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What Do These Lab Reports Indicate?

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Posted on Wed, 20 Sep 2017
Question: Hello, a month ago I started to have heart palpitations. I was diagnosed with PVCs and have been told they are harmless. A few days after the PVCs started I was also having shortness of breath and the feeling in my legs like I had climbed 3 or 4 flights of stairs upon doing any activities (such as climbing stairs, but also small activities such as stirring a pot). I went to the ER over three weeks ago. They hooked me up to a monitor for several hours, did 2 types of ECGs, a chest X-ray, a lot of blood work and had me walk around with the monitor on. Everything came back negative. The only thing they noticed were the PVCs.

I also went to see my family doctor who has known me 14 years. He said that he feels this is all due to anxiety. I have suffered from anxiety for a few years now. The last few months my anxiety has been pretty bad and when the PVCs started, my anxiety became rather extreme. My doctor put me on Wellbutrin which I have been taking for 3 weeks now. This Friday my doctor is sending me for an Ankle Brachial Indices ultrasound as my legs feel like I have climbed 4 flights of stairs when only climbing one flight or doing other activities that would not normally cause a problem. He still feels it is all due to anxiety, but he said he would send me for the test to make me feel better.

I saw a cardiologist on Aug.15. He did an ultrasound of my heart and said it was normal. He also feels my symptoms are due to anxiety. He will be doing a stress test for me in September and said I have no need to regulate my activities.

I have been trying to relax, but as a naturally anxious person it can be hard. I have noticed that I am not getting as short of breath and the feeling in my legs (like I have climbed 4 flights of stairs when only climbing one flight) has been a little better. The one thing I have noticed is that the more active I am, the better my legs feel. I have also noticed my legs feel worse after a night of poor sleep. I have not had many good sleeps over the last month (probably from anxiety).

The one thing that I have noticed over the last 2 weeks is that I sometimes have an internal shaky feeling in my body, especially in my arms. I do not really shake much externally, but I feel shaky inside. It doesn't happen every day and it does not last all day when it does happen. I have not had any caffeine for the last few weeks, but when I am shaky it feels like I have had too much caffeine. I have been eating normally so I don't think it is my blood sugar. There have been a few times where I have woke up with this shaky feeling. One day when that happened, I laid back down and tried to relax and the shaky feeling went away.

I was wondering if this shaky feeling could be due to anxiety? As I said, I am trying to work on the anxiety, but I find myself still worrying about what is wrong with me and feel tense. This shaky feeling is concerning me.

I have attached some of the reports that were provided to me for the Holter monitor, blood work and chest xray.
Thank you.

doctor
Answered by Dr. Dr Sameer Maheshwari (1 hour later)
Brief Answer:
Could be due to anxiety

Detailed Answer:
Hi,
Welcome.
This is Dr Sander, cardiologist.
I went through your question & will try to help you in all possible ways.
First I would tell you that your Holter report is not normal. It has episodes of bigeminy(which can be there in a normal heart) & a run of non sustained VT(which needs treatment & other evaluation).

Your cardiologist has rightly advised you for a stress echo which you should try to do as early as possible. A normal echo does not rule out a normal heart.

Anxiety & panic attacks can cause frequent VPC's(ectopic beats) but it will not cause VT.
Frequent symptomatic PVC's definitely needs treatment.
For such cases we advise to start on a beta blocker - PROPANOLOL starting from 40mg twice daily which can be increased gradually.
It will take care of both PVC's & Anxiety.
Wellbutrin is brand name for bupropione, which I don't expect will help you much. We also advise a antianxiety medication like Alpraxolam 0.25mg once daily at bed time to decrease anxiety & help in sleeping.

I will also advise you to get Vitamin D3 checked because its deficiency can result in leg cramps & easy fatigability. If it is low than taking supplement will help you greatlly.
I hope these will solve your problems & you will be fine soon.
Thanks & take care
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr Sameer Maheshwari

Cardiologist

Practicing since :2010

Answered : 818 Questions

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What Do These Lab Reports Indicate?

Brief Answer: Could be due to anxiety Detailed Answer: Hi, Welcome. This is Dr Sander, cardiologist. I went through your question & will try to help you in all possible ways. First I would tell you that your Holter report is not normal. It has episodes of bigeminy(which can be there in a normal heart) & a run of non sustained VT(which needs treatment & other evaluation). Your cardiologist has rightly advised you for a stress echo which you should try to do as early as possible. A normal echo does not rule out a normal heart. Anxiety & panic attacks can cause frequent VPC's(ectopic beats) but it will not cause VT. Frequent symptomatic PVC's definitely needs treatment. For such cases we advise to start on a beta blocker - PROPANOLOL starting from 40mg twice daily which can be increased gradually. It will take care of both PVC's & Anxiety. Wellbutrin is brand name for bupropione, which I don't expect will help you much. We also advise a antianxiety medication like Alpraxolam 0.25mg once daily at bed time to decrease anxiety & help in sleeping. I will also advise you to get Vitamin D3 checked because its deficiency can result in leg cramps & easy fatigability. If it is low than taking supplement will help you greatlly. I hope these will solve your problems & you will be fine soon. Thanks & take care