PVCs and exercise

[Maya551]

I'm hoping someone can help shed some light on this....

I'm a 34 year old female, and in relatively good shape.  I had my first baby a few months ago, so I'm still losing the baby weight.  I've always been in good health and a pretty competitive athlete.  About a month after my baby was born I started experiencing a few PVCs per day.  I saw a cardiologist who had me wear a holter for 24 hrs and confirmed that they are indeed PVCs and are benign.  I was okay with this.  When I started exercising again, I noticed that I was experiencing a similar sensation in my chest: harder beats throughout my exercise routine.  The beats usually did not happen one right after another, but rather spoadically during my workout.  I would get anywhere from 5-10 during a 45 min workout.  I called my cardio back and he had me do a stress test.  I only had one PVC during the test, and I had a lot of recovery PVCs.  He told me that my heart is strong and that I am more than okay.  I should mention that I had a full work up (holter, stress test, blood work, and echo) in 2009 when I experienced PVCs
for the first time.  I only ever used to get them when I was nervous, and they would quickly subside once my anxiety went away.  These new PVCs seem to be presenting differently-more random and with exercise.  I just wasn't feeling confident in what my cardiologist told me, so I had a second opinion.  My new cardio reviewed my tests from 2009 and 2012, and basically said that yes, they are PVCs and I can try meds if I want.  He also told me that I am safe to exercise in spite of the PVCs.  He said that I can have another echo if I want, which I have scheduled.  He does not think that the structure of my heart has changed, or that pregnancy did anything bad to my heart.  He is allowing the echo to ease my mind.  I guess my worry is that my first cardio only saw one PVC during my stress test. He did not see the full picture of what I experience when I am exercising.  I am worried that he may have missed something.  Although I don't get many PVCs on a daily basis, the fact that I have them at all and especially during exercise is really scaring me...so much so that it's kind of taking over my life.  I'm scared to exercise!!  I also find that my PVCs get worse around ovulation and menstration, but my new cardio said he has never heard of a hormonel connection.  Any help and/or advice would be greatly appreciated.  Should I just let go of the fear and exercise, or should I pursue getting a third opinion?  

[MichelleP_3811]

It is good news to hear that your echo came back fine.  From what my EP told me if the pvcs are bothersome they sometimes will try bp meds to regulate the heart beat.  This helps some but not all people.  If your pvcs are such that you are really bothered by them then by all means try the bp meds if they are offered but do consider the side effects and the fact that if you are on them for any length of time you will likely need to stay on them the rest of your life.  So weigh both angles and decide what feels the most right. Also if it is a matter of finding peace about them so you can go about your life without constantly worrying about them do consider speaking with a professional at least for the short term to get past the anxiety about them.  I know they can be very disconcerting and it is hard to comprehend that they aren't a danger but medical research seems to point in that direction so we have to trust that all will be well with our hearts moving forward.  But if you ever need to talk you are in good company.  There are many here who feel the same as you just trying to figure out how to live a full life despite the odd beatings of our hearts.  We are here for you.  Good luck with the EP.  Let us know how it went.

[Maya551]

You asked me to get back to you about my echo.  Results were good!  Asked cardio why I'm getting them during excercise.  He does not know, but said I'll have to take his word for it that it's okay to be active.  Still nervous, but feel better that heart is structurally normal.  I'm meeting with an EP in two weeks to continue investigating this.  

[achillea]

Your heart has been checked out several times, and almost certainly your doctors did *not* miss anything.  I know that's hard to believe when you have the sense that you are being kicked in the chest every few seconds, but lots of us here have lived with that sensation for years.  I've had benign PVCs for decades, and during the spells when I have tons of them (4800 in 24 hours), I'd be delighted to have only one every 10-20 beats!  

It will probably help you to read about PVCs and what goes on with them.  For some user-friendly explanation, type this into your google search box:

Kenyon cardiology/forums/backup/topic-24286.html

There will be a series of helpful posts for you to check out.

Next, you need to get back to your regular doctor or your cardiologist and tell him/her that these things are scaring the #%@* out of you and that you need some help dealing with them.

There are a few medications like beta blockers that help some people. If that isn't enough, seeing a psychiatrist who understands the connection between fear and odd heartbeats will go a long way towards helping you settle down.  Really, it's a lot faster and more efficient to talk with the right professional, and a shrink *is* the right doc for this.

[Maya551]

I'm really scared.  I had the worst episode of PVCs yesterday that I've ever had.  I had one every 10-20 beats..sometimes every two or three beats for hours.  The only thing that calmed them down was laying down and falling asleep.  Not sure what brought them on yesterday!  I'm really at a loss.  I have a brand new baby and I'm so scared that something is going to happen to me and I won't be here for her.  I don't know what to do.

[MichelleP_3811]

I don't have vt that I know of.  I had an svt, Supraventricular Tachycardia called avnrt.  I had an extra muscle fiber leading into the avnode that the electrical signal would get caught on and it would cause episodes where my heart would beat upwards of 230bpm.  You can't mistake it.  I was born with it and mine was triggered by pvcs though most are triggered by pacs.  I have those as well but didn't notice any of the extra beats, pacs and pvcs, until I had the svt cleared up.  I have had a handful of instances where my heart has felt like it has sped up but it doesn't last but a few seconds so it doesn't cause any symptoms whatever it is.  I exercise daily.  I have gotten pvcs while I exercise though I mostly get them on cool down.  My doctor cleared me to continue exercising.  It sounds like yours did too though you might want to have them clarify that for you.  Ask them to explain what needs to be evident for them to be a danger to you and where you are at on that scale.  Of course there are no guarantees in life but everything I have read suggests that in a healthy heart, pvcs and pacs are of no consequence even if one experiences them in short bursts or runs.  The likely hood of a person with a healthy heart falling into a dangerous rhythm from the pvcs or pacs is slim.  So then it becomes a matter of learning to trust that our heart is going to keep on pumping just fine regardless of the odd way it pumps on occasion.  Well I would say get your echo and hopefully that will ease your mind a bit and then try to go back to exercising.  It is better for you if you continue to exercise but maybe stop if you notice you are falling into a heavy pattern of pvcs.  Maybe try to cough them out, it sometimes works for me, wait for them to tapper off or simply go back to the workout the next day.  But if you are given the all clear with your health your best bet is to try and come to grips with having the pvcs for your own peace of mind because it is very likely you will continue to live a long life and wind up dieing from something completely unrelated to the heart. Ok, take care.  Do get back to us on the echo results.  

[Maya551]

Thank you for your thoughtful response.  How did you know that you had VT?  What were/are your symptoms?  I don't experience any adverse symptoms from excercise.  In fact, my cardio kept commenting on how impressed he was with my fitness level.  He ended my stress test a few minutes early-I guess he saw what he needed to see.  I'll know more after my echo.  Is it safe to assume that if my echo is good, then my heart is okay in spite of these PVCs during exercise?  

[MichelleP_3811]

You have to go by what you feel is right for your health but it does sound like your heart is healthy based on the tests you have had so far and as long as you are not falling into vt when you exercise it is likely you are ok in that respect as well.  The biggest thing I learned from my heart issues, svt for 45 years and now pvcs and pacs is that there is only real concern if you are experiencing troubling symptoms like shortness of breath, dizziness or passing out.  If none of this happens with your pvcs then you likely have nothing to worry about considering your heart is structurally normal and free from disease.  I would say it is possible that having the baby changed or stressed your heart a bit but with some time it will rest and recover and the pvcs will fade away.  Though they may not as well but if the doctor gave you the all clear to exercise I would do so but maybe just not push it too hard if you notice pvcs jumping in.  Just go a bit slower until they ease up.  In any event, your heart is a very resilient muscle that can keep beating even with all sorts of issues so you will likely not have anything to worry about even if the pvcs don't disappear.  Take care and keep us posted on how you are doing.