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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having Increased PVCs. Experiencing Sinus Tachycardia. Lab Tests Normal. Cause For Symptoms?

I am 44 y/o female. I am healthy and have always been active in sports. I do have nasal allergies and am on patanase , singulair, b vitamins , vitamin E , and calcium . I am 5 91/2 and 154 pounds. I have very rarely experienced PVC s throughout my lifetime, but in the last 2-3 years they have increased. In the last 2-3 months, they have increased to many throughout a day s time. Some days more than others. Now I am starting to experience sinus tach and have shown u-waves in a 6 lead monitor. I have done an event monitor that exhibited the PVCs at one point in a run of 5. All my labs are within normal ranges. My bp is in the low 100 s over 70-90. I am frustrated in not knowing what is causing this. Some say it could be due to premenopause as well. Again, all labs are normal and my doctor is suggesting beta blockers, but I hesitate to take that step without a real diagnosis and with a fairly low bp. What do you think?
Sat, 9 Feb 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

It is very difficult to find the cause in many problems - the approach is costly, cumbersome, not cost effective and poor success rate. A typical case is increased blood pressure. Treatment may often be easy and safe.

You may need several investigations -
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
      TMT (Treadmill exercise ECG) is done to exclude Ischemia (reduced blood flow).
     LABORATORY work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on.
     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 of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
The treating doctor may suggest them depending on need, based on his assessment of the situation. Discuss with him and plan for further approach

Take care
Wishing speedy recovery
God bless
Good luck
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Having Increased PVCs. Experiencing Sinus Tachycardia. Lab Tests Normal. Cause For Symptoms?

Hi friend, Welcome to Health Care Magic It is very difficult to find the cause in many problems - the approach is costly, cumbersome, not cost effective and poor success rate. A typical case is increased blood pressure. Treatment may often be easy and safe. You may need several investigations - ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality). TMT (Treadmill exercise ECG) is done to exclude Ischemia (reduced blood flow). LABORATORY work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. 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 of increasing complexity – Electro Physiological Studies (EPS) it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. Discuss with him and plan for further approach Take care Wishing speedy recovery God bless Good luck