different diagnosis, different doctors

[sek978]

Hello, when I was 23 I experienced high blood pressure and sudden squeezing sensations, and a stopped heartbeat, which then started to race in my chest This occured after using my inhaler more than usual and then exerting myself. I went to the doctor and bp was 123 over 90 heart rate 101, and I felt like someone was squeezing my chest when I laid down. But there were no abnormalities on my ecg, even though I had ingested caffeine.

This evolved into what are now frequent pvcs. They are worse (of course) with caffeine).  I did two stress tests, one with caffeine in my system showed non specific st abnormalities with possible anteroseptal infarct (even with caffeine use in the past, I did not have this on my ecg, months before that)

I experienced  pvcs during peak exercise. The next stress test was with doppler echo. I was told by  the technician that I have systolic anterior leaflet mitral valve prolapse (minimal) with trace regurgitation. But my doctors have told me I am normal normal normal. I am wondering what has changed, something did. I had an aching sensation when I breathed in for months after this initial episode.

now lately, the pvcs that I have been diagnosed with since the fall of 2010 have felt less pounding, softer but still take my breath away, they happened in a store today, and it felt like 10 seconds of continuous pvcs, during which I felt dizzy.  I am wondering how one doctor can say I have mitral regurgitation from prolapse and one can say it is just physiological. It is different than it was before and I just want to understand my issue.

[sek978]

Thank you for your response and thoughts, it is very much appreciated

[CCFHeartMD 15]

Hello. Nobody can diagnose through internet but from what you explain, I would think that your main issue is the history of PVCs. In general, an increase in PVC's frequency in patients previously stable is associated to a rise of catecholamines in the blood (stress hormones) or changes in electrolytes levels (drop in potassium or magnesium in the blood). My recommendation would be to increase potassium/magnesium intake (potassium: bananas; magnesium: all nuts, artichokes, spinach, beans and tomato), and try to decrease your stress/anxiety if possible. If you feel under too much pressure, stressed or with anxiety, I would recommend seeing your physician to discuss about therapy (med and no med). If you persist with PVC symptoms, you could be started on a beta blocker which is a medication to decrease the effect of stress hormones in your heart. As a last resource if your symptoms persist, you can consult an electrophysiologist to discuss about "burning" or ablating the spot in your ventricle that is producing the PVC.
In terms of the mitral prolapse, it is usually over diagnosed and is not significant if the degree of mitral regurgitation (leaking) is mild; this has nothing to do with your PVC symptoms. I you have an echocardiogram done by 10 different techs on the same day, you will probably have different results as there is a subjective component. That is why the general picture of the test is what matters. In your case is a normal ventricle and mild mitral regurgitation that is frequent in normal patients. Good luck.