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Does Anxiety Cause Premature Ventricular Contractions?
Question: Dear Dr Iliri,
It is OCD XXXX, and less than a week since echo, I am considering a trip to the doctor, but my cardio says all is well and my EP is not concerned. I need your honest advice about if I am just far too sensitive due to my past history and my anxiety issues, or if I have a real concern.
Two weeks ago, I felt a few isolated PVCs and was very very frightened by them. Although my need to check my pulse waxes and wanes, over the past year, I have not felt many PVCS and my heartrate has usually been very steady, always in the low 50s at rest and I haven't felt heart racing normally. A few times I have noticed periods where my heart seems more "irritable" and my heart rate is much more variable- times when my heart seems to go too fast just from a few flights of stairs or sometimes for no reason. But then it generally settles down quickly. When I badly cut my hand in XXXXXXX I noticed fast heart rates once in a while for a few days.
This time, though, even though my echo was fine, I am still experiencing episodes where it seems my heart is going too fast for no reason. Out of the shower, for instance, heart can be at 100. Just while making lunch, 100. Watching a movie this evening it was 74, when usually it would be 60 or lower. Right now, I have been running up and down stairs, doing housework but have now been sitting in bed for 10 minutes and it is 77. I have attached photo of app that took my heartate. It looks like there were PVCs too (?) although I didn't feel any in my chest. I believe in the next hour, as it has the last two weeks, it will eventually go back down to 55-60, and will be be 50-55 in the morning. However, before two weeks ago, the minute I was resting in bed, I would take my pulse and it was always 50-60. I generally tried not to take pulse too often but whenever I checked it was in 50s if I was sitting/lying down, and 70s if standing/walking. The last two weeks, it is 65-78 during day resting, and about 90 or even 100 when standing and walking.
My cardio says all is well and it is anxiety. I explained my sudden heart rate changes to my EP's nurse and she said he doesn't think I need to come in unless I have heart rate over 100 continuously at rest.
Do you think this is purely anxiety from feeling those PVCs and this is nothing? That terrible app has been causing me much stress and of course, may not be reliable, but I'm assuming that it pretty accurate, as it has good ratings as compared to pulse oximeter. The Android version does have pulse oximeter and iphone version was tested as just as accurate.
Anyway, assuming that these rates are real, is this something I need to worry about? I have not stopped exercising, changed diet, or taken any new meds, nor do I drink alcohol or coffee or any illegal drugs, or smoke cigarettes. Because my cardio saw me just last week, he told me just to relax as I am totally fine. I want to believe it, but as a survivor of a malignant arrythmia, I am not at all convinced. I am scared this is the beginning of another huge problem.
Do you think I need to insist on an appointment with my EP although he is unconcerned? I am always anxious, as you know, and my life circumstances are very stressful, but other than feeling those PVCs two weeks ago, which scared me, nothing has really changed to cause my heart rate to be faster now.
Please tell me if you think I need to consult with a doctor. Again, later tonight, my resting heart rate will likely be down to 60 or under, but all day it is highly variable, quite often hitting 100 while doing leisurely activities.
Thank you so much for all your help. You save my life so often.
I hope you are well.
Many thanks,
XXXXX
It is OCD XXXX, and less than a week since echo, I am considering a trip to the doctor, but my cardio says all is well and my EP is not concerned. I need your honest advice about if I am just far too sensitive due to my past history and my anxiety issues, or if I have a real concern.
Two weeks ago, I felt a few isolated PVCs and was very very frightened by them. Although my need to check my pulse waxes and wanes, over the past year, I have not felt many PVCS and my heartrate has usually been very steady, always in the low 50s at rest and I haven't felt heart racing normally. A few times I have noticed periods where my heart seems more "irritable" and my heart rate is much more variable- times when my heart seems to go too fast just from a few flights of stairs or sometimes for no reason. But then it generally settles down quickly. When I badly cut my hand in XXXXXXX I noticed fast heart rates once in a while for a few days.
This time, though, even though my echo was fine, I am still experiencing episodes where it seems my heart is going too fast for no reason. Out of the shower, for instance, heart can be at 100. Just while making lunch, 100. Watching a movie this evening it was 74, when usually it would be 60 or lower. Right now, I have been running up and down stairs, doing housework but have now been sitting in bed for 10 minutes and it is 77. I have attached photo of app that took my heartate. It looks like there were PVCs too (?) although I didn't feel any in my chest. I believe in the next hour, as it has the last two weeks, it will eventually go back down to 55-60, and will be be 50-55 in the morning. However, before two weeks ago, the minute I was resting in bed, I would take my pulse and it was always 50-60. I generally tried not to take pulse too often but whenever I checked it was in 50s if I was sitting/lying down, and 70s if standing/walking. The last two weeks, it is 65-78 during day resting, and about 90 or even 100 when standing and walking.
My cardio says all is well and it is anxiety. I explained my sudden heart rate changes to my EP's nurse and she said he doesn't think I need to come in unless I have heart rate over 100 continuously at rest.
Do you think this is purely anxiety from feeling those PVCs and this is nothing? That terrible app has been causing me much stress and of course, may not be reliable, but I'm assuming that it pretty accurate, as it has good ratings as compared to pulse oximeter. The Android version does have pulse oximeter and iphone version was tested as just as accurate.
Anyway, assuming that these rates are real, is this something I need to worry about? I have not stopped exercising, changed diet, or taken any new meds, nor do I drink alcohol or coffee or any illegal drugs, or smoke cigarettes. Because my cardio saw me just last week, he told me just to relax as I am totally fine. I want to believe it, but as a survivor of a malignant arrythmia, I am not at all convinced. I am scared this is the beginning of another huge problem.
Do you think I need to insist on an appointment with my EP although he is unconcerned? I am always anxious, as you know, and my life circumstances are very stressful, but other than feeling those PVCs two weeks ago, which scared me, nothing has really changed to cause my heart rate to be faster now.
Please tell me if you think I need to consult with a doctor. Again, later tonight, my resting heart rate will likely be down to 60 or under, but all day it is highly variable, quite often hitting 100 while doing leisurely activities.
Thank you so much for all your help. You save my life so often.
I hope you are well.
Many thanks,
XXXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear XXXXX,
I am sorry that you are feeling so anxious again!
I totally understand the way you feel after all that you have been going through, but I would explain that these are just some rare ectopic heartbeats related to anxiety.
As I already have told you anxiety is determined as an irrational fear without a specific known stimulation.
Cutting your hand, imposes a great physical and emotional stress for your body. It is quite normal to have an increased heart rate and even ectopic heartbeats in normal and healthy individuals.
From the other hand cooking, climbing stairs are physical stress for the body, leading to loads of adrenaline in your blood.
Besides, your cardiac ultrasound is a proof that you have a normal cardiac function, even though you have been having these palpitations or increased heart rate time after time.
Even though, your application may have registered a PVC, it does not indicate any serious cardiac disorder. It is just anxiety or physical activity.
I assure you that there is nothing wrong with your heart.
It is just functioning normally as it should do.
There is no reason for you to perform additional tests.
Just relax and try to think about beautiful thoughts.
You don't need this application. It is just making you more anxious unnecessarily.
Feel free to ask me again if you need!
I will be always happy to discuss with you about these issues!
Best wishes,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear XXXXX,
I am sorry that you are feeling so anxious again!
I totally understand the way you feel after all that you have been going through, but I would explain that these are just some rare ectopic heartbeats related to anxiety.
As I already have told you anxiety is determined as an irrational fear without a specific known stimulation.
Cutting your hand, imposes a great physical and emotional stress for your body. It is quite normal to have an increased heart rate and even ectopic heartbeats in normal and healthy individuals.
From the other hand cooking, climbing stairs are physical stress for the body, leading to loads of adrenaline in your blood.
Besides, your cardiac ultrasound is a proof that you have a normal cardiac function, even though you have been having these palpitations or increased heart rate time after time.
Even though, your application may have registered a PVC, it does not indicate any serious cardiac disorder. It is just anxiety or physical activity.
I assure you that there is nothing wrong with your heart.
It is just functioning normally as it should do.
There is no reason for you to perform additional tests.
Just relax and try to think about beautiful thoughts.
You don't need this application. It is just making you more anxious unnecessarily.
Feel free to ask me again if you need!
I will be always happy to discuss with you about these issues!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Do these show PVCS do you think? If so, then I think I am having more than rare PVCs as these weird patterns keep showing up, although they all look different. Perhaps I need to insist on holter from EP although he says I dont need to be seen now.
Are you sure that my frequently higher heartrates are just anxiety and not a sign of more serious arrythmia? I am so scared right now. My mother is in hospital from near choking incident and my father fainted in her room. So much stress and chaos but when it happens I immediately think I will get sick again as I first got sick when my mother first got so sick.
Please let me know if these are PVCs as I think I may need to see my EP.
Trying to stay calm but I am in the hospital for my parents and tempted to check myself in.
Thank you so much,
XXXX
Do these show PVCS do you think? If so, then I think I am having more than rare PVCs as these weird patterns keep showing up, although they all look different. Perhaps I need to insist on holter from EP although he says I dont need to be seen now.
Are you sure that my frequently higher heartrates are just anxiety and not a sign of more serious arrythmia? I am so scared right now. My mother is in hospital from near choking incident and my father fainted in her room. So much stress and chaos but when it happens I immediately think I will get sick again as I first got sick when my mother first got so sick.
Please let me know if these are PVCs as I think I may need to see my EP.
Trying to stay calm but I am in the hospital for my parents and tempted to check myself in.
Thank you so much,
XXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
DearXXXX,
I reviewed all your uploaded videos and images and would explain that this application is based on your pulse. It is not based on cardiac electrodes put in the heart region.
I can not exclude the presence of rare PVC, but most of them seem to be just artifacts from the movement of loss of contact.
So, there is nothing to worry about!
I understand the stressful situation that you are going through and every healthy person would react like this.
There is no need to perform a Holter monitoring as it will result normal.
I just recommend you to focus on your anxiety.
During those moments, when your mind is full of stressing thoughts which are pushed forcefully into your mind, try to stop them. Try to think nothing.
Meditation can help you in this regard. My advise during these episodes would be: stop doing everything, close your eyes and take some deep breaths. Try to focus on them for some minutes (you can feel the intensity of the breath, try to focus on the number 1-2-1-2 inspire-expire). If you do this for some minutes, it will help manage the situation.
You should know that the adrenaline released in your blood during those episodes of anxiety is metabolized within 10 minutes by your body. If you meditate for at least 5 minutes, you will be able to make the difference: your heart rate will go down and you will not feel palpitations any more.
But, there is no need to perform further tests. As a cardiologist, I can assure you about that.
Hope to have clarified some of your uncertainties!
Let me know about everything! I will be always here for you!
Regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
DearXXXX,
I reviewed all your uploaded videos and images and would explain that this application is based on your pulse. It is not based on cardiac electrodes put in the heart region.
I can not exclude the presence of rare PVC, but most of them seem to be just artifacts from the movement of loss of contact.
So, there is nothing to worry about!
I understand the stressful situation that you are going through and every healthy person would react like this.
There is no need to perform a Holter monitoring as it will result normal.
I just recommend you to focus on your anxiety.
During those moments, when your mind is full of stressing thoughts which are pushed forcefully into your mind, try to stop them. Try to think nothing.
Meditation can help you in this regard. My advise during these episodes would be: stop doing everything, close your eyes and take some deep breaths. Try to focus on them for some minutes (you can feel the intensity of the breath, try to focus on the number 1-2-1-2 inspire-expire). If you do this for some minutes, it will help manage the situation.
You should know that the adrenaline released in your blood during those episodes of anxiety is metabolized within 10 minutes by your body. If you meditate for at least 5 minutes, you will be able to make the difference: your heart rate will go down and you will not feel palpitations any more.
But, there is no need to perform further tests. As a cardiologist, I can assure you about that.
Hope to have clarified some of your uncertainties!
Let me know about everything! I will be always here for you!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you. I know I must calm down. My own cardio told me he does not wish to do holter as I was fine during exam and echo and everything looked good.
I am trying to be reasonable and remember that my echo was normal and I am generally not feeling PVCs and when I had so many, I always felt them.
I cannot help myself, though, and need to ask this final question, and I vow to delete this app after I ask. I uploaded three images showing the weird beats I often see in this app. In "image1" I sometimes see these sloped wider beats. In "image2" it looks like I'm having many weird beats in a row, and then after those waves, there were normal beats with normal spacing. In "image3", that was my ex-husband during a workout cooldown and he felt a PVC and we see a sharper, longer beat. As this is not a real EKG, could those all be PVCs, or could they just be spacing from heart slowing down or speeding up, or as you said, the camera not picking up the beat?
I know I have to just stop this. I am not scheduled for holter until April and I must trust that I will be okay.
One last question- would echo have shown PVCs? As that took about 15 minutes, if I was having many PVCs, would the echo have recorded them? I believed that the echo had EKG telemetry (if that's what it's called), but I am not sure.
Thank you so much, Dr Iliri. You help me so much. My father is still hospitalized and we remain a family in crisis so I know I have to keep myself calm.
I hope you are well, and happy, and peaceful.
THank you so much,
XXXX
Thank you. I know I must calm down. My own cardio told me he does not wish to do holter as I was fine during exam and echo and everything looked good.
I am trying to be reasonable and remember that my echo was normal and I am generally not feeling PVCs and when I had so many, I always felt them.
I cannot help myself, though, and need to ask this final question, and I vow to delete this app after I ask. I uploaded three images showing the weird beats I often see in this app. In "image1" I sometimes see these sloped wider beats. In "image2" it looks like I'm having many weird beats in a row, and then after those waves, there were normal beats with normal spacing. In "image3", that was my ex-husband during a workout cooldown and he felt a PVC and we see a sharper, longer beat. As this is not a real EKG, could those all be PVCs, or could they just be spacing from heart slowing down or speeding up, or as you said, the camera not picking up the beat?
I know I have to just stop this. I am not scheduled for holter until April and I must trust that I will be okay.
One last question- would echo have shown PVCs? As that took about 15 minutes, if I was having many PVCs, would the echo have recorded them? I believed that the echo had EKG telemetry (if that's what it's called), but I am not sure.
Thank you so much, Dr Iliri. You help me so much. My father is still hospitalized and we remain a family in crisis so I know I have to keep myself calm.
I hope you are well, and happy, and peaceful.
THank you so much,
XXXX
Brief Answer:
My opinion:
Detailed Answer:
Dear XXXX,
Regarding your concern, I would explain that all those images seem to be related to artifacts caused by movement or not a scarse contact.
I don't think they are PVC.
Besides, you should know that PVC can be detected during the cardiac ultrasound very easily. So, I am sure that your doctor would have seen them if they were present, but they were not.
15 minutes are more than sufficient to come into such conclusions regarding PVC.
So, I can assure you that you do not need a Holter monitoring as you are not experiencing any cardiac arrhythmia.
It is all related to anxiety and the stressful situation that you are going through.
So, just take a deep breath and relax!
You have nothing to worry about!
I remain at your disposal whenever you need!
Best wishes,
Dr. Iliri
My opinion:
Detailed Answer:
Dear XXXX,
Regarding your concern, I would explain that all those images seem to be related to artifacts caused by movement or not a scarse contact.
I don't think they are PVC.
Besides, you should know that PVC can be detected during the cardiac ultrasound very easily. So, I am sure that your doctor would have seen them if they were present, but they were not.
15 minutes are more than sufficient to come into such conclusions regarding PVC.
So, I can assure you that you do not need a Holter monitoring as you are not experiencing any cardiac arrhythmia.
It is all related to anxiety and the stressful situation that you are going through.
So, just take a deep breath and relax!
You have nothing to worry about!
I remain at your disposal whenever you need!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Iliri,
Thank you. If you see this image from app with hearttate 73 I just uploaded- it is like one beat is very wide and the others are very regular. I know many readings just look unclear but that one seems clear and looks so much like PVC ive seen on pulse oximetry waves from hospital visits. I am not so upset about one but last night I saw six such odd beats in just one 20-second reading. I could not feel PVCs internally what else could that be when they look so clearly like irregular beat. Has not continued but every night I see these weird beats.
Are you sure I dont need holter? Very worried.
Thank you,
XXXX
Thank you. If you see this image from app with hearttate 73 I just uploaded- it is like one beat is very wide and the others are very regular. I know many readings just look unclear but that one seems clear and looks so much like PVC ive seen on pulse oximetry waves from hospital visits. I am not so upset about one but last night I saw six such odd beats in just one 20-second reading. I could not feel PVCs internally what else could that be when they look so clearly like irregular beat. Has not continued but every night I see these weird beats.
Are you sure I dont need holter? Very worried.
Thank you,
XXXX
Brief Answer:
My opinion:
Detailed Answer:
Dear XXXXX,
I viewed your uploaded image and would explain that a PVC can not be excluded. Artifacts of the machine can not be excluded either.
Anyway, you are going through a difficult time.
Anxiety can stimulate the sympathetic nervous system and cause ectopic heart beats.
It is quite normal, as long as you have a normal heart structure and function (resulted in your ultrasound).
So, relax!
You notice them during the night, because you are looking anxious at your application, as if you need to make a discovery . You know that something will happen and it happens... All this is called anxiety.
I can not see how this application is going to help you! I would recommend uninstalling it, because it is making you more anxious.
You should have faith in your doctor and your performed cardiac tests, which are performed by a professional of this field and all they are indicating that there is nothing wrong with your heart!
Hope you will try to listen to my advice!
Regards,
Dr. Iliri
My opinion:
Detailed Answer:
Dear XXXXX,
I viewed your uploaded image and would explain that a PVC can not be excluded. Artifacts of the machine can not be excluded either.
Anyway, you are going through a difficult time.
Anxiety can stimulate the sympathetic nervous system and cause ectopic heart beats.
It is quite normal, as long as you have a normal heart structure and function (resulted in your ultrasound).
So, relax!
You notice them during the night, because you are looking anxious at your application, as if you need to make a discovery . You know that something will happen and it happens... All this is called anxiety.
I can not see how this application is going to help you! I would recommend uninstalling it, because it is making you more anxious.
You should have faith in your doctor and your performed cardiac tests, which are performed by a professional of this field and all they are indicating that there is nothing wrong with your heart!
Hope you will try to listen to my advice!
Regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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