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Feeling thump in chest and have mild mitral valve prolapse. Is this serious?

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Practicing since : 1981
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I am a 22 year old female. Sometimes I have a thump in my chest followed quickly by a softer thump. I had this when I was sitting down after eating. I have had a holter monitor about six months ago that showed about 40 PAC's during 24 hours. They didn't find anything else. I also have mild acid reflux and am on Prevacid.
Posted Sun, 2 Dec 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Anil Grover 1 hour later
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
What you have described are the symptoms of heart beating out of rhythm that is arrhythmia. Normally, heart beats for about 100,000 times a day (72 x 60 x 24); one percent of these beats can be normally out of rhythm, to a sensitive and more perceptive person, these may be perceived as missed beats. You have 40 that is 0.004% abnormal beats as recorded by Holter which you know A furhter test of Holter may be needed if your ECG suggests or cardiologist feel, wherein 24 recording of ECGs is done by a portable i pod like device to be analysed by a computer, In normal persons Holter has revealed that att times heart can beat faster rate it can be due to rhythm disorder which can be:
1. Proxysmal Supra Ventricular Tachycardia (PSVT), comes like a bolt from blue and after few minutes to hours stops as abruptly as it came. Manifests as Palpitation. This is not the symptom you are having.
2. Inappropriate Sinus Tachycardia: Similar to above but gradual set in and set off also manifests as palpitation that is not the situation with you.
3. Irregular beats inappropriately timed ventricular or supra ventricular ectopics (Proxysmal Atrial Ectopics or PAC's) which may manifest as missed beats or at times as palpitation. If ventricular function is normal (as determined by clinical examination, echocardiography or when there is normal ability to perform adequate exercise in form of stress test it is normal) then these ectopics are of not much significance except a little apprehension for the person who perceives them. All of us are exposed to stress, how we react to that is what counts. Once investigated and declared normal heart I assume anxiety will also be alleviated.

Personally, I feel a cardiology consult, where a cardiologist will thorougly examine you and may plan ultrasound of heart that is echocardiography which would confirm normal structure and function of heart. . These are needed to find whether remotedly, you need any medication or not. There is nothing to worry, the whole thing could be normal aberration and after illness have become more perceptive.

The other symptom you described is because of reflux of stomach (Gastric) contents into your food pipe(esophagus). Apart from Pervacid which you are taking. Avoid lying down for at least after mean specially dinner. A short walk is recommended after lunch too.
Please continue taking precautions and medications as and when required for asthma, I hope that is not troubling you much. Find out what causes you allergy and try to avoid that. Finding out about allergen by special test is also another way should you feel that problem is something you can not handle.

If there is further query which you might have I will be most happy to answer. Good Luck.
RegardsWith Best Wishes:
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
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