Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXX!

Welcome on HCM!

I passed carefully through your recent medical history and would like to explain that your actual Holter monitoring shows a significant extrasystolic ventricular arrhythmia (around 20000 PVCs in 24 hours).

When significant arrhythmia is persistent and if left untreated, it may lead to what is called arrhythmia-induced cardiomyopathy; which is a pathological condition primarily affecting the myocardium (cardiac muscle).

Coming to this point cardiac performance may become impaired and clinical picture of heart failure is likely to be present.

All the above consequences make necessary a thorough investigation to properly uncover the reason of arrhythmia, promptly treat and prevent any severe cardiac damages.

Now, returning to your concrete question about the potential responsible causes of frequent PVCs, I would say there are several of them (including intra-cardiac or extra-cardiac):

- presence of an arrhythmogenic focus inside myocardium,
- coronary artery disorders may lead to arrhythmic events,
- certain cardiac inflammations (myocarditis) may lead to extrasystoles,
- certain drugs (amphetamines, some psychotropic drugs, etc.) and substances (caffeinated beverages, alcohol, nicotine, etc.) may trigger arrhythmia.
- thyroid gland dysfunction,
- certain blood electrolytes imbalances may lead to arrhythmia enhancement,
- certain systemic disorders secondarily affecting the heart (by producing myocardial fibrosis) may lead to extrasystolic arrhythmia, etc.

In this regards, it is necessary first to confirm whether your actual cardiac structure and function is normal by performing several cardiac tests (cardiac ultrasound, exercise cardiac stress test, eventual cardiac MRI, etc.)

In no reversible cause of your cardiac arrhythmia is revealed by the recommended tests (to exclude the above possible mentioned causes), then cardiac electrophysiological study (EPS) is the next step to follow.

EPS could definitely localize the arrhythmogenic focus (responsible for the frequent PVCs) inside myocardium and could be followed by a successful cardiac ablation procedure, which could definitely resolve the arrhythmia issue.

You may discuss with your cardiologist about the above mentioned issues in the upcoming scheduled visit.

Hope to have been of some help to you!

Nevertheless, in case of any further uncertainties, feel free to ask me again.

Wishing you a Happy New Year!

Kind regards,

Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:
Hi again,

As you don't have a long history of persistent arrhythmia and your previous cardiac tests have resulted normal, there is nothing to fear in this regard.

I just mentioned the above consequences for making more clear the importance of this clinical condition, but you shouldn't worry about that as you are right in time to look after this new appearing health issue.

Please, let me know how things are going with the diagnostic work up after the doctor's meeting.

I would be glad to give a second professional opinion.

Regards,

Dr. Iliri

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Brief Answer:
You are welcome!

Detailed Answer:
I will be glad to review your medical tests and discuss with you about concerning health conditions.

You could reach me directly at any time through the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best wishes,

Dr. Iliri

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