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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With PVCs Couplet, PACs. Done Echocardiogram, Stress Test. Why Does My BP Fluctuate?

I am 49 years old diagnosed with PVCs couplet and also PACs. Done echocardiogram and stress test AND PASSED. My cardiologist says these were benign (PACs and PVCs). Lately however im feeling more of chest pressure short of angina and PVCs becoming more frequent. I have also been belching almost everyday now and somehow feel relieved after such belching.Had this belching since 2008 when initially I felt the chest pressure. ECG did not reveal it yet but PVCs and PACS only appeared on my last ECG last may! Im taking ex-forge for HB and OMEPHRAZOLE for the hyperacidity. Im very worried now cause of the chest pressure im feeling and another cardiologist this time advised me to undergo angiogram and perhaps angioplasty if the test proves positive. This is contarary to the earlier assessment of my cardiologist (another doctor) . I am now very worried. Could it be possible that I have heart block despite having passed the 2Decho and stress test? Is there a danger of me having a heart attack anytime soon? By the way my BP often fluactuates from 110 over 70 to as high as 150 over 90 during tepisodes of pvcs or pacs .
Tue, 18 Jun 2013
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Cardiologist,  's  Response
Hi friend,
Welcome to Health Care Magic

The first priority will be an endoscopy to look at the oesophagus and stomach...
Anxiety appears to be the contributing / psychological assessment and assistance can help...

     The possibility of heart attack is rare indeed when the stress test and echo are normal. Your symptoms do not suggest CAD. / If you are not convinced, the next step is TMT with thallium isotope. It is the ideal non-ivasive way to evaluate ischemia - to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. / If there is a suggestion, the next step is to see the ANATOMY (structure) – CT angio is non-invasive study for the anatomy. Coronary arteriography is invasive
     So too for the arrhythmia if bothering to the extent of interfering with life style – Electro Physiological Studies (EPS) > it resembles angio –Though the test is the gold standard, it is INVASIVE and and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.
     Keep following up with your doctor...
     
Take care
Wishing speedy recovery
God bless
Good luck
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Diagnosed With PVCs Couplet, PACs. Done Echocardiogram, Stress Test. Why Does My BP Fluctuate?

Hi friend, Welcome to Health Care Magic The first priority will be an endoscopy to look at the oesophagus and stomach... Anxiety appears to be the contributing / psychological assessment and assistance can help... The possibility of heart attack is rare indeed when the stress test and echo are normal. Your symptoms do not suggest CAD. / If you are not convinced, the next step is TMT with thallium isotope. It is the ideal non-ivasive way to evaluate ischemia - to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. / If there is a suggestion, the next step is to see the ANATOMY (structure) – CT angio is non-invasive study for the anatomy. Coronary arteriography is invasive So too for the arrhythmia if bothering to the extent of interfering with life style – Electro Physiological Studies (EPS) it resembles angio –Though the test is the gold standard, it is INVASIVE and and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. Keep following up with your doctor... Take care Wishing speedy recovery God bless Good luck