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Advice on Ectopics - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   I had an ectopic episode in january pulse rate 120, irregular beat, adrenaline to chest, lasted 14 hours. I now have PVC/PAC's and some prolonged heart beats. Since I came out of hospital I have trouble with nightime breathing...I wake up from a deep sleep and cant breathe at all, then after about 3 seconds or more its like the switch is put back on and I can start again, its terrifying. I take my bp immediately after these incidents and they are all very low 90/40 or 88/36 was my latest reading.....I think my BP is bottoming out and waking me up. Sometimes its low during the day, but usually its about 110/65 which is good          
Doctor :   Hi
User :   hello
Doctor :   Dr xxx here
Doctor :   Let me read what you have typed.
Doctor :   May i know your age?
User :   sorry, yes of course 39, vegetarian, dont drink
Doctor :   Are you on any medications?
User :   no
User :   no
User :   just the pill
User :   for low estrogen
Doctor :   Ok
User :   my bp has always been fairly low
User :   my weight is 8st 3
Doctor :   Do you have any other problems?
Doctor :   Like increased sugar or cholesterol?
User :   yes, my pvcs kick in badly at about 150 whe i try and do sport, if I ignore them i start getting chest pain
User :   so I stop
User :   been active all my life and am, well was pretty fit
User :   my weight was 7stone 7 when i got episode
Doctor :   When did you get your last check up done?
User :   about 8 weeks ago
Doctor :   Was the ECG done at that moment?
User :   no
User :   only ecg was in january which highlighted pvc's
Doctor :   Do you have breathing problems during daytime also?
User :   also had echo and I was structurally normal
User :   no breathing problems in day , no
User :   I know when i am going to have it
User :   my breathing slows and pulse goes down to about 58
User :   but it is at night
User :   my pulse has always been 72-75
Doctor :   Ok
User :   so i take my bp before sleep and if its lower than 52 before I go to sleep, I know Im going to wake up
Doctor :   Do you have frequent chest pain also?
User :   I only ever take my BP when I am feeling odd, cold, tired and out of sorts
User :   no
User :   no frequent chest pain at all
User :   so for bp at night is that acceptable
Doctor :   I will suggest you to get your ECG done once again and also to get yourself examined for low BP.
User :   I am each and every time I am at the hospital, but during the day its normal, so tehy think its fine, its only at night
User :   BP
Doctor :   But you need to get the ECG done to see the exact cause.
User :   I have had Echo and normal
Doctor :   When was the echo done?
User :   structurally normal
User :   about May
User :   so can you tell me if that blood pressure is ok? or is it far too low
Doctor :   Do you have your reports with you?
User :   no
User :   ??
Doctor :   The night time fall in BP as compared to day is ok but since you also have on and off chest pain that needs to be evaluated.
User :   so why am i waking unable to breathe?
User :   and I am totally relaxed, no stress no anxiety
User :   chest pain is only when i push it exercise wise
User :   so i just stop.
Doctor :   Ectopic heartbeat is a a heartbeat which momentarily loses its rhythm. The heart may miss a beat which is then followed by a heavy jolt.
Doctor :   ectopic beats are usually harmless
User :   but 3/5 secondd of no oxygen no nothing, when I have it, I think thats it this time Im not going to start breathing
User :   could it be GERD
Doctor :   Do you have any heartburning or burping?
User :   I know they are, although they effect my exercise and fitness, i know they are harmless, though I think they are telling you your body is out of balance.....however the nightime breathing concerns me enormously
User :   I got indigestion before my episode
User :   I am belching, dry belching
User :   no heartburn
Doctor :   The belching and heartburn is related to gerd.
Doctor :   Did you get your 24 holter moniter done?
User :   no they gave me an event monitor which was a mistake really, that picked up PVC's and Prolonged heart beat, can you tell me if a prolonged heart beat is anything to worry about
User :   they suggested beta's but that made the night time breathing even worse, so I came off them
Doctor :   What was the cardiologists opinion? WHAT IS HIS NEXT PLAN?
User :   so can you tell me if a prolonged heartbeat is a worry?
Doctor :   Yes prolonged heart beat is worrisome.
User :   can you tell me why?
Doctor :   They can reduce blood supply to heart and add on is the anxiety.
User :   he never eben mentioned the prolonged beat in his written report to the doctor only when I was with him, he said hmmm you have some prolonged beats in there too....but he didnt seem concerned by them
User :   my mum has afib and my sister svt
Doctor :   I will suggest you to discuss this with your treating doc and also get a 24 hour Holster Monitor done.
Doctor :   Since you have a family history also this also is a risk factor.
User :   can I still exercise ok?
Doctor :   No exercise can increase the chest pain
User :   so you suggest a holster monitor 24 hour, to see whats there...
Doctor :   Yes.
User :   cardiologists next plan is gastro specialist and also POTS test
Doctor :   It would be better.
User :   yes i agree, it should have been done in the first place
User :   do you think the nightime breathing is anything to worry about, or will I always wake up
Doctor :   May be the symptoms you are telling of burping and belching indicate GERD also
Doctor :   You can take an opinion form Gastro
User :   and gerd can cause pvcs cant they?
User :   is there anything else I should be pushing for?
Doctor :   No gerd cannot cause PVCS
User :   ok, I thought it could, my error
User :   what are the main causes of ovcs
User :   Pvcs
User :   are they anyhting to wrry about
Doctor :   First thing of concern is prolonged heart beat so better have a consultation for that
User :   can you tell me why someone haas a prolonged beat
Doctor :   Later if required cardio can refer you to gastro.
User :   what are the main causes
Doctor :   It can be Long QT interval Syndrome which is a inherited condition
User :   so it is the SADS
Doctor :   Or CAD
User :   sudden adult death syndrome
Doctor :   Heart injury
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