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Suggest Treatment For Ectopic Heart Beats Despite Having Normal Cardiac Tests
Question: I had an Echocardiogram 5 months ago which showed a structurally normal heart and I passed my stress test. My 48 hour Holter showed sinus rhythm with 400 pacs and 15 pvcs. However last year my Holter showed 925 PACS with 3 couplets and 3 big my cycles. The last few days I have been getting more etopic again. They mainly happen at night before bed but even worse when I wake up in the morning. This morning I felt 2 or three in a row and this really worried me. Also my heart rate alternates fast and slow. I need some reassurance please?
Brief Answer:
Your heart seems to be in normal conditions
Detailed Answer:
Hello!
Thank you for your question on HCM!
Regarding your concern, your heart seems to be in a normal condition without any cardiac disorders.
I would like to explain that it is common to have some pacs and pvcs in normal persons. They may be caused by anxiety or physical activity.
As you refer all the cardiac tests that you have done have shown a normal heart, and this is another reassurance fact. The Holter's results are normal findings and exclude any cardiac arrhythmia.
So relax! There is nothing wrong with your heart!
I recommend you to continue with the behavioral therapy to control your anxiety.
Hope to have been of help!
Feel free to ask any other questions whenever you need!
Greetings! Dr. Iliri
Your heart seems to be in normal conditions
Detailed Answer:
Hello!
Thank you for your question on HCM!
Regarding your concern, your heart seems to be in a normal condition without any cardiac disorders.
I would like to explain that it is common to have some pacs and pvcs in normal persons. They may be caused by anxiety or physical activity.
As you refer all the cardiac tests that you have done have shown a normal heart, and this is another reassurance fact. The Holter's results are normal findings and exclude any cardiac arrhythmia.
So relax! There is nothing wrong with your heart!
I recommend you to continue with the behavioral therapy to control your anxiety.
Hope to have been of help!
Feel free to ask any other questions whenever you need!
Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor my cardiologist says my heart is very healthy. Also several doctors here at Healthcare magic tell me the same. Everyone says that pacs are harmless. I have read in several forums that frequent Pacs over 200 per day are a precursor for afib. They say there are several studies that prove this. Is this accurate? I'm not sure if that is true. I know some people who have lived with pacs or pvcs for years and had over 5000 per day. However most people complain of pvcs. Mine are mostly PACS
Brief Answer:
Your PACs are benign.
Detailed Answer:
Hi XXXX!
When frequent ectopic beats are an indicator or severe structural heart damage, it would be true that they are precursors of more complex and serious arrhythmia (including atrial fibrillation).
But this is not your case. You have a structurally normal heart, and yours are rare ectopic beats. So, things doesn't match for what you are so persevering disturbed.
At the end, even if you had a hypothetical atrial fibrillation scenario (which doesn't fit with your normal well being), optimally treated, it would not pose any serious dangers to your life. So relax!
Regards! Dr. Iliri
Your PACs are benign.
Detailed Answer:
Hi XXXX!
When frequent ectopic beats are an indicator or severe structural heart damage, it would be true that they are precursors of more complex and serious arrhythmia (including atrial fibrillation).
But this is not your case. You have a structurally normal heart, and yours are rare ectopic beats. So, things doesn't match for what you are so persevering disturbed.
At the end, even if you had a hypothetical atrial fibrillation scenario (which doesn't fit with your normal well being), optimally treated, it would not pose any serious dangers to your life. So relax!
Regards! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor. I just got worried because last night while resting the pacs started pretty bad. 10-12 per minute. Also I was getting 3 or 4 in a row. This lasted over an hour. Is this still normal? Why do they happen out of the blue and so furious?
Brief Answer:
Your symptoms may be just anxiety, without any obvious cause
Detailed Answer:
Hi XXXX!
It is hard to predict that your palpitations (ectopic heart beats and those 3 or 4 consecutive running beats) are really true. That is, most of the referred palpitations feelings, when studied by ambulatory ECG come to be false alarms, without any clinical significance.
So the only way to confirm your currently frequent PACs, etc is to repeat a Holter monitoring. I would strongly advice to run this test.
I would also advice to consult with your doctor, to review the possibility of adding any appropriate anxiolytics to relieve your generalized bouts of anxiety, besides behavioral therapy.
I would like to explain that anxiety and panic attacks typically come out of the blue, without a specific cause.
Best wishes! Dr. Iliri
Your symptoms may be just anxiety, without any obvious cause
Detailed Answer:
Hi XXXX!
It is hard to predict that your palpitations (ectopic heart beats and those 3 or 4 consecutive running beats) are really true. That is, most of the referred palpitations feelings, when studied by ambulatory ECG come to be false alarms, without any clinical significance.
So the only way to confirm your currently frequent PACs, etc is to repeat a Holter monitoring. I would strongly advice to run this test.
I would also advice to consult with your doctor, to review the possibility of adding any appropriate anxiolytics to relieve your generalized bouts of anxiety, besides behavioral therapy.
I would like to explain that anxiety and panic attacks typically come out of the blue, without a specific cause.
Best wishes! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor I have some Ativan at home. Is that safe to take for my heart or can it cause more problems? I have .5mg tablets. Also you could be right it could have been more bigemy than triplets. In either case is it still benign? It lasted approximately an hour of pacs and then calmed down and I felt ok besides being anxious about the feeling. If PACS are benign are short runs also benign? I called my cardiologist today but he insisted again that my heart was healthy and I do not need a holter at this time.
Brief Answer:
I recommend you to consult with the psychiatrist for the proper treatment
Detailed Answer:
Hello!
Ativan's effect is more as a sedative (sleep inducer) than anxiolytic. So it may cause sedation during the day and interfere with your daily activity.
Alprazolam would be more helpful as anxiolytic. But I would not recommend this drug for a long period, because it can cause addiction and tolerance ( higher doses needed for the same effect).
I recommend you to consult with the psychiatrist for a long term treatment like sertraline, which has no effect on the heart, and can help you win your battle with anxiety for a long time.
Hope to have been helpful!
Greetings! Dr. Iliri
I recommend you to consult with the psychiatrist for the proper treatment
Detailed Answer:
Hello!
Ativan's effect is more as a sedative (sleep inducer) than anxiolytic. So it may cause sedation during the day and interfere with your daily activity.
Alprazolam would be more helpful as anxiolytic. But I would not recommend this drug for a long period, because it can cause addiction and tolerance ( higher doses needed for the same effect).
I recommend you to consult with the psychiatrist for a long term treatment like sertraline, which has no effect on the heart, and can help you win your battle with anxiety for a long time.
Hope to have been helpful!
Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor I have one last question. Do PACS trigger tachycardia? I woke up today and went downstairs in my kitchen to start working. I felt a couple of etopic and I noticed my heart was racing. Could this be the etopic or just anxiety. I also noticed my stomach felt uneasy
Brief Answer:
That seems to be just anxiety.
Detailed Answer:
Dear XXXX!
PACs may be precursors of a supraventricular tachycardia in a pathological heart.
But your racing heart rate coupled with some ectopic heat and an uneasy stomach seems to be pure anxiety; it is called panic attack.
You can use Alprazolam to relieve these unpleasant episodes.
Regards! Dr. Iliri
That seems to be just anxiety.
Detailed Answer:
Dear XXXX!
PACs may be precursors of a supraventricular tachycardia in a pathological heart.
But your racing heart rate coupled with some ectopic heat and an uneasy stomach seems to be pure anxiety; it is called panic attack.
You can use Alprazolam to relieve these unpleasant episodes.
Regards! 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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