Skipped beats when running

[NiteOwlKB]

Hi, I am a 33 year old woman, in good health.    Except since I was 17, I have been passing out and struggling with skipped beats. I saw a cardiologist when I was 21 and he said I have PVC's, syncope, and sinus tachycardia.  He put me on proponolol (not sure if spelled right).  Eventually went off meds and have learned to live with skipped beats and passing out, really haven't thought much about it until recently. In the last couple of weeks I have been having many skipped beats when I run on the treadmill.  They continue as long as I am running and quit when I stop.  Just wondering if this is a concern, maybe a sign things are changing from "nothing to worry about" to "time to see a doctor".  Also, don't know if it matters but my dad had a pacemaker put in a year ago because his heart was so slow he was passing out.  They told him, in layman's terms, that their was a problem between his brain and heart where the signal wasn't being sent to speed up.  His heart is in good shape, just doesn't keep time.

[JamesAA]

I get PVCs whenever, wherever.  I can go weeks with none (or next to none).  They tend to come in phases...like I'll have a "bad PVC week."  I wouldn't say mine increase with exercise, but I have noticed that when I get my HR really high (like 90% of my HR max) while running or doing some sort of higher intensity interval training, I will throw PVCs, particularly in the beginning stages of my workout.  This doesn't always happen though.  Earlier today during my exercise, I got my HR to 90% several times and did not throw one PVC.  How would you assess this Dr?  I've been under the impression that I can ignore them (the PVCs) and that they are normal or benign.  

[NiteOwlKB]

Thanks for the quick response!  I debated all day what to do, and I guess it's time to go see a doctor.  Sometimes it's hard to know what to do and your reply was helpful.

Thanks again!

[CCFHeart MD23]

Hi NiteOwlKB,

I think your instinct to revisit your symptoms with a cardiologist is correct. Premature ventricular contractions (PVC's) that increase with exercise are a concern and require further assessment, particularly if associated with dizziness or collapse.

It has been some time since you were seen by a cardiologist. The focus of any new assessment would be ruling out any so-called 'structural heart disease', meaning problems with the hearts pumping strength or changes in valve function. Remember to take along any reports about your fathers cardiac condition as this can be informative for your cardiologist.

Factors that can increase the frequency of PVC's include changes in electrolytes (especially potassium, magnesium), thyroid disease, and high caffeine/alcohol intake (and other recreational drugs). Stress and anxiety can increase your sensitivity to feeling PVC's (but not necessarily the actual frequency of PVC's). Older patients with coronary disease (disease in the blood vessels supplying the heart) can also have PVC's as a symptom of coronary blood flow problems.

I am including the cleveland clinic information sheet on PVC's for you to paste in your browser:

http://my.clevelandclinic.org/heart/disorders/electric/premature-ventricular-contractions.aspx

The sheet includes a telephone number for you to call should you wish to discuss your symptoms further.

Take care and good luck.