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What Causes Recurring Premature Ventricular Contractions?
Question: I have PVCS. They will go away for long periods then come back. I feel them mostly when lying down or sitting sometimes while exercising. Another opinion.
Brief Answer:
Need examination & investigations
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
The first step is to see a Cardiologist
It needs to be documented by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or precipitated by a specific activity like exercise, one needs Holter or event monitor. Holter records for days; Event monitor for weeks / Holter records continuously / Event monitor only at certain times.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG; may be with thallium isotope – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Thyroid are a few of the several factors that may be responsible.... At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
Many cases are benign, especially when associated with normal ECHO and may not require treatment, If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
If there are no clues and if the problem is still bothering to the extent of interfering with life style, one needs Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
The treating doctor may suggest depending on need, based on his assessment of the situation.
Take care
Good luck
Need examination & investigations
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
The first step is to see a Cardiologist
It needs to be documented by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or precipitated by a specific activity like exercise, one needs Holter or event monitor. Holter records for days; Event monitor for weeks / Holter records continuously / Event monitor only at certain times.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG; may be with thallium isotope – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Thyroid are a few of the several factors that may be responsible.... At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
Many cases are benign, especially when associated with normal ECHO and may not require treatment, If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
If there are no clues and if the problem is still bothering to the extent of interfering with life style, one needs Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
The treating doctor may suggest depending on need, based on his assessment of the situation.
Take care
Good luck
Above answer was peer-reviewed by :
Dr. Prasad
I couldn't put all this in first question, but when I first had this three years ago an echo was done which came back normal. Holter has been done 3 different times. It did show some abnormalities. I have seen a Cardiologist. He didn't seem to be concerned. These come and go. It seems like they go away for the longest time and then come back. Went to my GP this week. He checked my pulse, and didn't feel any skips, and didn't feel I needed anything further at this time. The Cardiologist said they are extra beats.
Brief Answer:
Benign event
Detailed Answer:
Hi
That means they are benign
No active interference investigation or treatment – is necessary unless they increase in frequency or severity.
The feeling depends on individual sensitivity – some do not feel them at all; some may feel every beat.
If they are disturbing, the first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. Your doctor will give proper prescription and follow up
Regards
Benign event
Detailed Answer:
Hi
That means they are benign
No active interference investigation or treatment – is necessary unless they increase in frequency or severity.
The feeling depends on individual sensitivity – some do not feel them at all; some may feel every beat.
If they are disturbing, the first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. Your doctor will give proper prescription and follow up
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
So no further testing is necessary as long as the initial testing 3 years ago was fine. Will these episodes affect my heart?
Brief Answer:
Not Now
Detailed Answer:
Hi
Yes, you need not do anything – for the present
VPCs are usually benign - especially when examination & ECHO are normal
Go for EPS, if it interferes with life style
Regards
Not Now
Detailed Answer:
Hi
Yes, you need not do anything – for the present
VPCs are usually benign - especially when examination & ECHO are normal
Go for EPS, if it interferes with life style
Regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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