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What Causes Premature Ventricular Contractions And Occasional Bouts Of Supraventricular Tachycardia?
Question: HI Dr Ilir...I have spoken with you in the past regarding my worries about my premature ventricular contractions and occasional bouts of svt. I returned my loop monitor today and I have to wait approximately two weeks for results. I am leaving for a vacation on wednesday for a week and am very nervous that they might find something wrong and I will be away. I was on the monitor Cardiophone which is monitored 24/7 in real time by a cardiac technician. I assume that if there were anything serious that came up during the monitoring they would have contacted me or my dr right away? Being that I didn't hear anything during the monitoring period I can assume that anything that needs to be addressed right away would have been done so....so I am ok to go on my trip. I am worried that because I was so anxiety ridden during the monitoring I triggered a fib or something worse..... I mostly felt a lot of extra beats and a couple runs of palpitations which I assume was my svt acting up. What are the chances I triggered a fib to happen due to my stress? Also I was reading that PVC's can lead to ventricular fibrillation which can cause sudden death....can this happen to me? I have had a normal echo and ecg two weeks ago.... I am so anxiety ridden over this. If everything comes back ok and its just pvc's and still svt occasionally is a beta blocker effective in reducing them...I hate the feeling i get when I have this and it causes me anxiety
also ....while I was on the monitor...I was taking benadryl sometimes for allergies and to help me sleep - no more than 100 mg a day and the last three days I had a bad cold so I took a nightime cold and sinus medication that had psuedoephedrine/tylenol in it....can these induce a fib or something worse? Now I am scared that I induced an arrhythmia by the medications I took for my allergies and cold..I can't take this anxiety anymore....if I had a fib or something worse would they have called me from the monitoring centre while I was being monitored?
sorry I meant to say no more than 50 mg of benadryl /day...not 100 mg
also ....while I was on the monitor...I was taking benadryl sometimes for allergies and to help me sleep - no more than 100 mg a day and the last three days I had a bad cold so I took a nightime cold and sinus medication that had psuedoephedrine/tylenol in it....can these induce a fib or something worse? Now I am scared that I induced an arrhythmia by the medications I took for my allergies and cold..I can't take this anxiety anymore....if I had a fib or something worse would they have called me from the monitoring centre while I was being monitored?
sorry I meant to say no more than 50 mg of benadryl /day...not 100 mg
Brief Answer:
I am glad to confirm you are safe and ready for a pleasant vacation.
Detailed Answer:
Hello dear XXXX!
I reviewed your previous medical history again and I am glad to have this opportunity to share my professional opinion with you.
The first thing, which relieves me after reviewing your medial data is that: YOU HAVE A STRUCTURALLY NORMAL HEART! NEVER FORGET THE LATTER SENTENCE!
When discussing about triggering any possible cardiac arrhythmias, it is very important to recall in mind the cardiac structure issue.
Returning to your concrete questions, I would say that:
Anxiety does influence the arrhythmia (atrial fibrillation) triggering threshold. But, in a structurally normal its significance is inconsistent. So, relax my dear!
We can't pay anxiety more attention that it really deserves (when facing the underlying cardiac issue).
Regarding ventricular arrhythmia (those separated PVCs), their clinical significance is quite unimportant (as it is not correlated to any obvious cardiomyopathies [structural abnormality]). From this we can judge that the possibility a PVC could lead to such a life-threatening arrhythmia (ventricular fibrillation) is quite nonexistent.
Don't even thing about these very unlikely possibilities, dear XXXX!
Regarding the "cold'sinus" medication issue, I would explain that pseudoephedrine may interfere with cardiovascular system leading to several consequences like hypertension, PVCs and sometimes even atrial fibrillation, etc. But in your case it doesn't seem to be possible, as it is used for a short period of time.
Both Pseudoephedrine and Benadryl do not show any adverse interactions with your ongoing therapy (Escitalopram)
50 mg of Benadryl does not show any significant interactions even when taken together with Pseudoephedrine (especially when used for such a short time). So relax again!
As you were on a real time monitoring for possible serious cardiac arrhythmias, any obviously prolonged complex arrhythmias would have been noticed by the cardiac technician, and as a general rule you would be informed.
But it doesn't seem to be the case!
So, dear XXXXXXX don't worry about! I wish you go and enjoy your vacation!
Please let me know about the loop recorder results, when it comes the time!
So, I could review the conclusion and discuss with you again!
Hope to have been helpful for you!
I will be at your disposal, whenever you need!
Best wishes,
Dr. Iliri
I am glad to confirm you are safe and ready for a pleasant vacation.
Detailed Answer:
Hello dear XXXX!
I reviewed your previous medical history again and I am glad to have this opportunity to share my professional opinion with you.
The first thing, which relieves me after reviewing your medial data is that: YOU HAVE A STRUCTURALLY NORMAL HEART! NEVER FORGET THE LATTER SENTENCE!
When discussing about triggering any possible cardiac arrhythmias, it is very important to recall in mind the cardiac structure issue.
Returning to your concrete questions, I would say that:
Anxiety does influence the arrhythmia (atrial fibrillation) triggering threshold. But, in a structurally normal its significance is inconsistent. So, relax my dear!
We can't pay anxiety more attention that it really deserves (when facing the underlying cardiac issue).
Regarding ventricular arrhythmia (those separated PVCs), their clinical significance is quite unimportant (as it is not correlated to any obvious cardiomyopathies [structural abnormality]). From this we can judge that the possibility a PVC could lead to such a life-threatening arrhythmia (ventricular fibrillation) is quite nonexistent.
Don't even thing about these very unlikely possibilities, dear XXXX!
Regarding the "cold'sinus" medication issue, I would explain that pseudoephedrine may interfere with cardiovascular system leading to several consequences like hypertension, PVCs and sometimes even atrial fibrillation, etc. But in your case it doesn't seem to be possible, as it is used for a short period of time.
Both Pseudoephedrine and Benadryl do not show any adverse interactions with your ongoing therapy (Escitalopram)
50 mg of Benadryl does not show any significant interactions even when taken together with Pseudoephedrine (especially when used for such a short time). So relax again!
As you were on a real time monitoring for possible serious cardiac arrhythmias, any obviously prolonged complex arrhythmias would have been noticed by the cardiac technician, and as a general rule you would be informed.
But it doesn't seem to be the case!
So, dear XXXXXXX don't worry about! I wish you go and enjoy your vacation!
Please let me know about the loop recorder results, when it comes the time!
So, I could review the conclusion and discuss with you again!
Hope to have been helpful for you!
I will be at your disposal, whenever you need!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks dr. What about using Benadryl long term? I have been using it on and off for a couple months due to allergies and sleep issues. Would that cause a fib or anything scary. I only used the pseudoephedrine for 3 days. Again no more than 50 mg per day of Benadryl bis that a safe dosage to ensure no cardiac abnormalities?
Brief Answer:
Take care when using those drugs!
Detailed Answer:
Hi XXXXX!
Benadryl doesn't cause atrial fibrillation. So, relax! It may cause sedation, and you should be aware when driving. I would not recommend concomitant Benadryl prescription and driving a car or other dangerous machines.
From the other hand, Benadryl may increase palpitation feeling. So, please, try not to get used to long term Benadryl idea!
I discourage Pseudoephedrine continuation for longer periods of time.
An occasional 50 mg Benadryl intake will never be harmful to your heart.
Regards,
Dr. Iliri
Take care when using those drugs!
Detailed Answer:
Hi XXXXX!
Benadryl doesn't cause atrial fibrillation. So, relax! It may cause sedation, and you should be aware when driving. I would not recommend concomitant Benadryl prescription and driving a car or other dangerous machines.
From the other hand, Benadryl may increase palpitation feeling. So, please, try not to get used to long term Benadryl idea!
I discourage Pseudoephedrine continuation for longer periods of time.
An occasional 50 mg Benadryl intake will never be harmful to your heart.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sometimes I take 0.25-0.5 mg of Ativan also. Is that ok. I only take the Benadryl mostly for seasonal allergies. So there is little chance that the Benadryl or cold medication I took during the loop monitoring caused anything I should be concerned about? Also the stress during the monitoring is unlikely to cause any a fib or worries because my heart is structurally normal? Am I getting this right. Also is a fib unlikely due to my age. It seems to be more related to older folks?
Thanks again for being so kind
Thanks again for being so kind
Brief Answer:
Nothing to worry about!
Detailed Answer:
Hi XXXX!
You are right! You are quite young! Sensitive, attentive, caring for your health!
I strongly discourage Ativan use for longer periods of time (more than 2 weeks).
No risk for disturbing atrial fibrillation appears to be present. Those transient medications are not to be considered.
So, there is nothing to worry about!
I am sending you a warm hug, assuring that nothing dangerous is going to happen with your heart!
Dr. Iliri
Nothing to worry about!
Detailed Answer:
Hi XXXX!
You are right! You are quite young! Sensitive, attentive, caring for your health!
I strongly discourage Ativan use for longer periods of time (more than 2 weeks).
No risk for disturbing atrial fibrillation appears to be present. Those transient medications are not to be considered.
So, there is nothing to worry about!
I am sending you a warm hug, assuring that nothing dangerous is going to happen with your heart!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
omg you are so nice and reassuring... I still feel worried I have taken the benadryl for probably two months or so ...not everyday but most days, no more than 50 mg /day ..(maybe 100 mg per day on some days when it was really bad) as I have severe seasonal allergies....are you sure this isn't going to have affected my heart for the loop monitoring? I only use ativan in the event of a panic attack...i feel like crying Im so worried I have done something awful to myself by taking it for so long
well my allergies have been acting up since the begining of may....so since then
it still won't cause a fib or anything horrifying to my heart that I took it so long?
I believe I need help with my anxiety more than anything....which I am getting...
when I read about heart probelms associated with antihistamines is that more in the case of ovedose?
Would the pseudo ephedrine only cause a fib if it were used for a long time. I only used it for 3 days due to a super stuffy nose
well my allergies have been acting up since the begining of may....so since then
it still won't cause a fib or anything horrifying to my heart that I took it so long?
I believe I need help with my anxiety more than anything....which I am getting...
when I read about heart probelms associated with antihistamines is that more in the case of ovedose?
Would the pseudo ephedrine only cause a fib if it were used for a long time. I only used it for 3 days due to a super stuffy nose
Brief Answer:
Managing your anxiety is the most important clue.
Detailed Answer:
Dear XXXX!
As I said you above, you have been using quite a low daily dose of Benadryl (50 mg), and there aren’t any important cardiac consequences for such a regimen.
You just need to calm down. Relax and don't worry!
You may consult an allergist for an appropriate seasonal allergy therapy.
Regards,
Dr. Iliri
Managing your anxiety is the most important clue.
Detailed Answer:
Dear XXXX!
As I said you above, you have been using quite a low daily dose of Benadryl (50 mg), and there aren’t any important cardiac consequences for such a regimen.
You just need to calm down. Relax and don't worry!
You may consult an allergist for an appropriate seasonal allergy therapy.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much....I will let you know the results when I get them....Im going to try to enjoy my vacation and not worry too much about the results as I hope and in my heart of hearts know they will be benign like before...I just get myself so worked up and then you read things on the internet that scare you.....
thanks you again for your compassion and patience...I know it is not easy dealing with anxiety sufferers but I want you to know that I appreciate your time and understanding as anxiety is a difficult road to go down.
thanks you again for your compassion and patience...I know it is not easy dealing with anxiety sufferers but I want you to know that I appreciate your time and understanding as anxiety is a difficult road to go down.
Brief Answer:
You are welcome!
Detailed Answer:
XXXXXXX
It's a pleasure to discuss and feel helpful for you!
I am glad to know you feel much better now! Do not hesitate to discuss your uncertainties, whenever you need!
Enjoy your vacation!
Greetings! Dr. Iliri
You are welcome!
Detailed Answer:
XXXXXXX
It's a pleasure to discuss and feel helpful for you!
I am glad to know you feel much better now! Do not hesitate to discuss your uncertainties, whenever you need!
Enjoy your vacation!
Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I know this is redundant but do you truly think that they won't find a fib or anything scary on my loop based on what I have told you? That is probably just my normal palps and occasional svt due to my anxiety? Honestly?
Brief Answer:
I would appreciate even an alternative opinion.
Detailed Answer:
Hi XXXX!
I don't think I could predict what is going to be revealed by your loop recordings.
Instead, I was trying to give my professional opinion on the matter.
These are my conclusions (based on medical history and clinical symptomatology reviews).
Every normal person may experience some "cardiac electrical storms" during his life. They may be just isolated ectopic beats, or even more complex ones (SVT, paroxysmal atrial fib, etc). But, their clinical importance remains irrelevant.
Such is your case: whatever arrhythmic events come registered, they lack clinical importance.
That's all, I was trying to explain you, during our discussion.
Nevertheless, if you have more suspicions to resolve, and my explanations do not meet your expectations, you are free to have an alternative opinion. HCM is a mega community. I would appreciate it!
I hope to have been helpful! Dr. Iliri
I would appreciate even an alternative opinion.
Detailed Answer:
Hi XXXX!
I don't think I could predict what is going to be revealed by your loop recordings.
Instead, I was trying to give my professional opinion on the matter.
These are my conclusions (based on medical history and clinical symptomatology reviews).
Every normal person may experience some "cardiac electrical storms" during his life. They may be just isolated ectopic beats, or even more complex ones (SVT, paroxysmal atrial fib, etc). But, their clinical importance remains irrelevant.
Such is your case: whatever arrhythmic events come registered, they lack clinical importance.
That's all, I was trying to explain you, during our discussion.
Nevertheless, if you have more suspicions to resolve, and my explanations do not meet your expectations, you are free to have an alternative opinion. HCM is a mega community. I would appreciate it!
I hope to have been helpful! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are so helpful...is paroxysmal a fib dangerous and is that likely for me with a structurally normal heart?
Brief Answer:
Nothing to consider.
Detailed Answer:
XXXXXXX
A paroxysmal atrial fib is possible for every normal individual (as you are), but it has a trivial relevance.
Greetings!
Nothing to consider.
Detailed Answer:
XXXXXXX
A paroxysmal atrial fib is possible for every normal individual (as you are), but it has a trivial relevance.
Greetings!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
so nothing to worry about? still unlikely for my age?
if a fib only last seconds is it anything to worry about - would you need treatment?
if a fib only last seconds is it anything to worry about - would you need treatment?
Brief Answer:
We should expect the results.
Detailed Answer: XXXXXXX
This latter needs some more explanations.
It is better to wait loop recorder results.
You are actually healthy, no need for additional therapy.
Please, could you upload a photo, I am trying to understand how anxious you are!
Regards,
We should expect the results.
Detailed Answer: XXXXXXX
This latter needs some more explanations.
It is better to wait loop recorder results.
You are actually healthy, no need for additional therapy.
Please, could you upload a photo, I am trying to understand how anxious you are!
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just need to stop worrying about this right? I know my risk for this is low but it is overtaking my mind. Can I stop worrying about this?
I uploaded a pic of myself:). It's in reports. Thank you for all your help. I know this is more about anxiety than my heart:)
I uploaded a pic of myself:). It's in reports. Thank you for all your help. I know this is more about anxiety than my heart:)
Brief Answer:
You look a bit anxious!
Detailed Answer: XXXXXXX
You look a bit anxious, especially your eyes!
And you are a nice girl too!
It is quite important to relieve your anxiety.
I recommend to try some physical activities, for example aerobics or yoga. They give a great relief.
Regards,
You look a bit anxious!
Detailed Answer: XXXXXXX
You look a bit anxious, especially your eyes!
And you are a nice girl too!
It is quite important to relieve your anxiety.
I recommend to try some physical activities, for example aerobics or yoga. They give a great relief.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks. I'm working on my anxiety. Thanks for all your time. I'll let you know how things are going;). Enjoy your evening.
Brief Answer:
Wish you all the best!
Detailed Answer:
Thank you XXXX!
I am at your disposal for the next discussion, whenever you will need!
Wish you a pleasant vacation!
Dr. Iliri
Wish you all the best!
Detailed Answer:
Thank you XXXX!
I am at your disposal for the next discussion, whenever you will need!
Wish you a pleasant vacation!
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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