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I Am Having Problems With Pvc And Wanted Another Opinion..

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Posted on Wed, 13 Jan 2021
Question: I am having problems with pvc and wanted another opinion.. I get my pvcs mostly during exercise .. one right after another.. is this the more dangerous kind? What is causing these? I have exercised for years without any problems! This has been going on for a month ..how can I stop these.. is it dangerous to exercise with them?
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Follow up: Dr. Ilir Sharka (0 minute later)
I am having problems with pvc and wanted another opinion.. I get my pvcs mostly during exercise .. one right after another.. is this the more dangerous kind? What is causing these? I have exercised for years without any problems! This has been going on for a month ..how can I stop these.. is it dangerous to exercise with them?
doctor
Answered by Dr. Ilir Sharka (16 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello dear XXXXXXX

Welcome back to Ask a Doctor service!

I passed carefully through your question and reviewed your test reports and would explain that your 24hours Holter monitoring shows only 211 PACs and only one single PVC.

PACs (premature atrial contractions) in general arising from the atrial muscle are considered quite benign. They are not dangerous.

Furthermore there is quite a few number (211).

Besides experiencing some unpleasant feelings when they occur, they will not harm you, will not threaten your life or make you limit your physical activity.

As they have no potential capability of producing a dangerous cardiac issue, the main point of concern is why they arise right now and during exercise? Any potential reasons and how can they be suppressed?

Coming to this point, let me explain that there are some main clues to be addressed, such as:

- A potential important diastolic dysfunction during physical activity (a mild diastolic dysfunction is present on rest as confirmed by your cardiac ultrasound report, but it may be accentuated during physical exertion). Basal interventricular septal hypertrophy may be a marker of diastolic dysfunction.
- Extracardiac issues such as : a pulmonary function disorder (acute such as inflammation or chronic), thyroid dysfunction, anemia, anxiety, increased psychological stress, chronic systemic inflammation, dehydration (electrolyte imbalance), vitamin D, magnesium, vitamin B complex deficits, excessive stimulating drinks including coffee intake, alcohol, increased circulating chatecholamines levels may be potential causes.

For this reason, I would recommend discussing with your attending physician on the possibility of checking the following tests:

- a cardiac stress echo to study cardiac haemodynamics on exerction
- complete blood count and leukocytes, PCR, ESR to study for anemia and inflammation
- thyroid hormone levels
- vitamin B12, vitamin D, vitamin B1 plasma levels
- magnesium and potassium plasma levels
- circulating chatecholamine levels at rest and immediately after physical exertion.

For the moment, I would recommend only taking magnesium, vitamin B6, L-carnitine, Coenzyme Q10 supplements.

I would recommend following only supervised aerobic physical activity program-mes and avoiding strenous physical activities.

Hope to have been helpful!

Let me know in case of further uncertainties!

Kind regards,

Dr. Ilir Sharka

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello dear XXXXXXX

Welcome back to Ask a Doctor service!

I passed carefully through your question and reviewed your test reports and would explain that your 24hours Holter monitoring shows only 211 PACs and only one single PVC.

PACs (premature atrial contractions) in general arising from the atrial muscle are considered quite benign. They are not dangerous.

Furthermore there is quite a few number (211).

Besides experiencing some unpleasant feelings when they occur, they will not harm you, will not threaten your life or make you limit your physical activity.

As they have no potential capability of producing a dangerous cardiac issue, the main point of concern is why they arise right now and during exercise? Any potential reasons and how can they be suppressed?

Coming to this point, let me explain that there are some main clues to be addressed, such as:

- A potential important diastolic dysfunction during physical activity (a mild diastolic dysfunction is present on rest as confirmed by your cardiac ultrasound report, but it may be accentuated during physical exertion). Basal interventricular septal hypertrophy may be a marker of diastolic dysfunction.
- Extracardiac issues such as : a pulmonary function disorder (acute such as inflammation or chronic), thyroid dysfunction, anemia, anxiety, increased psychological stress, chronic systemic inflammation, dehydration (electrolyte imbalance), vitamin D, magnesium, vitamin B complex deficits, excessive stimulating drinks including coffee intake, alcohol, increased circulating chatecholamines levels may be potential causes.

For this reason, I would recommend discussing with your attending physician on the possibility of checking the following tests:

- a cardiac stress echo to study cardiac haemodynamics on exerction
- complete blood count and leukocytes, PCR, ESR to study for anemia and inflammation
- thyroid hormone levels
- vitamin B12, vitamin D, vitamin B1 plasma levels
- magnesium and potassium plasma levels
- circulating chatecholamine levels at rest and immediately after physical exertion.

For the moment, I would recommend only taking magnesium, vitamin B6, L-carnitine, Coenzyme Q10 supplements.

I would recommend following only supervised aerobic physical activity program-mes and avoiding strenous physical activities.

Hope to have been helpful!

Let me know in case of further uncertainties!

Kind regards,

Dr. Ilir Sharka

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (55 minutes later)
Thank you so much! I have been under stress with the COVID ..two sisters contacted it but I have not.. exercise has always been my stress release.. so you are saying I should not exercise without being with someone? They have me on a beta blocker that suppresses them somewhat should I stop taking that? Is this something that can be fixed? It all started when they put me on the generic for norvasc.. the next day when I exercised I kept getting skipped beats but they told me to keep taking it it would level out.. I took it for about two months and then my blood pressure was getting too low so I went off of it.. one week later I started getting the skipped beats all the time during exercise. Is this something I should go to the Er for? I am not feeling well and sometimes I get this burning feeling in my back..my sleep is very disruptive ..I wake up often thanks so much!
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Follow up: Dr. Ilir Sharka (0 minute later)
Thank you so much! I have been under stress with the COVID ..two sisters contacted it but I have not.. exercise has always been my stress release.. so you are saying I should not exercise without being with someone? They have me on a beta blocker that suppresses them somewhat should I stop taking that? Is this something that can be fixed? It all started when they put me on the generic for norvasc.. the next day when I exercised I kept getting skipped beats but they told me to keep taking it it would level out.. I took it for about two months and then my blood pressure was getting too low so I went off of it.. one week later I started getting the skipped beats all the time during exercise. Is this something I should go to the Er for? I am not feeling well and sometimes I get this burning feeling in my back..my sleep is very disruptive ..I wake up often thanks so much!
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Follow up: Dr. Ilir Sharka (10 hours later)
One more thing I started taking vitamin d supplements about the same time these started .. any connection..my blood work was good except my bit 12 was high.. I take a supplement.. would that cause this.. trying to solve the puzzle.. thanks so much
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Follow up: Dr. Ilir Sharka (0 minute later)
One more thing I started taking vitamin d supplements about the same time these started .. any connection..my blood work was good except my bit 12 was high.. I take a supplement.. would that cause this.. trying to solve the puzzle.. thanks so much
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Follow up: Dr. Ilir Sharka (14 hours later)
My vitamin b12 levels last test was 1546! My doctor did not even mention it to me..I had them send the report to me..
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Follow up: Dr. Ilir Sharka (0 minute later)
My vitamin b12 levels last test was 1546! My doctor did not even mention it to me..I had them send the report to me..
doctor
Answered by Dr. Ilir Sharka (58 minutes later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again, dear Lisa!

You are right about Amlodipine (Norvasc); it may very rarely lead to cardiac arrhythmias (<1% of patients under such therapy). Anyways, these adverse effects will subside once the drug is stopped.

As I explained you before, only 211 PACs (premature atrial contractions) are not a sufficient justification to ask medical assistance to an ER service. These PACs are quite harmless, they will not impose your heart to any immediate risks; they don't interfere with your normal heart functioning or lead to any additional life-threatening cardiac arrhythmia.

You may perfectly follow your physical training.

In additional, I think that anxiety and insomnia is playing an important role in all this clinical situation.

For this reason, I would recommend trying some natural supplements like melatonin and Valeriana to help relieve your anxiety and improve your sleep.

Hope you will find this answer helpful!

If you have any other questions, please don't hesitate to ask me again!

Wishing all the best ,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again, dear Lisa!

You are right about Amlodipine (Norvasc); it may very rarely lead to cardiac arrhythmias (<1% of patients under such therapy). Anyways, these adverse effects will subside once the drug is stopped.

As I explained you before, only 211 PACs (premature atrial contractions) are not a sufficient justification to ask medical assistance to an ER service. These PACs are quite harmless, they will not impose your heart to any immediate risks; they don't interfere with your normal heart functioning or lead to any additional life-threatening cardiac arrhythmia.

You may perfectly follow your physical training.

In additional, I think that anxiety and insomnia is playing an important role in all this clinical situation.

For this reason, I would recommend trying some natural supplements like melatonin and Valeriana to help relieve your anxiety and improve your sleep.

Hope you will find this answer helpful!

If you have any other questions, please don't hesitate to ask me again!

Wishing all the best ,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (5 hours later)
Thanks so much! You are so wonderful!!!
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Follow up: Dr. Ilir Sharka (0 minute later)
Thanks so much! You are so wonderful!!!
doctor
Answered by Dr. Ilir Sharka (21 hours later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

Wishing you all the best for the New Year!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

Wishing you all the best for the New Year!
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9533 Questions

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I Am Having Problems With Pvc And Wanted Another Opinion..

I am having problems with pvc and wanted another opinion.. I get my pvcs mostly during exercise .. one right after another.. is this the more dangerous kind? What is causing these? I have exercised for years without any problems! This has been going on for a month ..how can I stop these.. is it dangerous to exercise with them?