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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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PVCs, Tachycardia, Chest Tightness, Shortness Of Breath. ECG, Echo, Stress ECG, Holter, Blood Tests Done. Treatment?

Hi following problem bothering me for 2 years and the problem is PVCs, tachycardia, chest tightness and shortness of breath. According to doctors heart is healthy (a slight mitral valve prolapse ) several times I happened fast heartbeat the first time without cause accelerated heart rate was about 180 beats a pause (beat beat pause beat beat beat pause) like that I called an ambulance, but when they arrive they did a electrocardiogram caught sinus tachycardia 150 beats (no skips). Following this time I had 2 times within 2 years same tachycardias with no success in capturing it on the ECG . Tests I ve done in these two years are ECG, Echo, Stress ECG, 24 Hrs Holter and blood tests.Also quite alot PVCs almost every day sometimes 2-3 a day sometimes 300-400 + sometimes is (beat beat skip beat beat beat ...) and sometimes is (beat skip skip skip beat skip skip skip skip beat beat beat ...)I read about electrophysiological study but the problem is this i live in Bulgaria here for such study the arrhytmia should be registered with ECG without ECG record of arrhythmia they dont do the study. So my questions are: 1:Are these PVCs,Tachy dangerous in the heart with a slight prolapse. 2:Is there a way to stop it. 3:Can PVCs,Tachy be turned into a dangerous arrhythmia. 4:Is there a need for electrophysiologic study after everything else is normal. 5:I am very worried that about PVCs that are (beat skip skip skip skip beat beat skip skip skip) is this normal? 6:I also have early repolarization which all doctors say it is nothing could this be the reason (there is a very scary stuff about it on the net) I m currently on beta blocker and vitamins my BP is normal range from (110-140 systolic, 60-90 diastolic)except for rare moments when i get scared it rises up to 170/100 for few minutes 10-15. 26 y/o smoker,non-drinker. I will be grateful if you advise me what to do.
Wed, 29 Aug 2012
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General & Family Physician 's  Response
Hello and thanks for the query
It seems by reading your mail that your main concern is your tachycardia and arrhythmia. You are already taking beta-blockers but not getting any relief. So try using Calcium channel blockers like Dilzem and Verapamil with beta- blockers in a dose you can tolerate. Consult your cardiologist for this.
These type of tachycardia are not life threatening unless it is associated with chest pain. But you have a valve prolapse so you have to take care that you don't do any thing that cause chest pain or heaviness like running, heavy Weight lifting etc.
As you ECG recorded HR of 150, I don't thing you need any other examination other than holter which you have already done.
Repeat Holter study after taking Beta-blocker and Calcium Channel blocker to note that they are not causing any bradycardia. You may need Pacemaker Implantation in future. So repeat Holter study every year.
Hope you got your answer.
Best Wishes
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PVCs, Tachycardia, Chest Tightness, Shortness Of Breath. ECG, Echo, Stress ECG, Holter, Blood Tests Done. Treatment?

Hello and thanks for the query It seems by reading your mail that your main concern is your tachycardia and arrhythmia. You are already taking beta-blockers but not getting any relief. So try using Calcium channel blockers like Dilzem and Verapamil with beta- blockers in a dose you can tolerate. Consult your cardiologist for this. These type of tachycardia are not life threatening unless it is associated with chest pain. But you have a valve prolapse so you have to take care that you don t do any thing that cause chest pain or heaviness like running, heavy Weight lifting etc. As you ECG recorded HR of 150, I don t thing you need any other examination other than holter which you have already done. Repeat Holter study after taking Beta-blocker and Calcium Channel blocker to note that they are not causing any bradycardia. You may need Pacemaker Implantation in future. So repeat Holter study every year. Hope you got your answer. Best Wishes