pvc's and slight st depression

[ally712]

Hi! I am a 38 yr old  (5'3", 115 lbs). Within the last few months, I have had some episodes of dizziness/lightheadedness(only for a few seconds at a time). They probably actually started some time within the last year, but were very occasional(maybe once or twice a month). About 5 weeks ago, I fell of a ladder (about 8 feet) and bruised my left rib (at least chest xray did not show a fracture or crack). Anyway, this fall was extremely stressful for me. I could not stop thinking about all the possible things I could have done. Stress level was high. Within 2 wks after my fall, dizzy spells seemed to become more frequent. Had MRI of the brain done -normal. Went back to internist and had ECG done. It showed a depressed (slightly) ST wave. Echo was normal. I was having pvc's though.  Anyway, went to cardiologist the next day and he did stress echo.  The ST depression actually improved toward the end of the stress test.  I had no chest pain or symptoms at all during the stress test and echo was normal.  He said he didn't think there was anything to worry about and that many people have pvc's and that they are not dangerous.  He gave me a prescription for atenolol if I wanted to try it. I haven't tried it yet b/c my heart rate is normally around 50-60 and my BP is normally around 90-100/60-70. I'm afraid of both dropping too low.  I have been completely freaked out by all of this and had a very hard time sleeping for the past week. The ST depression scares me the most (even though it was slight and it did get better with exercise instead of worse).Cardiologist said that might just be normal for me- said he wasn't worried b/c stress echo plus all my lab work (cholesterol, etc. was great). He felt that the fall had nothing to do with any of this. I know so many who have the pvc's, but the pvc's along with the ST depression makes me afraid that something more is wrong. I want so much to stop worrying about this and get back to my life, sleep on my own, and enjoy my family.  

[ally712]

Thank you for your reply. I agree that my stress is probably a contributing factor, especially since when I am distracted, the dizziness and pvc's seem to go away!  The dizziness is not at all caused by exertion. I usually feel pretty good when I exercise.  I had my doctor make a referral to a psychologist, so hopefully I can work on the anxiety and get rid of the other symptomes. Thanks again for your reply

[Lee Kirksey, MD]

Hello
Im glad that youre OK after the fall. It appears that you have had an extremely stressful period of time. It is true that the ST changes may be a normal variant for you and it sounds like you have passed all of your testing with flying colors and no abnormalities. It is unclear to me if the dizziness and lightheadedness has resolved completely. Are they related to exertion. My advice would be that if those symptoms persist you should consider seeing an elecrophysiologist to evaluate your electrical circuit for abnormality. Having said this, I think that your focus on the problem is also contributing to your stress and it would be adviseable to work on mindful meditation simultaneously. This is likely to be one of many challenges that you face over your long life and why not use it as a practice opportunity. Best of health.
LK