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I Am A 47 Year Old Female Who Experienced PVCs

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Posted on Sun, 25 Nov 2018
Question: I am a 47 year old female who experienced PVCs for the first time in July of 2018. I immediately scheduled an appointment with a cardiologist and they performed an EKG (which picked the PVCs up), then an echocardiogram, stress test, Holter Monitor, etc. All indicators pointed that the PVCs were BENIGN in nature. The Holter monitor detected ~1,600 PVCs in a 24 hour period and picked up some couplets (two in a row). I am scared to death. I went to see an electrophysiologist who did not have much time to spend with me and he looked at one EKG and said the PVCs are benign. I have cut out caffeine, etc. and kept a food log. There does not seem to be a common trigger. I have them every day; some days not quite as bad. I am scared that I am going to have a heart attack or stroke. I keep being assured that these are not life threatening, but how do you go from being a healthy middle-aged person to wake up one day to these awful electric misfires? My menstrual cycle has been all over the place since June-is it possible that these PVCs are related to perimenopause? I don't know how to relax about them. My whole life has been upside since they started and I am afraid to do anything--and it has caused me to become depressed. I want to get back to life, but feel that these few tests that depicts one point in time are thorough and maybe there is more going on. Any information or guidance you provide would be greatly appreciated.
doctor
Answered by Dr. Ilir Sharka (52 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on Ask a Doctor service!

I passed carefully through your question and would explain that this number of PVCs, including the presence of some couplets are not indicative of any serious heart arrhythmia.

In my opinion perimenopause and anxiety are playing an important role in all this clinical situation.

Coming to this point, I would recommend you trying to find more time to relax and have some rest; and also taking valeriana and passiflora extract and try performing Yoga, which can help reduce naturally anxiety.

Regular physical activity can also help prevent PVSs or any other cardiac arrhythmia.

In addition, it is necessary to exclude possible thyroid gland dysfunction: thyroid hormones level should be checked as well.

Hope you will find this answer helpful!

Kind regards!

Dr.Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ilir Sharka (14 hours later)
Thank you for the information above. I have had my thyroid gland check a few times and the TSH, etc. are within normal range. So, just to clarify, it is possible that PVCs are associated with perimenopause (chemical imbalance)? since all heart anomalies/disease, etc. been ruled out, how likely is that these PVCs will develop into something worse? (Ventricular Tachycardia, etc.). Sorry to be so anxious about this situation, but it is concerning when our electrical activity goes haywire in your heart after being a relatively healthy individual. I do not smoke, do not eat chocolate, cut white breads/pastas. I do have beer a few times a week (cardiologist said ok). Do you agree that is ok? I don't want to worsen my situation. I do exercise daily now.
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Regarding your concern, you should know that hormonal changes during perimenopause can lead to anxiety and increased psychological stress.

These changes lead to the activation of the sympathetic nervous system, as a normal physiological reaction, causing increased circulating levels of adrenaline and noradrenaline.

This can cause increased heart rate and ectopic heart beats, including PVCs.

That is why, I recommended Yoga and physical exercise.

I don't think that this situation is going to get worse, considering your healthy lifestyle and the fact that there is no underlying cardiac issue (coronary artery disease, etc.).

Anyway, I recommend follow up with another ECG Holter monitoring after 6 months, coupled with a cardiac ultrasound, just to be sure that everything is OK.

I would also recommend using the above mentioned herbal supplements, which can help calm your anxiety and thus prevent PVCs during stressful situations.

I hope you will find this information helpful!

If you have any other questions, please don't hesitate to ask me again!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (14 minutes later)
Thank you so very much! This information is great and very helpful. This service is wonderful. It can be intimidating when you are sitting at the doctors office. It is also challenging to think of your questions during that office visit, etc. Thanks again and I will follow up on all the items that you have mentioned. Have a wonderful day.
doctor
Answered by Dr. Ilir Sharka (26 minutes later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you have any other questions in the future, please don't hesitate to ask me directly at any time!

I would be glad to answer to all of your questions or review your future tests.

Wishing all the best,

Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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I Am A 47 Year Old Female Who Experienced PVCs

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome and thank you for asking on Ask a Doctor service! I passed carefully through your question and would explain that this number of PVCs, including the presence of some couplets are not indicative of any serious heart arrhythmia. In my opinion perimenopause and anxiety are playing an important role in all this clinical situation. Coming to this point, I would recommend you trying to find more time to relax and have some rest; and also taking valeriana and passiflora extract and try performing Yoga, which can help reduce naturally anxiety. Regular physical activity can also help prevent PVSs or any other cardiac arrhythmia. In addition, it is necessary to exclude possible thyroid gland dysfunction: thyroid hormones level should be checked as well. Hope you will find this answer helpful! Kind regards! Dr.Ilir Sharka, Cardiologist