Resolved question:
Hi there..my name is Jill and I am a 36 year old woman. 4 years old patientago I had a work up for heart palpitations and the workup showed PVC's and occasional short runs of svt, minimally symptomatic ( via a loop monitor) I also had an echo, keg and a bruce stress test - all normal. I do suffer from a severe anxiety disorder mostly related to my health. About 3 months ago my anxiety flared up again and I began to worry about my heart. My mom has atrial fibrillation and had a stroke at 53. I went to my dr and he ordered another round of tests for reassurance and a referral to the cardiologist. I had a echo and ekg again and all is normal. I am currently on a loop monitor again but the cardiologist really didn't think it was necessary. He is doing it to reassure me.....the only thing concerning me is the cardiologist confused me a little bit. He said that pvc's can lead to atrial fibrillation possibly later but I always thought they were benign? So I asked him how I would know the difference and he said I wouldn't...... So I have a few questions
1. Can pvc's or svt eventually turn into or cause atrial fibrillation?
2. How would I know if the palpitations I am feeling have changed into a atrial fibrillation....does it feel different than lvc's or svt? When I have svt it feels like a thump and then my heart races for a few seconds and it stops
3. Can atrial fibrillation occur in short burst like my svt?
4. IF so, can short bursts of a fib cause strokes or is that when it is more prolonged?
5. Why would the dr tell me pvc's and svt is benign if it can lead to a fib which I know is more problematic
6. Im really scared now and confused....am I going to get a fib like my mom because I have these apparent "benign arrhythmia"
7. Should I have my heart monitored periodically?
Thanks Jill
Submitted:
4 Days
Category:
Cardiologist
Dear Jill,
Thank you for your query at DoctorSpring.com
I have gone your case history, I would like to give a short review on PVCs. Most of the PVCs are asymptomatic , but sometimes it can be perceived as a skipped beat or palpitations. It can occur in healthy person of any age but common in elderly and in men.
Some of the causes are
High blood calcium
Medications like tricyclics antidepressants
Electrolyte imbalance
Alcohol , caffeine , cocaine
Foods like cheese that is strong, dark chocolate
Smoking
Thyroid problems.
The reason why I told you causes is if anything you are having it , then it is better to avoid it.
Isolated PVCs are benign require no treatment.In healthy individuals PVCs can often be resolved by restoring the balance of magnesium,calcium and potassium within the body.
Elimination of triggers like stopping the caffeine.
In symptomatic patients we use beta blockers or calcium channel blockers.
Life style modification like frequently stressed individuals should consider therapy or joining a support group.
In your case I would advice you to first check your thyroid status, send me loop recorder findings , avoid the precipitating factors which was discussed above.
Most of the benign PVCs do not progress to AFib , but frequently occurs PVCs have chance of progression to AFib, so it has to been periodically monitored.
Yes occasionally short episodes of AFib can cause stroke.
If you are having periodically palpitations which are proved as PVCs by loop recorders , then you have to be periodically monitored.
Periodically moniter your blood pressure and blood sugars as hypertension and diabetes can increases the chances of AFib and stroke.
Send the blood reports which has been ordered by your physician and I would like review with reports.
Regards
Dr Satish
Hi and thanks for the reply...I don't have my reports.....but I can tell you that I have had two normal echos, two normal ekgs, a bruce stress test that was ok with no signs of active ischemia....I have had two loop monitors that showed first just PVC's and the second one PVC's and short runs of SVT minimally symptomatic.....I am currently wearing a monitor for the third time just for reassurance. I have normal blood pressure and sugar. I am 36 years old patientold, not overweight and exercise regularly. I have had my thyroid tested and it is fine.
What do you consider frequent PVC's - I maybe feel 1-2 /day at most...my svt episodes are occassional.....I do suffer from a severe anxiety disorder which is under treatment with therapy and SSRI's ....is it possible all of that all of this is caused by my anxiety and nothing more?
Dear Jill,
To quantify VPCs as significant , it should be 20% of all heart beats in 24 hr monitoring , for which we initiate treatment after ruling out any reversible factors.
In your case i wouldn't suggest any medications for the present.Don't stress yourself and live a happy life .
Regards
Dr Satish