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Have PVC, MVP, incomplete right bundle branch block, smoker, drinker, marital discord, on zoloft and xanax, family history of panic attacks. Treatment?

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Practicing since : 2002
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I'm a 33 yr old female 5'10 158 pounds with mvp and pvc's along with incomplete right bundle branch block. I was college athlete and now a school teacher. I go to a cardiologist yearly and everything seems to be benign. The pvcs are troublesome and cause me to have panic attacks which run in my family. I have also been smoking lately and drinking more than I want to. I am on zoloft 50 mg along with Xanax as needed for my anxiety. I am also having serious marriage issues. I have recently noticed an increase in my pvc's and they are really concerning last echo was in XXXXXXX and everything was the same. Could my smoking, drinking, and coffee in the morning be contributing to this increase even though I have been doing it for 3 months?
Posted Wed, 18 Apr 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Robert Galamaga 45 minutes later
Hello and thanks for the query.

There are several lifestyle modifications in your case which are going to be critical to help both your mental and physical health.

First of all you must quit smoking as soon as possible. The influx of nicotine in your body with smoking serves as a stimulant and can promote irritability of the heart making the PVCs(premature venticular contraction) more common and bothersome. You are to some degree self-medicating some of the stimulant effect of this and the stress you are under with the alcohol.

I am sure you are aware that we would never recommend alcohol intake in a patient who is also taking Xanax. This is simply XXXXXXX and potentialy life-threatening.

In addition, coffee intake must be tempered to include no more than one or two cups per day with last drink of coffee before 2 PM. Caffeine remains active in your body for 8 hours or more and can affect your ability to obtain restful sleep if you drink it later in the day.

I recommend that you work on these modifications and set goals for yourself regarding stopping smoking and drinking as well as lowering the daily intake of caffeine.

You will likely need good support of family and freiends as you do this. In addition a good clinical psychologist would likely be able to provide you with some guidance as well. I would recommend you ask for a referral to a psychologist from your doctor.

In addition it is absolutely critical that every day you do some form of exercise for at least 45 minutes. This will not only channel some of your stress but will also have beneficial effects on your heart and will likely over a period of 6 months to one year decrease the prevalence of the PVCs.

I realize that right now things seem very overwhelming but let me reassue you that you are doing the right thing by reaching out to us for recommendations. From today you can start working toward goals of self-improvement. Day by day this will start to have a positive impact on the many facets of your life including friendships, marriage and work life. Think positive. I am sure you can get to where you want to be.

I thank you again for the query and hope this response has proven to be helpful. If you have any additional concerns I would be happy to address them.


Dr. Galamaga
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