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What do the following stress tests, echo and holter monitor test result indicate?

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Posted on Mon, 9 Mar 2015
Question: Hi I have had several tests done on my heart. Stress tests , 2 echos, 10 ecgs, 2 holter monitors. My tests all came back normal. The holter monitor showed 200 PACS and 15 isolated PVC. I am worried because my resting heart rate is 52-55 . I am not an athlete. I have lost 75 lbs over tthehe last 10 months through. I don't feel fine. My heart rate went down to 41 during sleep at 2:45 AM. Doctor still says this is all normal and I shouldn't worry. That is not easy for me as I suffer from extreme anxiety. I got a second opinion from another cardiologist who also says I have a healthy heart. One thing I noticed that happens sometimes is when I stand up from sitting or just start moving I will have 5 or 6 slow heart beats that are strong and then the heart rate speeds up. What can this be?
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
You need to explore causes of vagal dystonia

Detailed Answer:
Hello! Thank you for your question on HCM!
I understand your concern and I think that we have to do with vagal dystonia. We have to examine possible causes of that.
First regarding your heart it seems that all your tests are ok. Bradycardia is a common finding of sick sinus syndrome(SSS). To exclude SSS we perform a heart stress test (exercise or pharmacological). If heart rate doesn't increase more than 100-110bpm it is SSS. But I don't believe that you suffer from that at your age. Besides, you have performed Stress tests and yor doctor should have noticed that.
Other causes of bradycardia are different abdominal tumors or brain lesions that compress vagal structures.
To conclude and cut it clear to you I recommend to perform some lab tests like complete blood count, PCR, liver and renal function tests, abdominal echo and a brain CT scan.
Hope to have been helpful.
Greetings Dr.Ilir
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ilir Sharka (15 minutes later)
Hi Doctor Thank you for your response. I have had all the blood work done and everything has come back normal. I will ask for the abdominal ultrasound. With vagas dystonia does that mean the heart is fine and it cam be coming from somewhere else? My stress test was normal and my heart rate went to 166 BPM .


Also I forgot to mention that the heart rate only goes low at rest. Not when moving around.
doctor
Answered by Dr. Ilir Sharka (14 minutes later)
Brief Answer:
I recommend to perform these tests

Detailed Answer:
Hi. I am glad that all your blood tests are normal. With your response about the stress test results everything looks normal with your heart. So our attention should be paid to the other causes I mentioned.

I would also like to know if you have had headaches, gait imbalance or limb numbness lately.
I forgot to ask you if have checked thyroid hormone levels. Hypothyroidism can be a cause of bradycardia.

I still recommend that you get an abdominal echo, thyroid tests, a chest x-ray and a brain CT scan (especially if you have the other neurological complaints I mentioned above).

Please feel free to ask me whenever you need.

Best regards Dr . Iliri
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Ilir Sharka (18 minutes later)
Hi Doctor I have had chest x ray 6 months ago and it was normal. Thyroid function was normal. I do not usually get headaches. My cardiologist thinks that my heart rate goes lower at rest because the heart is simply resting because I do have anxiety. He thinks the PACS AND PVCS are due to anxiety. I had cut scan 8 years ago and it was normal. Abdominal ultrasound 4 years ago was normal. I do feel like I get problems with digestion and when I do I notice the heart issues more. Am I in danger? I'm really scared
doctor
Answered by Dr. Ilir Sharka (51 minutes later)
Brief Answer:
Please exclude other causes before ending anxiety

Detailed Answer:
I am glad about your past exams but they are a little out to date; we cannot account on them to explore the etiological causes of your recent complaints. Perhaps all your problems are connected with extreme anxiety. But in medicine we generally don't afford the patient safety basing on our beliefs and uncertainty.
If you were my patient I would exclude every possible organic causes and only after that I would declare with certainty a functional disorder like anxiety.
My best wishes!
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7718 Questions

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What do the following stress tests, echo and holter monitor test result indicate?

Brief Answer: You need to explore causes of vagal dystonia Detailed Answer: Hello! Thank you for your question on HCM! I understand your concern and I think that we have to do with vagal dystonia. We have to examine possible causes of that. First regarding your heart it seems that all your tests are ok. Bradycardia is a common finding of sick sinus syndrome(SSS). To exclude SSS we perform a heart stress test (exercise or pharmacological). If heart rate doesn't increase more than 100-110bpm it is SSS. But I don't believe that you suffer from that at your age. Besides, you have performed Stress tests and yor doctor should have noticed that. Other causes of bradycardia are different abdominal tumors or brain lesions that compress vagal structures. To conclude and cut it clear to you I recommend to perform some lab tests like complete blood count, PCR, liver and renal function tests, abdominal echo and a brain CT scan. Hope to have been helpful. Greetings Dr.Ilir