PVC's and shortness of breath with no diagnosis?

[JohnM67]

I'm 48 and have a cardiac history: aortic insufficiency since childhood, had a defibrillator implant in 2010 and had aortic valve replacement in 2012.  I currently take coumadin and sotolol.  About 5 weeks ago I started having bouts of PVC's in the evening, initially lasting 10-30 minutes but gradually increasing to several hours each episode.  Two weeks ago I also started having chest tightness and shortness of breath.  My cardiologist sent me to have an echocardiogram, chest x-ray, CT Scan of the lungs, bloodwork, an interrogation of my device, and finally a pulmonary efficiency test.  None of the tests showed anything wrong with me.  Yet at various times during the day I feel very weak and still have intermittent shortness of breath.  It's like I turn into a 90-year-old man.  My cardiologist wants me to have a nuclear stress test, but the likelihood of having blockage when a cardiac catheterization four years ago showed none is very remote.  What is wrong with me???

[MichelleP_3811]

You say the heart tests all show that things are fine but you have a defibrillator.  Do you have a history of VT?  No one online can tell you what is going on unfortunately.  Sometimes pvcs just have a mind of their own.  But considering your other health issues it may be possible you have some scarring from the valve issue compounding the problem maybe causing the pvcs to repeat on themselves though I can't say for sure, it is just a possibility some possible scarring is compounding the problem for you.  Unfortunately there isn't much they can do about scarring but you may try an ablation to find the spot that is causing the most pvcs and see if it helps.  PVC ablations do not have as good success rates as do ablations for svt but it may be worth a shot if the pvcs continue to get worse.  Discuss it with your cardiologist if they think it would be worth it considering your quality of life is being impacted by them.

Until then see if you can see a pattern to when they occur to see if you have any major triggers you can possibly avoid.  Like can you tell if they happen after meals?  Heavy meals, carbohydrates, caffeine and anything that can upset the stomach can trigger my pvcs so try to see if you can remove most of that from your diet and see if it helps.  In any event, it is good your heart is generally OK all things considered and it may just be the pvcs are causing some of the fatigue.  I know they can with me a bit so just try to avoid the bigger triggers if you can and see if it helps.  In any event, keep up with the doctors and hopefully things will sort themselves out.  Keep us posted on how you are doing.