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I’m hoping my PVCs are JUST stress related
Hello community, I am a 30 year old male. Non-smoker but I do tend to imbibe. Primary exercise is cardio, easily 5 hours worth a week. Not overweight, no history of heart diseases personally. However, my mother recently suffered a "minor" heart attack and is currently working through an arythmia related issue. My little girl, now 6 was born with transposition of the great arteries. She bravely had corrective surgery a week after she was born and is a healthy little girl. Nothing points toward a genetic disposition. That was just a little bit of background for my story to follow.
I woke up on a Wednesday morning and was changing into my workout clothes to obviously work out, as I usually did. While changing I feel my heart flutter, start, stop, speed up and slow down seemingly all at once. My left pectoral muscle was also spasming. I frantically woke up my wife to feel my chest to confirm she could feel what I thought I was feeling; she did.
The episode slowly subsided. I did not work out and and went to work. As soon as I pulled through the gate, I had another episode. I told my supervisor and was off to the ER. Blood test, EKG, and chest X-ray came back normal. I was told it was likely stress related do to the COVID concerns.
I shrugged off that theory because while I do currently have a stressful job, I was also in the U.S. Army assigned to a unit with a very high operational tempo which only afforded me four days off a month. I pondered on the fact while I had restarted my graduate degree program and beginning a new but very competitive position at work, I was always very good with my stress management.
I was sent home with more questions than answers. The symptoms only increased in their occurances. I found myself back in the ER on Friday and Sunday. Same tests conducted, same results, same discharge orders. It was not until my third ER visit I was finally referrred to a cardiologists.
I had telephone consultation and he sent me a seven day Holter monitor. I only ended up wearing it for five days because I sweated the adhesive off between working out and my work equipment. I figured I would do my best to give the doctor an accurate snapshot of what my heart does by trying to live my life as close to normal as possible.
The Holter showed I had JUST one incident of non-sustained ventricular tachycardia. It was a 3 second run, of 9 beats which averaged a total of 136 bpm. It was apparently and episode I felt, but cannot recall because I activated the event button.
I was then asked to undergo an echo and a stress EKG. I completed the echo but was not able to schedule the stress EKG due to COVID precautions. Last week I was informed my heart was anatomically correct and was physiologically functioning normally. It was recommended I take magnesium tablets in the hopes of mitigating the episodes.
The muscle spasms have gone away completely but they have been replaced by a sporadic radiating or sometimes sharp pain in my left arm and chest and what feel like tension on the left side of my neck, always on my left side.
I was given medication to help me sleep and have tried my hand at meditating. I am willing to do ANYTHING to feel normal again. I haven't felt normal since I woke up that Wednesday morning. I have distanced myself from my wife and children because I don't want them to see me suddenly stop and place my hand on my chest to see if I just had another episode.
The remedies help to a small degree. The doctor said the PACs/PVCs are not a cause for concern due to there not being any abnormalities during the echo (during which I was very stressed and was having a PVC every 8-10 heart beats. This eases my mind, a little but I can't shake this feeling, these palpitations, this inconvenience especially when I'm in bed, afraid to fell asleep.
I can feel my heart beat in my chest and I can also hear it through the day and it pulses in my ears. I am also jolted awake as a doze off due to the large thud the follows my PVCs.
Has anyone experienced this? Or anything close to it? What helped? I have an in office visit with the cardiologist's PA, any questions I should ask?
NewPacer73, May 29, 2020 7:35am EST
@JLopez: You may be embarking on the beginning of a road I have conquered. I am 74. I am doing great. My family history has mostly been about cancer, but also some heart stuff. To me, it's been decades of exploration and changes to figure out how complicated the heart is. What I did at your stage, when they knew a lot less, is keep going, keep asking, keep checking things out. To me, there is nothing more worrying than not knowing for sure if your heart is going whacko and that's if it's dangerous or routine. Here's the good news. They know so much now about cardiology that wasn't even a twinkle in a cardiologist's eye back then. I'm going to offer only one idea that has been consistently helpful over the decades. Even as an old lady, I now use the patient portal of a trusted cardiologist. If I have symptoms or concerns, I write to her and she answers me mostly on the same day about what to do. Usually it's no crisis (short episodes of nothing) and/or some med adjustments and I'm telling you, even in this terrible pandemic, this has lowered my stress level to almost nonexistent. Cardiac issues are stressful all by themselves for me because there is no "app" to use to figure it out. (smile). It's a process. I"d start by making sure you have the best cardiologist around who specializes in your problem. You can have a general cardiologist too to oversee your case. I bet what happens next, because of how dedicated you are to being healthy, you will have many years of no issues. But I think the first step you need is an outlet, especially during the pandemic, where you document your symptoms. I report in heart rate, BP, symptoms, etc. We just found out recently the problem I had required med changes, and it's working. Communicating with a trusted cardiologist is key. The current cardiologist is not my first one. I was seeing an interventionalist who was in over his head, although an amazingly dedicated hard worker. So, getting the right cardiologist for where you are today is your key decision. I asked around. Found the one I have now and it's made a huge difference in keeping stress to a minimum during episodes of worry. I have an Omron BP machine that detects arrythmmias while also taking blood pressure. I have a finger oximeter that I take with me to check oxygen and heart rate if I get symptomatic. I hardly write to the cardiologist, but it's there as an outlet when I get worried about how I feel. Once in awhile, it's important to check it out. She knows when to bring me in for an echo, stress test, etc. So from an old lady to someone who is beginning to check out cardiac concerns, relax. They have so much now they can do to intervene or help, it's ridiculous. Get a cardiologist you believe in and use the patient portal to communicate and document symptoms. Sometimes, several portal messages add up to a picture that says more than most doctor visits. Good luck and continue to take care. You've got a lot going for you so this is just one thing more to get under control. And you will.
AHAASAKatie, May 29, 2020 9:00am EST
Good morning, I can share what we have on SVT's to help with the education side of this. I also think, if you can, a second opinion is a good idea. From reading your post, you do not sound comfortable with the wait & see approach. I do not have a solid understanding of how military medicine works, but if you are allowed, I would get another opinion. I am not sure if you saw a cardiologist or a Cardiac Electrophysiologist. Electrophysiologists manage arrhythmias and afib.
I am not in any way saying the current treatment was inappropriate or lacking, but if you would be more at ease, it is your right as a patient to have a second opinion, possibly from an electrophysiologist.
I also commend you (and am maybe a bit envious) of your commitment to working out and staying healthy. Personally, I have been challenged with that during COVID19 and staying motivated.
Please know that we are here for you.
Jlopez, May 31, 2020 2:10am EST
Thank you for the responses. It is comforting knowing there are others who feel the same thing, even if they are for a multitude of reasons or underlying causes.
I will continue to persevere and speak with the PA about a referral to an electrophysiologist.
Jessica0509, June 2, 2020 12:17pm EST
Hi! So sorry to hear that you're going through this. This has been my normal for the past two years. While at the beginning it feels traumatic and beyond scary,
I eventually began to adapt to my symptoms. I too get minor chest pain at times that radiates into my left side, it never lasts for more than a few seconds and eventually passes. For me, it helps to apply a little bit of pressure to the area until it subsides. I definitely would recommend seeing an electrophysiologist, as that has helped me made some sense of the situation. It is extremely helpful that both my electrophysiologist and cardiologist operate out of the same office so they can easily communicate about my care. I think it is important to pay extra close attention to your body and what you're doing when you experience the tachycardia so that you can try to avoid those triggers. I know that stress, alcohol, too much sugar, and caffeine are triggers for me so I try to be mindful of my intake. Bending over can also be a trigger for me sometimes so I make sure I squat whenever I pick something up instead of lunging over. I find it helpful to keep a log of my attacks and how fast my heart rate gets and what/if any maneuvers helped to get my heart rate down. There a lot of youtube videos available on maneuvers that can help get you out of Tachycardia as well. If there is any questions you have please do not hesitate to reach out!
Jlopez, June 2, 2020 5:54pm EST
I am doing my best to make notes of what I'm doing or have done when I experience an episode.
I am at a loss because I can work out and really exert myself and I feel great, normal, like I used to. But when I am laying in bed I feel everything.
I assume it is because I keep myself busy throughout the day and am distracted as opposed to being so self aware at the end of the night.
I try to trick myself by telling myself that I've likely had this for a long time but just now am aware of the symptoms.
I scheduled my stress EKG for this Friday and I am doing my best to get an in office visit with the Cardiologist on Monday instead of a phone consult.
I know the doctors see this all the time but I feel like they are being very dismissive.
sh4166, June 5, 2020 12:24pm EST
First of all, I am sorry that you have to experience what a lot of us who are going through or have gone through in the past. I know how much added stress it can cause, how much it can consume every minute in your day, and the negative impact it has robbing you of your time with your family. I have had the same problem much of my life. It comes and goes when it chooses. I was diagnosed with heart arrythmias in my late 20s with pvcs and tachycardia. In my late 30s I was diagnosed with svts along with pvcs and pacs and since have been on a beta blocker which has been increased over the years. Forward 20 years later, two months ago, out of nowhere, I started a horrible episode of pvcs that woudn't quit. My heart would stick in bygimeny in a session of 14 beats. I couldn't stop it no matter what I did. Unfortunately, this was at the start of Covid so my cardiologist told me to double my dosage of my beta blocker. This made things worse and I couldn't function throughout the day. I was awakened by heavy thuds (pvs) that robbed me of my sleep. I felt a since of panic and feared that my time was coming to an end. I am still here and doing better with each day. I was placed on a 30 day event monitor and was finally able to see my doctor after being on it for 20 days. I did have one run of atrial fibrilation that lasted seconds. I had an echo the next day and all came back normal. He wanted me to go on an anti arrhythmia drug, but I told him I did not want to unless he felt it was necessary. He left it up to me, so we both agreed that if I feel the need for it he would call in a prescription for it at any time. I did start taking a baby aspirin everyday per his request. I have finally stopped worrying about it and have been able to go through my day without feelng my pulse or counting how many skips I have. My heart can still skip several times a minute on bad days, but for the most part I am having less than before. I did start a magnesium supplment when it all started and it seemed to help, but it took a couple of weeks. I haven't been taking it for a few weeks.and have been okay. I hope you find what works for you and know that with all of your testing, you will be fine.