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Suggest Treatment For Benign PACS And Rare PVCs
Question: Hi I have what my cardiologist says are benign pacs and rare pvcs. I noticed lately I've been waking up with my heart racing and also having etopic beats. The heart rate is all over the place. It is very strange to me. My cardiologist says it is normal for me as I have some anxiety. I don't think I have anxiety right when I wake up but I could be wrong. Also I noticed my palpitations are always worse right when I wake up in the morning
Brief Answer:
please see details
Detailed Answer:
Dear sir
1. First thing in work up is that if you ever had any dangerous symptoms like loss of consciousness, blackout or unexplained fall. If they are present one must see the cardiologist on priority.
2. In absence of above symptoms, we should look for rhythm disturbance at time of palpitation. The modalities for this could be ECG, holter monitoring or loop recorder.
3. Third thing is to get an echo or cardiac ultrasound which will tell about structural heart disease.
4. APCs or VPCs in absence of structural heart disease do not carry any adverse prognosis. They are increased by alcohol, smoking, fever, anxiety, coffee, tea and some medicines. If excessive and symptomatic, they can be suppressed by simple medicines.
5. When we suddenly wake up especially from deep sleep heart rate normally accelerate and is normal.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Dear sir
1. First thing in work up is that if you ever had any dangerous symptoms like loss of consciousness, blackout or unexplained fall. If they are present one must see the cardiologist on priority.
2. In absence of above symptoms, we should look for rhythm disturbance at time of palpitation. The modalities for this could be ECG, holter monitoring or loop recorder.
3. Third thing is to get an echo or cardiac ultrasound which will tell about structural heart disease.
4. APCs or VPCs in absence of structural heart disease do not carry any adverse prognosis. They are increased by alcohol, smoking, fever, anxiety, coffee, tea and some medicines. If excessive and symptomatic, they can be suppressed by simple medicines.
5. When we suddenly wake up especially from deep sleep heart rate normally accelerate and is normal.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doctor
I have had holter done 2 times. Always in sinus rhythm just showed mostly Pacs (925) in 48 hours and 15 PVCS. My resting heart rate sometimes goes down to 55 bpm. It went down to 41 bpm during sleep. Cardiologist also says it's normal
Echocardiogram showed structurally normal heart with some trace regurgitation.
Stress test was also normal
I do not drink alcohol or coffee. I only drink water. I do not take any medications. All my tests were done 2 months ago
I have had holter done 2 times. Always in sinus rhythm just showed mostly Pacs (925) in 48 hours and 15 PVCS. My resting heart rate sometimes goes down to 55 bpm. It went down to 41 bpm during sleep. Cardiologist also says it's normal
Echocardiogram showed structurally normal heart with some trace regurgitation.
Stress test was also normal
I do not drink alcohol or coffee. I only drink water. I do not take any medications. All my tests were done 2 months ago
Brief Answer:
Try to reduce your anxiety/ medicines will help.
Detailed Answer:
Dear Sir
1. If you experienced palpitations when you were wearing the holter? If Yes, then you have palpitations because of benign premature contractions. APCs and VPCs occur in 2/3 rd of population on any given day. They are common phenomenon in normal subjects and is mostly without symptoms.
2. A Heart rate of 41 bpm during sleep is normal.
3. In view of all these facts, as mentioned by you, a simple addition of medicine which reduce sympathetic drive should help if symptoms are profound. Anxiety definitely contribute to them and you must understand the benign nature of these events and reduce your anxiety. For actual prescription of the single agent for these premature contractions , you must consult your internist / cardiologist.
Feel free to discuss further.
Sincerely
Sukhvinder
Try to reduce your anxiety/ medicines will help.
Detailed Answer:
Dear Sir
1. If you experienced palpitations when you were wearing the holter? If Yes, then you have palpitations because of benign premature contractions. APCs and VPCs occur in 2/3 rd of population on any given day. They are common phenomenon in normal subjects and is mostly without symptoms.
2. A Heart rate of 41 bpm during sleep is normal.
3. In view of all these facts, as mentioned by you, a simple addition of medicine which reduce sympathetic drive should help if symptoms are profound. Anxiety definitely contribute to them and you must understand the benign nature of these events and reduce your anxiety. For actual prescription of the single agent for these premature contractions , you must consult your internist / cardiologist.
Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor Thank you for your response. That is the best explanation I have ever received from any doctor. Most just tell me not to worry but it's nice to understand. I have a few last questions before I close the discussion. Does it matter how many etopic beats I have per day? Also I have mostly Pacs and a few PVCS is it normal to have both? Is either one more dangerous? Also is my resting heart rate of 55 bpm normal?
Brief Answer:
please see below.
Detailed Answer:
Dear sir.
1. Yes, normal individuals can have both APCs &VPCs.
2. None of them is dangerous as such. They are significant only if they indicate a seriousstructural heart disease or they initiate a serious rhythm disorder.
3. There is no number limit for nnormal APCs or VPCs.
4. For a healthy fit person , heart rate of 55 per minute is absolutely normal.
Sincerely
Sukhvinder
please see below.
Detailed Answer:
Dear sir.
1. Yes, normal individuals can have both APCs &VPCs.
2. None of them is dangerous as such. They are significant only if they indicate a seriousstructural heart disease or they initiate a serious rhythm disorder.
3. There is no number limit for nnormal APCs or VPCs.
4. For a healthy fit person , heart rate of 55 per minute is absolutely normal.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor I am not very fit. In the sense that I have not been exercising because of the fear of the palpitations. However over the last 11 months I have lost 80 Lbs through good diet and eating well. I stopped sugar intake as well as white flour and pastas and started drinking just water and eating whole foods and also juicing. Is the 55 bpm still normal? My cardiologist says it's fine but doesn't explain much else. Also you said pvcs and pacs are not dangerous unless they trigger another rhythm or structural heart disease. My tests were all clear. Is there still risk to develop these problems and how long are my tests good for?
Brief Answer:
try to avoid thinking too much
Detailed Answer:
Dear Sir
1. Healthy and fit, pertains to the person who has no symptoms due to low heart rate and these are not present in your case.
2. You do not have structural heart disease as your ECHO is normal.
3. There is no evidence of serious rhythm disorder as per your holter report.
4. In general, none can judge or estimate the risk of these events in a given individual. These tests only tell you current state of affairs. Future predictions can not be made in a given individual. They are done only to explain your symptoms. you must try to avoid thinking too much over the issue and try to accept your cardiologist's advice. He is the best judge.
Sincerely
Sukhvinder
try to avoid thinking too much
Detailed Answer:
Dear Sir
1. Healthy and fit, pertains to the person who has no symptoms due to low heart rate and these are not present in your case.
2. You do not have structural heart disease as your ECHO is normal.
3. There is no evidence of serious rhythm disorder as per your holter report.
4. In general, none can judge or estimate the risk of these events in a given individual. These tests only tell you current state of affairs. Future predictions can not be made in a given individual. They are done only to explain your symptoms. you must try to avoid thinking too much over the issue and try to accept your cardiologist's advice. He is the best judge.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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