confusing doctors & structurally normal hearts

[ocdgal]

The title of my question is alittle off.
I am so confused with different info docs give me and my cardio avoiding specific ques i ask him. -not to mention how rudely he treated me over the phone today. I feel absolutly defeated and helpless. I wanted to make an appointment to see him and he said how does mid feb sound. -are u serious. I said well i like to get in before that because i knew they had openings for next week. He said well your tests all came back fine, I wanted to just go over a few ques. with him so i can try to get on with my life again. he was very short with me and said OK loudly and said your 1st question is, he sounded as if  i was a major inconvience by him taking a few mins out of his day.  All i really wanted to know as if in a structually sound heart are all arhythmias benign (rather its pvcs or another type) and he kept avoiding that specific question and was saying well this is real life and things can happen i have no crystal ball-SAY WHAT, great way to answer an already anxious patient . Then he so nicely informed me that theres was no need to keep calling his receptionist all the time. Well if they believed in returning calls when they said they would then i wouldnt have to call back. I see my family doc in the morning and im going to ask him for a referral to a different cardio. I live in canada and its public health care and i really think at times it should be private or at least offer it more in the smaller provinces like the one im in (there are a few private spots opening in bigger areas). Wait times can be terrible and u gotta nag to get some tests (i was denied an event monitor).  I have probabley asked this before but in a structually normal heart confirmed by an echo are all arrhythmias benign. When i asked my cardio when should i head to the ER if things well off with my palpitations, he said if i was having constant non stop racing heart  for around an hour to head to the ER. Now i had an ER doc. tell me one time if my heart begins to flutter non stop for several mins to yes head to ER. any advice will be extremely appreciated.

[youngandignored]

I've been going through this long enough to understand your frustration.. I know how hard it is to take yourself seriously when no one else does. If it weren't for my husband having literally heard my heart act up, I would feel insane. I have Sinus tach and suspected avnrt, but of course, that part hasn't been recorded. Ignorance is bliss in the med field, apparently. Take care <3

[grendslori]

The bottom line is that if your heart, evaluated by echo, is structurally normal, premature beats are not going to harm you. They are a back-up system for your normal heart's electrical system, so they are actually a good thing. The more you worry about this the worse it will become because you are worried, you are flooding your bloodstream with adrenaline which makes the problem worse. Take care

[MichelleP_3811]

My heart rate would get to 230bpm when I was in svt but it was atrial not ventricular.  I had avnrt and it was triggered by the pacs and pvcs.  I had an ablation to correct it in september and it seems to have worked for the fast beat but not the pacs/pvcs.  I probably should have gone to the ER but I did leave to go once and it stopped on the way so I just assumed they would stop and they eventually did.  Most of the episodes only lasted a minute or two and I grew up with them so I didn't give them much mind.  That said, I never got as sick as I did with the svt as I did with the pvcs/pacs.  I had a bout of them for about a week that probably averaged 10,000 - 15,000 a day.  I think there is a large stomach factor in my case.  Because I got so sick I wound up fasting, I just couldn't eat much but some granola and bananas, and the pvcs/pacs cleared up.  Prior to that I was dealing with a lot of gas that I just couldn't figure out how to get rid of.  The over the counters that were suppose to help with gas made the situation worse.  But this unplanned fast seemed to have straightened my stomach out some what and helped alleviate most of the pvcs.  Not totally but I now only get a handful to maybe a 100 a day.  

So after I got the pvcs/pacs so bad I went back to my cardiologist who ablated the avnrt and was informed that there isn't much beyond the beta blockers that they do for them.  It was a little disheartening to say the least and a little ironic.  The thing that didn't bug me the svt could be easily fixed but the pvcs that made me sicker than ever can't. Life can be frustrating to say the least. I should say they can be fixed but the problem is an ablation to fix them is a lot trickery than it is to fix most svts.  The success rate isn't as good and the chances of creating more problems is there so I think most EPs tend to recommend management of them over an ablation.  That said, if the pvcs and pacs are disrupting your ability to live and function then something needs to be done.

The first step I would try would be to see if you have any underlying stomach issues that can be addressed.  There does seem to be a big stomach correlation and correcting any underlying problems may help ease the pvcs for you.  The other big factor that contributes to them is stress.  Do whatever you can do to reduce your stress when you feel the emotions coming on.  Finally, if that fails, then try the beta blockers.  They won't get rid of the pvcs but may help slow them down and help you feel better.  

As for the doctor, you really shouldn't feel bad about wanting a consult.  If you are having trouble with one find another but I would recommend going to a different office.  This way you can get a more unbiased evaluation. That said, you will likely get the same recommendations as you have already.  Do your best to find and rid yourself of the triggers, go on beta blockers and only come back if they get worse or start to happen in a row that causes you to get dizzy or lightheaded or passing out.  If not pay them no mind because they should not affect the health of your heart in the long term.  Easier said than done but that is the going medical view on the whole thing at this time.  

I wish there was an easy fix to get rid of these things, maybe one day there will but until then we have to all figure out how to cope.  If you search around the forum you will find a lot of posts on the subject so we are not alone.  Take care and if you have any more questions just let me know.    

[ocdgal]

hi michelle, thanks for the info. and support. My doc. did suggest beta blocker, but i can have blood pressure on the lower side at times and since beta blockers can lower bl pressure even more......  I decided against it for the moment. How many pvcs did u usually average daily?  To get rid of some stress and triggers i  drink only decaf coffee and teas, only abit of cola at times and i went out for a 3month leave from my job, I work in a call center and it is awful lol ;)  I have been taking paxil for anxiety for yrs now.

U said u once had a 12hr episode of svt , what rate was it at and did u go to the er to get it correct. I thank god i havent had any sustained funky beats lasting over several secs, but come and go all day-blah!!  

As for my cardio, i called his office today and left a msg for an appointment to talk about him setting me up an appointment with an ep specialist just to have a discussion on my pvcs and other  funky beats, and also stated how i know he probably will not want to do this, so if he didnt want to see me in his office anymore (as to how our conversation last week )then could he please set me up with a colleague that may take me as a new patient. I was very polite in how i stated it and i was apologetic  for calling again so soon, which is why i said  if he preferred not to have me in his office again to at least set me up with someone who would. I dont know which is worse - fighting with doctors or dealing with my heart HA!!!      Have a great evening

[MichelleP_3811]

That is quite a few pvcs a day. I know I had a bout of them around that amount for a week and felt just sick as can be.  Has your doctor suggested beta blockers?  My EP stated it wouldn't necessarily stop them but could help alleviate some of the symptoms.  Do your best to try and find stress release because that will make the situation a lot better for you.  There really is no reason for them to continue to get worse if you can get a handle on at least some of the triggers, stress and anxiety being the biggest trigger.  Good luck and feel better soon

[ocdgal]

hello merileegal, they have diagnosed me with very frequent pvcs-14,000.day mostly in bigeminy patterns which showed on my 24hr holter. I was concerned however with other odd beats that i had been feeling that have never been recorded yet. I told my cardio this and he didnt seemed concerned and said it could be some svt but didnt explain much to me about svt so i had to do the research myself. I do some vagal manuevers when i get the bad ones. Im 34 now and i remember feeling some around age 20 and have got worse. My holter 4yrs ago only showed 1400-a big difference in 4yrs i scared to know what they will be like in another 4yrs. My cardiologist didnt want to refer me to an EP doc either.

[MichelleP_3811]

I had an svt, avnrt, my whole life.  I did not notice pvcs until the last 5 years.  I was told my svt did not cause the pvcs.  I did let a couple of the episodes go too long, one 8 hours and another 12 hours.  They mostly were 1 to 30 minutes so I always assumed the longer ones would stop.  So I rather believe that my svt is a contributor to the pvcs and pacs.  I also have also read that left untreated over time svts can lead to congestive heart failure.  So though in general most arrhythmias will not lead to premature death I think they can lead to complications if not taken care of proper.  However, for the most part, most people live long productive lives with their condtions so the medical community doesn't see them as major health issues.  

I have run across my fair share of rude doctors.  They are people just like you and me who are pressed for time and have egos.  I had a gyni who was super rude to me because I  found a fibroid through a cat scan and not through her through an ultra sound but I had went to her first telling her I felt sick and she blew me off so I went to my GP thinking it was something other than a female issue.  That said, what I have found is honesty really goes a long way.  If I explain to the doctor that I am not trying to give them a hard time that I just need to understand what is going on they will a lot of times put their guard down.  Your doctor likely doesn't know what else to do for you and feels a bit pressed to fix you when he may not be able to.  But just be as honest as you can about how you feel emotionally about the whole situation and what you need from him and if they are still rude then definitely find another doctor.  You deserve to be treated with respect.  

Take care but please take some time to release some of your fear about your condition.  You will likely live a very long life with a few extra hickups that not everyone experiences.  The more you can deal with and release the stress the better you will feel emotionally and physically.  I hope you feel better soon.  Keep us posted on how you are doing.

[merileegal]

Have they given you a diagnosis of what you have? I had SVT  and had an ablation for it last June.  I dealt with attacks for over 20 years and learned to convert my heart back to normal rythm by using vagal manuevers. When I saw an electrophysiologists for the first time and found out my arrythmia could be cured, he told me that I should've gone to the ER during those years just to get a picture of what was going on. I also went through a lot of different doctors and was brushed of like you are right now so good idea to get a different doctor that treats you as a person. Good luck.