Brief Answer:
My opinion as follows :

Detailed Answer:
Hi dear XXXXX!

I am glad to hear from you again!

It's nice to see you have started your physical fitness activity and you are progressing quite well.

The wonderful thing of exercising is the increasing feeling of liberating your mind, having those hard and fast heart beats, sensing blood flow vibrating distal edges of your body, making your mind and heart speaking the same artistic language of the real life.
So, you just feel being alive, happy to rule your entire body, giving strength to your daily determination, and optimism to your perseverance on reaching to the end of every challenge, feeling satisfied of those daily "small" victories.

Probably a friendly heart will be there, next to you and give some support.

And when returning to the real "slow-motion" activity, you turn your head back and look how your life is smiling to you, a hearty player of her nature.

I used to be part of a professional team some years ago, and remember it was fun and joyful.

I hope that training workouts be the same to you! I think it is a good part of cognitive behavioral therapy.

As I actually know your clinical heart conditions, I would say that an escalated, gradual supervised physical straining is quite beneficial and undisturbed by any serious arrhythmic events.

So, I don't believe you are going to experience suxh disturbing pals (ectopic beats), as to limit your activity.

Remember that palpitations are normal when exerting sports and the absence of such a feeling would be uncommon. Whereas few ectopic heart beats are quite normal, as the level of catecholamines (and consequent cardiac stimulating activity) increases during training. But, it doesn't mean a pathological process is occurring.

There is no medial based reason to support such fears, like associated chest pain, or out of proportion breathlessness. You have a healthy heart (this could not be a matter of controversies), and every exaggerated feeling comes out of your persistent anxiety.

An issue to be considered would be any evidence of complex cardiac arrhythmia; such as several runs of SVT, atrial fibrillations, or even ventricular arrhythmia: options that seem such impossible for a young, healthy active lady like you.

I would conclude that, if you follow a well scheduled training program, on a technically supervised workout (a certified trainer) center, and keep feeding your mind with that positive thinking; no anxiety intrusion could ruin your plans.

Remember that an active girl lives better and longer than a scared thoughtful one.

At the end, I would say that a weak violin could never change the charm of an orchestra play.So, keep in mind what your doctor said (just ignore those scarce ectopic beats!!).

Wish I could be of help to you!

I am at your disposal for further discussions, whenever you need!

Let me know how you are changing the way to control your anxiety, if further uncertainties perturb your mind!

A warm hug! Greetings! Dr. Iliri

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Brief Answer:
No medical indications for a current cardiac stress test.

Detailed Answer:

Hi XXXXX!

I am trying to explain that you are not at an increased risk of having any adverse cardiac events.

Don’t worry about what you read recently; as palpitations are common during exercise and a couple of minutes (proportional to the length of physical strain) on recovery.

Just keep in mind: No one has died from a few PACs during exercise.

As you have a perfectly normal cardiac structure, there is no justifiable fear of more complex cardiac arrhythmia (as I mentioned above).

A cardiac stress test, as a diagnostic tool is not justified for studying the presence of PACs, even when they may be frequent. If you haven’t evidence of complex arrhythmia or any ischemic cardiac implications behind that, there is no medical indication for performing a cardiac stress test.

If I were your attending doctor, I would not recommend a new cardiac stress test (at least for your actual complains).

You said me that Loop (event) recorder has registered a few isolated PACs, but you didn’t upload any report for a review.

Based on that conclusion, I would consider such a recording without any clinical importance regarding any cardiac disorders.

My advice is to ignore overreaction on hypothetical cardiac arrhythmia, but to be always aware of your health and clinical conditions.

I would like to be helpful in eliminating your cardiac issue fears! Hope to be so!

Let me know if this is of any real help!

Wishing you the best! Dr. Iliri

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Brief Answer:
A few PACs, or even PVCs are not able to harm you at all.

Detailed Answer:
Hi again dear XXXXXXX

Yes, that's right: isolated PACs during and around exercise have no clinical significance.

They will never be able to harm you.

The same holds true for PVCs: they are not considered complex arrhythmia.

Nevertheless you didn't experience PVCs during your event recorder period.

That's all I could say about this.

So hope you will are going to be fine, hereinafter.

If you have any further uncertainties, do not hesitate to contact me!

Wishing you a good health!

Regards,

Dr. Iliri

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Brief Answer:
There is no need performing a stress test

Detailed Answer:
Dear XXXXXXX

As I have explained before, there is nothing to worry about.

It is a small number and just isolated PACs. You are just a normal, healthy person.

I still insist in ignoring them.

If I were your doctor, I would surely not recommend to continue with other tests like a stress test.

Physical exercise is the best thing you can do, for a healthy body in a healthy mind.

So, just relax and continue with your daily activity.

I am always here for you, happy to answer if you have any other questions.

Best wishes,
Dr. Iliri

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Brief Answer:
You are welcome!

Detailed Answer:
You are welcome!

Thank you for trusting on HCM and for your high consideration of my opinions.

Greetings!
Dr. Iliri

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