.
Those sporadic unpleasant feelings do not impose a dangerous threat to your life.
You just need to get used to this idea.
Wish you a pleasant evening,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
if they were caused by an actual problem I would feel them more consistently and always with exercise instead of sporadically correct?
Brief Answer:
It's quite correct!
Detailed Answer:
You are right XXX!
A persistent problem would yield very frequent arrhythmia event, and for sure other associated clinical symptoms.
But. fortunately, it is not the case with your healthy heart.
Greetings!
It's quite correct!
Detailed Answer:
You are right XXX!
A persistent problem would yield very frequent arrhythmia event, and for sure other associated clinical symptoms.
But. fortunately, it is not the case with your healthy heart.
Greetings!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Once again you are incredible and wonderful!! Thank you so much.
Brief Answer:
You are welcome!
Detailed Answer:
Dr. XXXXXXX
I will be always happy to answers to all your uncertainties!
Best wishes,
Dr. Iliri
You are welcome!
Detailed Answer:
Dr. XXXXXXX
I will be always happy to answers to all your uncertainties!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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