Question: hello i am a 50 year old who recently started to have pvcs went to hospital did ekg showed up but Dr said cant see much to be concerned about went to family Dr she ordered 24hr heart moniter still have them for about 4 weeks now they wake me up at night should i be concerned?
Brief Answer:
Probably NOT!
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
These beats are common and often may be normal.
Yet it is advisable to have it investigated.
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / Medicines like Phenylephrine used for ‘cold’ / may be responsible....
At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
A thorough history and physical examination is the first step –
ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show. It may also detect silent (no symptom) ischemia.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG; may be with thallium isotope – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > The test is the gold standard, but it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
Since it is a month now / you have no other complaint like pain, breathlessness and so on / you may only need an ECHO and follow up..
The treating doctor may suggest them depending on need, based on his assessment of the situation.
Good luck
Take care
Wishing all well
God bless
Follow up: Dr. Anantharamakrishnan (4 hours later)
Thank you so much DR, i had been sick with a very bad coldcough etc for about 3 weeks prior and was taking amoxillin I started getting these pvcs about 2 days after starting amoxillin could that be the cause or being sick with cold that may have triggered them and can pvcs that occur on a dail basis damage the heart and lead to other heart problems or elevate blood presure thank you . I am up at 2 am now from them .
Brief Answer:
You may benefit from Beta-blockers
Detailed Answer:
Hi,
It is NOT likely from Amoxicillin
PVCs do NOT damage the heart
PVCs do NOT lead to blood pressure
Sickness or the drugs might have triggered it…
These ectopic beats are not always symptomatic. / The feeling depends on individual sensitivity – some do not feel them at all / some may feel every beat.
Specific treatment may not always be necessary.
Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment... If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit missed beats (also pressure and anxiety)...
If they are not effective and if the problem is severe, several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs / they could have side effects and need follow up.
YOUR DOCTOR WILL GIVE PROPER PRESCRIPTION AND FOLLOW UP
Regards
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What Should Be Done For PVCs?
Brief Answer:
Probably NOT!
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
These beats are common and often may be normal.
Yet it is advisable to have it investigated.
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / Medicines like Phenylephrine used for ‘cold’ / may be responsible....
At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
A thorough history and physical examination is the first step –
ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show. It may also detect silent (no symptom) ischemia.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG; may be with thallium isotope – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > The test is the gold standard, but it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
Since it is a month now / you have no other complaint like pain, breathlessness and so on / you may only need an ECHO and follow up..
The treating doctor may suggest them depending on need, based on his assessment of the situation.
Good luck
Take care
Wishing all well
God bless