Normal...?

[EricW83]

I know there are several of these questions on here about PVC’s and PAC’s.  I have been to 3 different cardiologists.  I have worn several holter monitors, had 2 stress tests, 3 echoes, several EKG’s and my results have always been normal; negative.  Which you would think would put my mind at ease, and it does for a brief time.  Last year my family and I were traveling to Seattle for a wedding, it was an early morning flight, I am a nervous flyer and often get PVC’s (I think they are PVC's or Ectopic Beats) before flights.  This particular episode really scared me and maybe it was due to my fast pulse but it just felt stronger than previous skipped beats.  after the trip I went and was given a clean bill of health, structurally normal heart, slightly high BP but probably from anxiety and just being at office.  I take Bisoprolol 1.25mg daily, have so for the last 6 plus years.  I never worry about the pVC’s that occur when I am excited, or really nervous before a meeting as I feel  I know the reason they are occurring, its these darn ones that just happen when I watch TV, lay in bed, or just surf the internet.  I guess my worry is, they sometimes feel different, like when you exercise and a skipped beat hits it feels like a big thud…while others are light…Is this just due to the frequency of the beat perhaps or is there a danger with the different sensation.  Even though I have been to cardios I am now scared when I go to certain places.  I kid you not in airports I look for the AEDs and feel more comfortable when I see an ambulance or am close to a hospital thinking I am going to have a strong one and maybe pass out or it send my heart into a dangerous rhythm or stop it….I am really at my whits end here, not sure if I have a question or not…is there any way to overcome this?  and even though my heart is structurally normal both cardios have said, is there still a chance that because this certain pVC did not appear on the Echo or ECG it could be dangerous?

[achillea]

"...I don't want to start taking medication to deal with an emotional problem but it is just really difficult some times...   "

My own experience and suspicion is that this is NOT just an emotional problem.  Panic and anxiety run in families.  There isa sturdy hereditary component, as there is with diabetes, for example. Also, a disordered function of  neurotransmitters is involved. In other words, it is quite possible that what people like us experience is no less a purely medical condition than is, let's say, liver malfunction.

I have found medications to be a godsend for this problem, although it did take a trial of no fewer than four of them to find the right one.

I'd suggest that if medications are recommended, it would be a good idea to give them a serious try.

[mzak69]

I too, get a lot of PVCs after anything that produces adrenaline (exercise, sex, stress, etc). I went through all the supplements, nothing helped. Went to numerous cardiologists, EPs. Told they were benign. It comes down to this: our hearts have an extra electrical pathway which causes these pauses/hard beats. There are a few outcomes:

1. Hope it goes away. Mine come and go, sometimes for weeks or months.

2. Find a experienced EP that can ablate them. This is the only true potential cure.

3. Learn to live with them and ignore them the best as possible.  

Good luck!

[pacperson]

I don't think it's a coincidence that so many of us benign pvc/pac sufferers also mention anxiety, stress or panic when talking about ourselves. In my case, the anxiety preceded the ectopic beats by 30 some years. Of course, there will be some who become anxious because of the pvc's, but my guess is the reverse is more common.

[EricW83]

Hi Achillea, thanks for your post.  I hear what you are saying, and you are right with as many times as I have been to specialists I should be convinced, but each time they just spook me....Sometimes it is just out of the blue, and I always let that thought of..what if this is different?  creep in.  I think I do need to take the step of speaking to a professional as it is beginning to affect my focus and day to day schedule.  It is really nerve racking and I don't want to start taking medication to deal with an emotional problem but it is just really difficult some times...  

Anyways thanks again.

[achillea]

First, your heart has been checked out thoroughly and found to be healthy.  The people who examine hearts are specialists with a great deal of training.  Seriously, they know a LOT, and the chances they've missed anything after so many shots at you are vanishingly small.

However, I understand--having been there myself--that this kind of intellectual analysis will do nothing, as in nada, zip, diddly, to reassure you in any significant way.

Your comment "I am now scared when I go to certain places.  I kid you not in airports I look for the AEDs and feel more comfortable when I see an ambulance or am close to a hospital thinking I am going to have a strong one and maybe pass out or it send my heart into a dangerous rhythm or stop it…". Indicates that you flirting with a second disorder now, called "agoraphobia.".   You can google it.  

It's a case of the first fear triggering a secondary one, and it tends to make people housebound, as in, "What if I have an attack away from home?"  Well, the truth is that the same things would happen at home as out there.  Medically speaking, it would just amount to a miserable panic attack at home instead of somewhere else.  The outcome would be the same:  you'd be really scared, but you wouldn't die.  You might get transported to the ER, where they'd  run a few tests and find that--surprise-- your heart is perfectly healthy, but you have some benign ectopic beats.

Before going on, let me say that the reason you get ectopic beats when relaxing is that when your heart rate drops, as it does when you're at rest, the slightly over-excited cells that trigger irregular beats have a little more chance to sneak in an extra beat than when your pulse is faster.

Second, the exact sensations your perceive when experiencing these irregular beats--heavy, light, thudding, bubbly, gaseous, and so on--are completely insignificant.  They are your brain's way of tring to make sense of something unusual, but these little variations have no medical importance at all.

The point I'm trying to make is that the secondary fear I mentioned, agoraphobia, means that its time for you to see a counselor to learn how to deal with your awareness of disturbing but medically unimportant sensations and fears.  If you do not, there is a reasonable chance you will join the group of patients so paralyzed by what-ifs that you will no longer be able to leave your house.