PVC/PAC from excercise....New symptoms diagnosed with MVP

[ColtsFan1978]

I have MVP based on echo. It showed a normal heart with trace mitral valve regurgitation. No other issues were present. The cardio said no follow up was needed unless new symptoms develop. I have had the usual skipped beats, few seconds of racing heart while at rest, etc. for years.
I am 31 and started getting back into aerobic shape. I have always lifted weights and am not overweight.  I started playing paintball (lots of sprints, adrenaline followed by sitting, or slow jogs around a field), volleyball and added cardio at the gym. In addition I have added some new leg workouts that seem to give me heart issues.
1. Twice after paintball games, approximately 5 minutes after stopping play my heart went into bigeminy or rather what felt like bigeminy since I wasn’t wearing a monitor. It felt like my heart was skipping every other beat. This lasted for probably 10 – 15 seconds. Then back to normal. Is this something I need to worry about or follow up on?
2. When riding bike trails and doing weighted step up’s (holding weights in each hand and stepping up on a bench to work out your legs), my heart really races and skips beats. These really scare me. They seem to be initiated when I push myself up a hill while riding a bike and when doing these step ups. I don’t get them when jogging, doing regular leg lifts or riding a bike normally. My heart feels like it is beating very fast and I can feel the skipped beats every few beats or so. These don’t cause me any symptoms such as dizziness or fainting but I can really feel them in my chest and they make me a bit fearful. Do these seem worrying to you or something I should follow up on?
3. Could this be related to adrenaline? The strain of biking up a hill or doing step ups are similar to doing a sprint in that you start from a slow or stopped pace and jump into strenuous exercise. Can this be causing these symptoms?

Thank you for your time,

Matt

[Cleveland Clinic]

1.  This is most likely atrial bigeminy and if so, no further workup is necessary.  To be certain you should wear a holter.  If this is venticular bigeminy, then furhter workup should be done.  the holter will differentiate the two.

2.  Again, a holter should be done to get a sense of what these rhythms are.

3.  Yes.  Adrenaline is known to cause extra heart beats.

[ColtsFan1978]

I assume others follow these threads and might want to know results so they can apply to themselves. While this probably isn't a good idea (I am guilty of it as well) I figured I can give an update.

I wore a holter as suggested by the CC Doc and dropped it off at my cardio on Wednesday. He is on vacation for the next two weeks so till then I have no further information. I can only assume if I had something really disturbing on the holter they would have alerted me. As it stands I have been running and working out anyways, so we shall see.

It still confuses me why one specific leg exercise will trigger these feelings. Perhaps I am pushing myself too hard and my heart is just racing unusually fast and responding to the adrenaline. I realize I will most likely never know the answer but I hope I can at least reassure someone else that I have similar symptoms. I blame it all on the MVP.

[tickertock]

Thanks Doc for clearing up my confusion regarding PVCs, I was aware that when 15-20% of your total heartbeats are PVCs in can indeed cause PVC induced cardiomyopathy in rare cases , though I understand it is not as rare as once thought, I also understand that 1000s of Pacs daily can induce cardiomyopathy on rare occasions also, just as IST, so probably advisible to get an echo if either is a chronic condition. Thanks again.

[Cleveland Clinic]

PVC when too numerous can cause a form of cardiomyopathy which may lead to heart failure.  It is therefore important to get an echocardiogram and a Holter.  The latter to get an idea of the number of PVC's in 24 hours.  If more than 15% of all the beats/24 hours, further therapy may be needed.

[tickertock]

I notice the the doc here lately same to be putting more emphasis on PVCs as needing a further workup, Is there something regarding PVCs we're not being told!! Please note in no way am criticizing the doctor here or anyone , but from most information I've gathered over the years including being seen by numerous cardiologists, including an EP that PVCs were no more worry than PACs one you had a normal cardiac exam, sames a bit conflicting doesn't it.
PS normal cardiac exam = physical exam. ECG, Echocardiogram, holter monitor and in some cases a Exercise stress test.( all normal)

[ColtsFan1978]

Thank you for your response. I appreciate your advice. I make sure to ask for a holter when I make an appointment this week.

This is a fantastic site for those of us seeking opinions from reputable doctors and are scared of our symptoms. Thank you again.