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Suggest Treatment For Premature Ventricular Contractions

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Posted on Thu, 20 Nov 2014
Question: Hi,
I just had a very frightening experience and wanted an immediate professional opinion. I am a 33 year old returning to exercise; started a program last week. After working out this evening, I decided to lie down and take my recovery heart rate. During this time I witnessed what I believe to be a succession of about 20 or so PVCs in a row. I eventually got frightened and sat up, at which point my heart beat returned to normal, for a moment, followed by about 4 PVCs in a row, and then normal again. I laid back down, and I almost immediately had another event of 10-15 in a row.

My question to you is: Is this something potentially dangerous? An occasional PVC does not frighten me much anymore, but so many in a row and during a time when my heart rate was 115-130 was quite frightening. Some days I won't be able to detect a single PVC, and others I can feel them quite often. Very rarely have I ever witnessed a succession of more than one in a row. It is worth noting that these PVCs I felt this evening felt a little different, which I think may have been due to the higher heart rate at which I was listening to them. It almost felt as if my heart rate was beating fast in a normal rhythm but it was alternating a softer beat with a chest-thumping hard beat.

I've had an echo done by request 2 years ago that showed a structurally-sound heart. My doctor knows I experience PVCs and does not seem to be concerned. I am slightly overweight(6'0 220 pounds), I am a nicotine user(not cigarettes, but vapor), prescribed 20mg daily of amphetamine salts, and a pretty regular drinker. BP is either normal or just barely into high-normal. 2-3 years ago I was in extremely good physical condition.

Happy to provide any other useful information needed to give an accurate answer. I understand you're not my doctor, but I believe he thinks I am bit of a worrier when it comes to these things...
doctor
Answered by Dr. Benard Shehu (38 minutes later)
Brief Answer:
You should worry about your heart, examinas needed

Detailed Answer:
Hi XXXXXX!

I read your query very carefully and understood your concerns. You should worry about your Heart conditions. What you have experienced may be due to rhythm disorder (such as PVC and other ventricular arrhythmia) or a manifestation of other more serious heart disease (such as Heart failure).

If you were my patient I would recommend doing the following examinations for a proper evaluations of your heart:
- ECG
- ECG monitoring (Holter)
- Cardiac ECHO
- Stress test

Meanwhile i suggest:
- Stop the substance abuse (alcohol, nicotine ect)
- Lose weigh
- Stabilize the BP (the goal is to keep BP <130/85 mmHg)
- Reduce salt intake
- Increase physical activity.

Hope this was of help!
Dr. Benard
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Benard Shehu (11 minutes later)
That was quite a frightening answer. Would you mind elaborating as to why you think it's a cause for concern?

Please note again, I've already had a recent ECHO done and it came back perfectly fine. Comprehensive blood tests done less than a year ago with everything coming back normal, and my blood pressure is consistently below the range you stated above.

Lastly, is the rhythm disorder a cause for concern as well or just the heart disease? Wouldn't there be symptoms along with this aside from just PVCs?

Thank you in advance
doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
ECHO holter and stress test should be done...

Detailed Answer:
Hi and welcome back!

It's a good thing that two years ago your heart ECHO was perfectly fine, but since then to many things may have happened to you. This is why cardiac ECHO should be repeated every year.

Also it's a good thing that the test you have done one year ago were all normal and your BP is within the normal range. However all the mentioned examinations and blood test should be repeated every year (even if they are within normal range).

Ventricular premature beats, altered bigeminia and trigeminia, or ventricular run are very common findings during recovery phase. The best way to evaluate this rhythm disorders is to do a stress test and holter monitoring.

In few cases your symptoms may be an early sign of Heart dysfunction (the early stages of heart failure). Heart function (and dysfunction) is best evaluated with cardiac ECHO.

Wish you health!
Dr. Benard

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Benard Shehu (9 hours later)
If this is a potentially dangerous issue, why would you recommend increased physical activity in the meantime? Wouldn't that be a bad idea?
doctor
Answered by Dr. Benard Shehu (9 hours later)
Brief Answer:
Not dangerous,not bad idea neither...

Detailed Answer:
Hi back,

Thank you for your following up questions.

1. No, it is not dangerous to recommend increased physical activity in the meantime. And it is not a bad idea neither.

Physical activity and cardiac exercises are highly recommended in each stage of every type of heart disease.

Even in cases of heart attack, patients are advised to start physical activity as soon as better.

2. It is also very important to confirm the diagnosis with the mentioned examinations.

Hope it answered to your queries!
Dr.Benard
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Suggest Treatment For Premature Ventricular Contractions

Brief Answer: You should worry about your heart, examinas needed Detailed Answer: Hi XXXXXX! I read your query very carefully and understood your concerns. You should worry about your Heart conditions. What you have experienced may be due to rhythm disorder (such as PVC and other ventricular arrhythmia) or a manifestation of other more serious heart disease (such as Heart failure). If you were my patient I would recommend doing the following examinations for a proper evaluations of your heart: - ECG - ECG monitoring (Holter) - Cardiac ECHO - Stress test Meanwhile i suggest: - Stop the substance abuse (alcohol, nicotine ect) - Lose weigh - Stabilize the BP (the goal is to keep BP <130/85 mmHg) - Reduce salt intake - Increase physical activity. Hope this was of help! Dr. Benard