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Suggest Treatment For Occasional Ventricular Premature Complexes
Question: hello I'm a 22 year old male and I had a cardiac Ablation for RVOT frequent PVCs three months ago . My pvcs started when I was a teen , at the age of 15 - 16 went to see a cardiologist and holter showed I had 7000 pvcs at that time . Doctor did not give me any medicine and PVCs subside slowly. They returned over a year ago and at the ER room doctor said I had frequent benign PVCs , next day I had a Echo test RVDd : 2.8 cm IVSd : 0.75cm LVIDd: 5.5 cm LVIDs : 2.7cm LVPWd : 1.0cm FS: 51.4% EF ( TeiCh ) 82 . 2 % Ao root diam: 3.3 cm ACS : 2.6cm LA Dimension : 3.1cm .
Ejection Fraction 55%
Left Ventricle normal size . Normal wall thickness . Systolic function is normal .
RIght Ventricle is normal in size and function.
Left atrial Right Atrial size Normal .
summery : Essentially Normal Study . ( this Echo was one year and five months ago ) when I had thousands of PVCs a day 15 000 - 18 000 .
I also had a normal stress test and PVCs went away with higher heart rate on treadmill .
Doctors say it was not dangerous but I had horrible symptoms and I could not function normally . i started suffering from Panic Attacks because I though my heart was going go stop and I had this horrible butterfly feeling in my chest all the time . beta blockers did not work anti arrhythmetic drug Propafenone reduced the number of them but i was still getting them daily after being on this drug for couple of months I was offered to do Catheter Cardiac Ablation . Before ablation I had another Echo and MRI test on my heart and my left Ventricle was a bit bigger than normal . Mildly Dilated non hyperthropic left ventricle i will send the picture of my MRI diagnose , i remember i got a call from a doctor and he said MRI was normal but my heart was just a bit bigger ?! Then my cardiologist did not say anything wrong about my MRI results she just told me to go for the cardiac ablation . Now it has been almost four months since the ablation and I am PVCs free most of times even though I still get few of them and for some reason they feel more strong now I am nowhere close to the number I had before ablation. My question is about my heart size I have never been more confused they are saying that my heart is bigger , does this mean I have dilated cardiomypathy ? Is my heart going to fail ? Am I at increased risk of sudden cardiac death ? i need to know what really is going on because i fear the worst eary day and I live in constant fear ?! Could my PVCs enlarge my LV ? They have never found a reason why was I having thousands of extra beats from RVOT . I fear that I might have some type of cardiomypathy that caused my arrhythmia and now it might cause me to get heart failure or kill me .
I also remember some of them saying that this size might me normal for my body . Im 186 cm 83 Kg . please Doctor answer my question i dont sleep at night because i feel so scared .
Ejection Fraction 55%
Left Ventricle normal size . Normal wall thickness . Systolic function is normal .
RIght Ventricle is normal in size and function.
Left atrial Right Atrial size Normal .
summery : Essentially Normal Study . ( this Echo was one year and five months ago ) when I had thousands of PVCs a day 15 000 - 18 000 .
I also had a normal stress test and PVCs went away with higher heart rate on treadmill .
Doctors say it was not dangerous but I had horrible symptoms and I could not function normally . i started suffering from Panic Attacks because I though my heart was going go stop and I had this horrible butterfly feeling in my chest all the time . beta blockers did not work anti arrhythmetic drug Propafenone reduced the number of them but i was still getting them daily after being on this drug for couple of months I was offered to do Catheter Cardiac Ablation . Before ablation I had another Echo and MRI test on my heart and my left Ventricle was a bit bigger than normal . Mildly Dilated non hyperthropic left ventricle i will send the picture of my MRI diagnose , i remember i got a call from a doctor and he said MRI was normal but my heart was just a bit bigger ?! Then my cardiologist did not say anything wrong about my MRI results she just told me to go for the cardiac ablation . Now it has been almost four months since the ablation and I am PVCs free most of times even though I still get few of them and for some reason they feel more strong now I am nowhere close to the number I had before ablation. My question is about my heart size I have never been more confused they are saying that my heart is bigger , does this mean I have dilated cardiomypathy ? Is my heart going to fail ? Am I at increased risk of sudden cardiac death ? i need to know what really is going on because i fear the worst eary day and I live in constant fear ?! Could my PVCs enlarge my LV ? They have never found a reason why was I having thousands of extra beats from RVOT . I fear that I might have some type of cardiomypathy that caused my arrhythmia and now it might cause me to get heart failure or kill me .
I also remember some of them saying that this size might me normal for my body . Im 186 cm 83 Kg . please Doctor answer my question i dont sleep at night because i feel so scared .
Brief Answer:
I see no reason for worry
Detailed Answer:
Thanks for detailed description. Yes ,it looks like you had benign vpcs and cured of it. All normal people can get occasional vpcs and when they come very occasionally the thumping sensation is more stronger. But that is no thing to be worrying about. Now your LV size on echo is normal and getting report of little larger heart on MRI is not anything significant. If you have any cardiomyopathy it would have been picked up on Mar. Sometimes persistent tachycardia can cause heart to enlarge but generally not vpcs. May be to reassure yourself you can have mri repeated few month down the line. I can definitely say you don't have cardiomyopathy and no significant risk of sudden death. Stop worrying and your occasional vpcs will also disappear.
I see no reason for worry
Detailed Answer:
Thanks for detailed description. Yes ,it looks like you had benign vpcs and cured of it. All normal people can get occasional vpcs and when they come very occasionally the thumping sensation is more stronger. But that is no thing to be worrying about. Now your LV size on echo is normal and getting report of little larger heart on MRI is not anything significant. If you have any cardiomyopathy it would have been picked up on Mar. Sometimes persistent tachycardia can cause heart to enlarge but generally not vpcs. May be to reassure yourself you can have mri repeated few month down the line. I can definitely say you don't have cardiomyopathy and no significant risk of sudden death. Stop worrying and your occasional vpcs will also disappear.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Here are the results, in between the ( ) is the normal range, LEVDV 207ml (115-198).. LVEDVI 99ml/m2 (63-98).. LVESV 101ml (32-75).. LVESVI 48ml/m2 (16-38).. LVSV 106ml (76-132).. LVSVI 51ml/m2 (41-65).. LVEF 51% (58-75).. LV mass 150g (108-184).. LV massI 73g/m2 (58-91). The diagnosis is Mildly dilated, non hypertrophic left ventricle with normal regional and likely normal global systolic function. Normal big right ventricle with normal systolic function, no infarction, non ischemic district, no myocardial edema, no diffuse fibrosis or deposition. I also recently had another Stress test, which came back normal. My questions are, do these finding indicate that I have any chance of cardiomyopathy, or any chance of left ventricular hypertrophy, or congestive heart failure, and sudden cardiac death. I have also read that people with frequent pvcs had enlarged LV , I suppose the really question here is which was first ? Enlarged LV that caused PVCs or PVCs that caused enlarged LV ? What scares me so much is heart faliure that my ejection fraction is 51 % ? Shouldnt that be better at my age ? Im 22 . I just found out that my grandpa had heart failure, and died from it at the age of 70. Besides my grandpa, my relatives have no existing heart problems, that I know of. I am scared that I have a severe heart problem, or heart disease which caused my PVCs that is getting worse, and the doctors have not been able to find it yet.
Brief Answer:
I guess your anxiety is uncalled for
Detailed Answer:
I think you are reading and googling too much about your disease than what's called for and listening less to your physician. Your physician has more powers to understand and interpret your disease. And you need to accept their interpretation. Apologies if I seem being harsh.
With information that you have provided there is no evidence of cardiomyopathy nor something that predisposes for sudden death. Stop worrying and just keep monitoring your LV size. Your family history of heart failure is not significant. Just don't worry and live comfortably.
Your EF is fine. It's not age dependent.
I guess your anxiety is uncalled for
Detailed Answer:
I think you are reading and googling too much about your disease than what's called for and listening less to your physician. Your physician has more powers to understand and interpret your disease. And you need to accept their interpretation. Apologies if I seem being harsh.
With information that you have provided there is no evidence of cardiomyopathy nor something that predisposes for sudden death. Stop worrying and just keep monitoring your LV size. Your family history of heart failure is not significant. Just don't worry and live comfortably.
Your EF is fine. It's not age dependent.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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