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Fluttering feeling in the chest, shoulder and neck pain. Mild mitral and tricuspid regurgitation in Echo. PVC and PAC found. Should I worry?

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General & Family Physician
Practicing since : 2007
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hi. normal ekg, echo normal but showed mild mitral regurgitation and mild tricuspid regurtitation. PVCs' PAC's showed on a holter monitor (24hr). Dr. said the jumps are benign. But offered me a script for beta blockers....which I have not taken. All tests done within last 2 1/2 months I always know when I get pvcs pacs as I get a quick jump feeling that startles me. Now I have been geting a new fluttering feeling in the left side of my chest when I amvery nervous or when I move quickly. Is that related to my diagnosis. I also notice when my pvc's act left foot gets tingly. Should I worry?
Posted Tue, 8 May 2012 in Heart Rate and Rhythm Disorders
Follow-up: Fluttering feeling in the chest, shoulder and neck pain. Mild mitral and tricuspid regurgitation in Echo. PVC and PAC found. Should I worry? 10 minutes later
Should I see a Doc that specializes in electrical rythm of heart or could I have a circulation issue. The only other symptom I have is left shoulder/neck/arm pain. Which I have had in the past recent as the last episode of symptoms when I had all of those tests done. The pain in those areas is aggravated with movement of those areas. EG.: When I turn my head to the left side...left side of neck and shoulder hurt.
Answered by Dr. Mohammed Tauseef 9 hours later

Thank you for the Query.

I would like to know few more things which would help me in suggesting you better:

1.) When was PVCs(Premature ventricular contraction) and PACs(Premature ventricular contraction) diagnosed?
2.) Are you abnormally aware of your Hearbeats?
3.) Do you get chest pain?

I would like to let you know that your Symptoms are related to PVCs and PACs. You need a thorough physical evaluation by a Cardiologist so that he/she can examine you and suggest further blood work to rule out if you have Hyperthyroidism, and prescribe medications along with Beta Blockers if necessary. You need to take your Medications as directed by your Doctor.

In addition to this follow these lifestyle modifications,

1.) Make a note of your Symptoms and activities, this will help identify substances or actions that may trigger your heart Contractions.
2.) Avoid stress, practice relaxation techniques like yoga and meditation.
3.) Eat healthy nutritious balanced diet which should include fresh fruits and XXXXXXX leafy vegetables.
4.) Avoid caffeine, smoking, alcohol, if you use them.
5.) Do moderate exercises like brisk walking for 30 to 40 minutes daily and maintain a healthy weight.
6.) Stick to your treatment plan and go for regular follow up.

Hope I have answered your Query, I will be available to answer your follow up Queries.

Wish you Good Health.

Take Care.

Dr. Mohammed Tauseef.
Above answer was peer-reviewed by
Follow-up: Fluttering feeling in the chest, shoulder and neck pain. Mild mitral and tricuspid regurgitation in Echo. PVC and PAC found. Should I worry? 1 hour later
You asked me 3 questions:
1 I was diagnosed three years ago. But at that time I was only having very few per day. Now I am having some days when I notice 100+ per day.
2 I do not know if I am abnormally aware of them. They feel very strong sometimes
3 Of all of the times I have gotten them, I have only had a few that have presented with any pain. And the pain I would descrbie as a pressure that lasts in suration for only a brief second ot two.
I also do get headaches and they are almost always one sided (left side). They come and go, but when I get them, as I just started last night, they last more than one day. My last strange phenomenon is - I also get a pulsing sound in time with my heartbeat in my left ear VERY momentarily when I stress suddenly or bear down. This symtpom comes and goes periodically. I had these last - a afew years ago. I mentioned prior I had a huge neuro workup approx 2 years back. It included CAT scan, MRI, and MRA. All was normal - with mention of an arachnoid cyst in Sella. I mention this as my one sided headache returned again last night. Is there something in my shoulder or neck that could be causing alll of my symptoms? Or is that just a coincidence? As I definitely have a tightness and muscle-feeling pain when I move my neck. If not, could it be the anemia? I was tested for thyroid via bloodwork at the same timeframe I had the EKG, echo & holter. I was also tested via bloodwork for magnesium and potassium defficiency. Bot were normal. Dr also ran Lymes bloodwork. First test showed high positive titers, but western blot said negative. It's been a long road with these symtpoms as they seem to come and go in waves with breaks of feeling pretty good in between.
Answered by Dr. Mohammed Tauseef 23 minutes later

Thanks again for Writing back to me.

The headaches you been having do not seem to be related. It is probably incidental that you have these headaches along with premature ventricular / atrial contractions. These headaches appear similar to migraine. Your neurologist will be able to attend to this problem. You may need some preventive medications and life style changes to effectively treat the headaches.
Keep a headache diary even after you see your doctor. It will help you learn more about what triggers your headache and which treatment is most effective.

Coming back to your primary query, yes, the symptoms you described may be due to PVCs (Premature ventricular contraction) and PACs(Premature Atrial contraction). Betablocker use will be beneficial. Please do continue them as suggested by your doctor.

Anemia if present may be associated with your symptoms. Blood counts and hemoglobin levels if normal will rule out anemia. Thyroid hormone dysfunction is another condition that needs to be looked at. Consider discussing about it when you follow up with your Cardiologist.

Overall, I agree with your doctor. The PAC / PVC are non concerning. They can be treated with regular treatment and follow up. They are less likely to cause circulation disturbances.

Hope I have answered your query.

Wishing you good health once again.

Take Care.

Dr. Mohammed Tauseef.
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