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Extra systole from heart. BP, cholesterol, ECG normal. Reasons ?

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General & Family Physician
Practicing since : 2005
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I am a woman from Denmark, which allows me to ask a question in your forum. In Denmark we have no opportunity to contact or ask questions to a kardiog unless we are in hospital.

I am 39 years old, slim - blood pressure and cholesterol are fine, but I get so many extra systole from my heart that some day they are there all day and often in the series. I get so scared of them have made ​​as ECG did not show anything, but where do they come from? I can die from them?

I get them especially when I do something physical work, although it is not hard work. I also suffer from shortness of breath around the clock but my lungs were examined and the results are fine.

My father had a heart attack when he was 45 but he is doing well now. My grandfather also died of a blood clot, my cousin died of a heart condition since he was 19, so I am very afraid of having a heart disease.

How do I get rid of the fear of heart disease?

Greeting from XXXXXXX
Tue, 2 Oct 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Prasad 27 hours later

Thanks for your query.

Normally heart beats arises from 'Sinoatrial node'. Any beat that arises from elsewhere is termed as an abnormal beat - extra beat / extra systole / premature beat. The sites from where such abnormal beats arise are AV node or ventricular muscles.

Physiologically these abnormal beats are followed by a pause in the beat. Such pauses are felt while examining the pulse by a trained individual. However often these pause occur in paroxysm that it is most often missed in routine examination as well as short term recordings of the heart such as ECG. Holter monitoring (24 to 48 hours) which records the heart beats for a longer duration, have a higher chance of picking up these abnormal beats than ECG. If this test is normal, you are just safe.

Having said this, the cause of the problem is not known and 80 of 100 times, these events are not a concerning problem.

The best way to overcome the fear is by ruling out the condition causing these events. A complete heart evaluation that includes - physical examination, Holter monitoring, 2D Echo of the heart, stress test and blood chemistries will rule out most of the conditions causing these extra systoles. Since your father has a premature heart disease I suggest these extra investigations.

You may consult a cardiologist who will guide you through the test and thus relieve you of your anxiety. In the mean time XXXXXXX breathing exercises; regular sleep; meditation and physical exercises are means to treat the anxiety.

Hope I have answered your query.

If you have any doubts over my suggestions, I will be available to answer them as well.

Best Regards
Above answer was peer-reviewed by
Follow-up: Extra systole from heart. BP, cholesterol, ECG normal. Reasons ? 18 hours later
I work as a nurse and know when my heart beats extra beat, I do not suffer from other anxiety disorders.
My concern and that I'd like to have an expert answer to heart disease ... my question is: if not these extra beats are trapped on an ECG, can they still be dangerous? some days I can have extra beats all day and I'm short of breath throughout the day even though there is no extra beats, I must have the other studies you suggested
butcan i count on the extra beats I experience are not XXXXXXX
there are 2 months of waiting on other studies
Answered by Dr. Prasad 6 hours later

While I stress that you need the tests to determine heart disease as well as decide the prognosis of the condition; most often these extra beats are not a XXXXXXX condition, even though they were not trapped on regular ECG.

The morbidity of the condition depends on few factors. One of the factor being the heart rate (High pulse rate can increase the frequency of extra beats).

I am unable to explain shortness of breathe without the cardiac evaluation, given that lung conditions are ruled out. You may want to check your blood hemoglobin levels too, as anemia may be a factor causing shortness of breath.

The bottom line is that "80 out of 100 times, extra beat is harmless."
The cardiac evaluation which is scheduled 2 months later will prove beyond doubt if there are any reasons to worry.

I would also recommend you to monitory your pulse rate. If your pulse rate reveals tachycardia, get an ECG at that instant. There are higher chances to pick the extra beats on such ECG.

Thanks for following up.

Wish you the best.

Above answer was peer-reviewed by
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