Heart :: PVCs And PACs Upon Exertion


Jan 9, 2015

Just looking for some advice on next steps here. I'm 46 (male) and have had intermittent PVC / PAC for probably 10 years. They have always been infrequent and pretty mild truthfully. Once in a while if I'm stressed, have had too much to drink, or had a big meal close to bed, I'll have a more prolonged and severe episode, usually when trying to sleep. Many of you have probably been in the same situation - rolling around in bed to try and get into a position where you can't feel the pounding and fluttering as much.

Anyways, I'm reasonably fit, not overweight, and have no other conditions (AFAIK). I usually have one cup of Half-Caf coffee in the morning and that's it. I don't drink soft drinks or have a lot of sugar or anything. I HAVE had panic attacks in the past, but have learned to control them pretty well, just through breathing exercises and getting myself to relax. Exercise had always helped too, though I'm not on a "regular" exercise program.

My father had a bad case of Afib, which was solved by an ablation. My identical twin brother has had Afib episodes as well, with a couple being severe enough that he needed to be "shocked" back into rhythm. There is some history of heart disease in my family with 3 grandparents dying (eventually) from stroke, and the other had a moderate heart attack in his 60s (but lived to 93).

From a lifestyle perspective, in my younger years up until probably 35 I was reasonably active but ate a pretty poor diet - tons of dairy, red meat, etc. Typical bad American diet. Despite this diet, I was never really overweight much (blessed with a fast metabolism), and my cholesterol readouts have always been borderline, though in recent years they've improved as I've improved my diet.

3 weeks ago I started to notice PVC and PAC whenever I would exert myself - we're talking walking up 1 flight of stairs, walking quickly to rush to a meeting, taking the dog for a walk. Yesterday a pretty strong one came on while I was carrying something heavy for a home depot return. I had a strong one while carrying it (but just one), then another small one a few minutes after I had put it down. Likewise, I usually will get one or two AFTER I have reached the top of the stairs and starting walking a little bit. I've noticed they seem to be worse if I've recently eaten a meal.

I went to see my PCP who did a resting EKG that was normal, normal BP, resting pulse 65-70 or so. You can predict the response - you're fine and they're benign. Cutout caffeine, exercise more, relax, etc. He did offer up additional tests if I wanted and so I did a 24 hour holter monitor, thyroid blood test, and stress test (just ekg and bp, no echo or thalidomide). The holter showed occasional PVC and PAC. The day I had the stress test was a "good" day - I didn't feel any PVC or PAC while I was on the treadmill (of course!) but the cardiologist did say he saw a few.

Even though I know that what the docs are telling is very likely to be true, my problem now is that I just don't FEEL right. I had gotten used to the occasional PVC and PAC and they were never a problem, even if I had 1 or two DURING exercise. Now they seem to be brought on by exertion and I just can't help but think about the cause being some underlying coronary artery condition, even though my PCP and the cardiologist tell me they're benign. Even though these seem to be brought on by exertion, my fitness level is BETTER than it's been in a while and when I do "power through" the PVC and PAC that I get when I commence exercise, I actually feel pretty good - 30 minutes on the treadmill at fast walk / incline and I'm not even breathing that hard. 6 weeks ago I hiked for 2 days at 11,000 feet, mostly going up and while it was hard, I did it and felt pretty good. I had a few PVC and PAC during that trip, but not many. It's only been the last 3 weeks or so when they happen consistently upon exertion.

I've read online that PVC/PAC CAN be brought on by exercise but I've also read that PVC/PAC with exercise can be a sign of an underlying heart condition such as coronary artery disease. At this point every time I walk up the stairs I'm afraid of what might happen and I'm afraid to do any real exercise. I would really like to have another test done to check for any sign of blockages and so on but I'm not sure what to do since the docs are telling me I'm fine and I should just live with it. I'm just concerned because of family history, lifestyle, and the fact that these come on when I exert myself (it also doesn't help my state of mind that 1 friend and 1 colleague at work are of similar age and had heart attacks recently). Anyone out there experience anything similar?

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Heart Rhythm :: PVCs / PACS? Should Be Worried?

I went to the doctor a few months ago for a routine physical and mentioned that I had been feeling an occasional (0-10 times a day) thump in my chest (which I thought to be some sort of ectopic beat after looking it up online). They did bloodwork and an EKG and said my blood pressure was a little high but the bloodwork and EKG did not show anything to be worrisome. My doctor said it could be stress related (because this was right after Christmas)  but I am still having them. She also told me that if they get worse to let her know, but they haven't got worse and I am just worried that I should be having them checked more in depth than what was done during my physical.

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Heart Rhythm :: When To Worry About PACs/PVCs?

I've been experiencing a flare-up in my ectopics recently.

My heart is healthy (I had an EKG and an echo done two months ago when my ectopics started to bother me again). I don't know if what I'm experiencing now is PACs or PVCs (none were found on my EKG) but earlier I had only PACs. I would assume that most of my ectopics are PACs.

I know that stress and anxiety is a major trigger, and what often happens is that I'm having one ectopic, I'm trying not to worry about it, then I have another one and I get a major rush of adrenaline, which makes the ectopics go wild and I'm having 5-15 a minute for a while (15-20 minutes) and suddenly they just go away.

The sensation is quite variable from event to event, sometimes I get the throat fullness sensation followed by a thump, sometimes it feels like my heart stops and then a thump, sometimes I just feel some fluttering in my chest for a second or two. I'm worrying about the latter as I fear it's a run of ectopics.

The problem is, I KNOW that premature beats are benign but still I can't stop worrying. It's like a fear of fear, because I fear that the ectopics will ruin my life.

I'm taking 100 mg Metoprolol (and some Propranolol as needed) and it takes the edge off my ectopics, but it's not a cure. Also, I'm on Zoloft for my anxiety.

Test results:
EKG: Normal sinus rhythm, 64/min, normal.
Echo: All normal.
BP: 115/75 at doctor's office.

At what point should I worry about ectopics (how many)? Is it common to have a fluttering sensation even with a single PAC or PVC? Is it normal to get those flare-ups where you feel ectopics several times a minute?

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Heart Disease :: PVCs And PACs - Syncope With Erratic Sinus Rhythm

I am Nico, I am a 26 year old male who has been suffering from an array of symptoms since I was 17 years old. I am 5ft 8" and I weigh 235 lbs ( I've gained over 60lbs in the last year and a half) I have had a Panic Disorder, Generalized Anxiety Disorder, and dizziness (not vertigo) problem since 17 (nearly 8 years now). In 2009 I got into a car accident and fractured my frontal right sinus cavity and had to do a reconstructive surgery. In this accident I also got a concussion and was in shock and also unconscious for about an hour. The last few years my health has gradually been declining and my quality of life has gotten so low. I have seen a TBI specialist, a Neurologist, a Cardiac Electrophysiologist, a Psychologist, and a Psychiatrist for Psychotropic medication management

****(Since Wednesday Morning 10/7/15 I noticed whenever I am Sitting or Standing that My Heart Rate Is Super Erratic and Jumping around a lot, it goes into the 120s-140s when I stand "from a sitting 60-70 bpm" and then bounces all over the place, 40s to low 100s to 80s to 50s, etc. Also since this has started I have noticed an extreme shortness of breath made worse sitting or standing, made better by laying down on my side, my blood pressure since wednesday had also been very low for my normal average when standing, other symptoms with this are blurred vision and off balance/dizzy... I fainted for about 5 seconds friday 10/9/15 night after climbing my flight of stairs, earlier that friday morning I went to the Emergency Department to be evaluated and they said my chest xray was okay as well as my CBC and CMP blood tests.... I explained that most of my symptoms were POSTURAL and or ORTHOSTATIC but they kept me lying down till discharge and didn't let me show them, but on the monitor I was having 100s! of PVCs and PACs which is not normal for me to have that many, also the PACs were making my shortness of breath worse.... They discharged me even though I said I don't feel safe because these are new symptoms and they said well we need your room because we are busy and your cardiologist said all the Arrhythmias are from your Sinus Node so your fine and were discharging you.

. Here are the symptoms I have experienced daily or within this time frame:

*Panic Attacks
*Constant Fear/Adrenaline Rushes
*Always Tired
*No Sex Drive
*Irritable
*Easily Overstimulated (sensory Overload)
*Non-Rotational Dizziness
*Neck Pain
*Cervicogenic Dizziness
*Heart Arrhythmia (PVC's, and Sinus and or Paroxysmal Tachycardia)
*Sensitive to Sounds (Always have to wear earplugs)
*Sensitivity to Light (always wear sunglasses)
*Off balance
*Slight body tremors
*Chronic Neck and Muscle tension in Occipital and Trapezius Muscles
*Startled by normal everyday sounds (occasionally)
*Frequent muscle twitching (Eyelids, Stomach and Diaphragm, temple, legs)
*I can't climb a flight of stairs without feeling exhausted (2 years ago I used to hit the gym a lot)
*Always Feel Like I Am Dying or That I Have Some Serious Terminal Illness
*Tinnitus
*Elevated Blood Pressure
**Obstructive Sleep Apnea (Not using CPAP)
*Obesity
*Brain Fog Always
*Shortness of Breath
*Lump In Throat
* Every few months a random mouth and tongue become paralyzed for less than a minute when I eat then I get
Confused afterwards or Panic attack.

Here are the Medications I take everyday:

Clonazepam (Klonopin) .75 Mg
Diazepam (Valium) 5MG as or if needed
Aspirin 325MG

Here are TESTS performed in the last 7 years I will put a number next to it to indicate how many times I've had it done

* Head/Brain CT Scan   3-4 Times
* Brain MRI                    4-5 Times
* Neck/Throat MRI        2 Times
*Chest X-Ray              10+ Times
*EKG                           20+ Times
*Implanted Cardiac Monitor 4/01/2014(Still Implanted)
*EEG                           3-4 Times
*Basic Neurological Function Test            10+Times
*Echocardiogram Stress Test                   2 Times
*Echocardiogram                                     1 Time
*Stress Test                                              2 Times
*Transcranial Doppler Ultrasound  (testing for artery compression or insufficiency) 1 Time
*Neuropsych Testing  (TBI and cognitive function)          2 Times
*Blood Tests/Urinalysis   >CBC>CMP>CRP>Troponin>Metanephrines>Cortisol>Lipid Panel>Heavy Metal Compounds>Catecholamines>Thyroid Levels> and some others I can't remember.
*Pulmonary Lung Function Test (shortness of Breath)    1 Time
*Overnight Sleep Studies (In Lab)                  9 Times
*Cervical Trigger Point Injections (Marcaine/Lidocaine)      Done Monthly

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Arginine And Taurine Supplements For PACs/PVCs?

I have a question to ask. I'm a volunteer in one of the volunteer centers, and I started working with a group of people who have PAC and PVC in the last couple of days.

It's sort of a meeting where we all sit and talk about the conditions we have (I'm the leader of the meeting). Now, some of the people there were talking about the treatments for their conditions and what is actually good to do for people with their conditions. One of them, a woman in her fifties, said that arginine and taurine supplements are good for people with PAC and PVC. Is that true?

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Cardiac Arrhythmias :: Palpitations And Fast Heart Rate On Exertion

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Heart :: PVCs In A Row?

I've had undiagnosed PVCs for years now. The reason why I say undiagnosed is because the Holter Monitor could not capture any events when I wore it. Normal eco and normal stress-test. GP assumed they were just PVCs and benign.

Today I had incident of a run of a few of them in a row. I had the typical fluttering/thumping in my chest but decided to take my pulse at the time and it felt like a soft beat followed immediately by a strong beat, a pause, then a soft beat followed immediate by a strong beat, then a pause.

I read that 3-4 PVCs in a row are considered V-Tach and that in healthy hearts this is usually nothing to be concerned with. I am curious though because I had the strong beat immediately after the soft-beat if this could be considered V-tac or if this would just be considered PVC, Normal Beat, PVC, Normal Beat.

I have good tolerance to exercise and no other symptoms. Was not dizzy, although did freak out a bit and thought to myself "Am I about to slip into Cardiac Arrest".

My two questions are

1) Do you think this is V-tach?

2) Should sudden cardiac death be a concern? Is it worth continuing to investigate and exploring something such as ablation and trying another holter to try and catch up?

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Heart :: Having PVCs For 10 Years

im 27 and have been having pvc's for 10 years. when they first started I ended up in ER to be told it was stress. so I learned to cope with them. now fast forward 10 years and they are getting worse. I always remember feeling them when I was at rest. now when I move about they start up. I was in town yesterday with my 2 year old and concentrated on them so much I thought I was going to faint. if I only walk up the stairs I can feel them. obviously I then concentrate on them and feel them even more. My doc did an ECG back in june and that was normal also bloods were normal. other than that no other tests have been done. when I complained about them again the doc gave me anti-anxiety medication but I don't feel anxious so i'm not taking them. I feel i'm fighting a loosing battle and i'm terrified there is something wrong with my heart and no one is taking me seriously. I look forward to your replies and getting to know you all

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Heart Rhythm :: 19% PVCs

I had PVCs for about ten years before my mechanical aortic valve replacement in 1985 at 41 years of age. My cardiologist told me that the PVCs would probably get worse after surgery, because many times the insertion of a foreign object (i.e., my mechanical valve) fouls up the heart's electrical system even more. To the contrary, my PVCs completely went away after surgery!

In 2002, I moved to a new location, and my new cardiologist started me out with an ECG. He detected light, occasional PVCs, of which I could feel no effect. I moved again in 2011, and had a 24 hour Holter monitor done in April, 2012. All my cardiologist told me was that my PVC rate was 9.7% of total beats, but all asymptomatic, so not to worry. Again, I only occasionally noticed a PVC.

I went to my primary care physician for my regular four month checkup in mid-November 2015, and my pulse rate while sitting in a chair kept fluctuating between 35-40 (using the finger monitor for pulse and blood oxygenation). I made an appointment with my cardiologist for 10 days hence. The finger monitor again showed a pulse rate of 33-38 sitting (but 98% blood oxygenation), but when laying on the examining table with ECG leads strapped to me, my pulse read at 73. The ECG was abnormal, and I was ordered for another Holter monitor.

This one came back as abnormal with 19% multifocal PVCs, with episodes of ventricular couplets, ventricular bigeminy as well as ventricular trigeminy. Yet, the report stated that all episodes were asymptomatic (which I find hard to believe, since last August of 2015 my yearly echocardiogram indicated that my ejection fraction had decreased over the last few years from 62% to 45%).

At any rate, my cardiologist prescribed one daily Diltiazem CD 120mg Caps. What seems strange to me is that Diltiazem is for angina and high blood pressure, but is only an OFF LABEL use for arrhythmias. Hence, I have noticed no change in my PVCs (perhaps even a little worse for these first 25 days on Diltiazem, and especially heavy PVCs when I first try to go to sleep at night), nor has my blood pressure been lowered.

I am considering making an appointment with a different cardiologist to have him do a new ECG, go over my Holter monitor report, and consider a drug specifically for arrhythmias. Any other suggestions, or should a 72 year-old man like myself just let nature take it's course?

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Heart Rhythm :: Severe Runs Of PACs

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Heart Disease :: Amphetamine Addict - Possible Heart Attack?

I'm going to be completely honest and as thorough as possible, I'm an addict, and I've had an addiction to stimulants for the last year and a half (consisting of about 95% amphetamine usage, never used methamphetamine). I usually keep my doses anywhere around 10-60mg cause I never wanted to over do it. Unfortunately, last week I dove in deep to my addiction due to a recent break up, about 4 days ago I did around 130 mg spread out through the day, I felt fine until I took my very last dose (30 mg about), at that point it only increased negative side effects.

After a while of feeling odd and stuff, I began to have trouble breathing and chest pains (I can't remember which started first), it kind of felt like they coincided, but I still would get very minor and infrequent pain without breathing, it felt like I couldn't take a full breath of air, and when I did the chest pain would kick in (more), it felt like a tightening pain. My left arm soon became somewhat numb and tingly, not numb like when you accidentally sleep on it, but just a little numbing that felt like it stretched down my arm through a single vein, the numbness was generally more intense under my armpit and bicep area, and would intensify when I rubbed certain areas. I had a very sore/stiff neck, especially around the area between my shoulder blades and neck, it wasn't on one side, it was mostly in the middle (my neck and back are still sore after this experience, as well as the tingling sensation in my arm but its not at all that bad, and it comes and goes). I had anxiety during this event, and I felt like when people would talk to me I wasn't truly comprehending what they would say, but yet I still was able to reply to them, I just didn't say much or think about what I was saying, I only could pay attention to what was happening to me. I felt like things were kind of slowed down and I was very fatigued and zoned out. I felt as if I was slowly meeting my demise. I believe I got cold sweats a couple times, but not much. I had some heart burn later that night, and the next but its gone.

It came across to me that maybe this was a panic attack but the pain lasted 2-3 hours, after that it wasn't horrible, but it was still somewhat there, and the mental aspect of a panic attack wasn't that intense. I also do think that my left arm may just have "mouse arm" (cant remember medical term), cause I use a computer a lot, a part of my muscle/tendon in my hand has been sore for a while, and it is somewhat acting up now as I type. I really am not sure if a lot of this is me overreacting, or just a placebo effect (I hope so). I've had minor chest pains since I was 13 (I just turned 18), and every time I went in to get my heart checked out, they said I was fine, and that I had a slight irregular heart beat but it was nothing to worry about and a lot of people have it but don't know.

I also have this weird problem with my thought process either that started the night of the incident, or I haven't noticed before. The only way I can explain it is as if my brain buffers for a moment when I go back and forth between two thoughts, it's like I over excite the neurons responsible for those thoughts and I end up overriding my brain for a brief second with confusion, then it's fine. I do have some chest pains now, but it isn't very often, and honestly happens mostly when I think about it or worry about it (same with the left arm), which is why I think I could be conning my self about this entire incident, because I've had panic attacks before but they weren't as bad and were more mental than physical.

It's dumb of me but I never went into the doctors cause 1. I was too paranoid to go in, and 2. I don't want to worry my mom or waste her money just so the doc's (possibly) find nothing. I haven't lately because all I've been doing is researching about this stuff, off and on I think I'm fine and then I don't. So I came here to settle it once and for all, I have a doctors appt. next week anyways so if you guys don't think its serious (I don't, but it could be denial) I'll just wait until then, if it is then I'll go now. I know everybody says "If its your heart then don't risk it", but every time I go in for my heart, it's always nothing.

My family nor myself have a history of heart disease, diabetes, or just flat out obesity. I'm very fit, just oddly muscular for my age, but I don't work out as often as I should now-a-days. I also smoke cigarettes, and my heart pains/arm numbness do come back a bit when I have a cig, but then again it could just be my head. The last time I had any form of a heart test was probably about a year or two ago, it was an EKG and I believe a blood test, but my memory is a bit foggy in that area. My heart rate is normal, I don't know about my blood pressure, but I believe I got a test for it lying somewhere around my house. My last dose of amphetamines was today, yes I know its stupid, but it's literally my last dose (I weaned myself off).

Oh and I did have sex last night, being in the moment I may have over did it (I usually get this feeling just without the numbing), my heart pounded like hell, I got heart burn during it, my left arm and leg became pretty numb, I was kind of tremor-ish, and that's it. Once I orgasmed the numbing went away (except for under my armpit area), and my heart was fine, but beating pretty fast (110bpm).

So do you think I likely had a heart attack? Or do you think it's something else? Or a combination of things? Or simply nothing but a placebo affect or panic attack? And by the way how long does numbing of the left-arm and chest pains last after having a heart attack?

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Cardiovascular :: Trembling Heart - History Of Heart Disease

Recently my heart has been trembling a lot and i find it hard to sleep because i can feel it beating. I used to feel pain in my heart on occasion before, but i have not had that recently. When I drink coffee the tremors are more noticeable and more frequent. 

On my mother's side, she has history of high blood pressure and heart disease, her father died at 50 from a heart attack and my cousin (32 female) has a pacemaker. 

Other symptoms include: 

Redness under my eyes 

Pitted and grooved nails 

Personal profile: 

25 y/o male 

Smoker - 10 a day 

I used to use cocaine infrequently for around 2 years (a heavy session once a month)

I don't drink alot maybe once a week

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