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Intro/ER visit for PVCs


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#1 Rio Dax

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Posted 24 March 2011 - 03:18 PM

Hello my fellow heart people, I stumbled upon this board yesterday after my ER visit and figured I'd introduce myself and get some advice. I'm a 22 year old female that suffers from PVCs (typically 1-2 episodes per week, lasting <30 seconds). In 2008 I saw a cardiologisy to rule out Marfan Syndrome and at the time he diagnosed Mitral Valve Regurg via echo and arrhythmias via 30 day holter monitoring (arrhythmias included bradycardia when sleeping, sudden sinus tachycardia, runs of multi-focal PVCs, and possibly some other abnormalities). My cardio at the time attributed everything to stress and caffeine (which I agreed with), told me to calm down, switch to decaf and follow up with another echo in 3 years.

Since that time I've dealt with the occassional PVC which, while uncomfortable and scary, haven't adversely affected my life. Yesterday during work I experienced an acute episode of PVCs that lasted at least 5 minutes and were the worst I've ever had - it felt like two parts of my heart were fighting each other or like someone had grabbed my heart and was squeezing/choking it around the middle. I wasn't dizzy or lightheaded. I called 911 and the paramedics came. By that time the worst of it had passed but I was still feeling abnormal uncomfortable beats. The paramedics hooked me up to an ECG (I think it was a 5 lead) and didn't see any arrhythmias despite the fact that I knewthey were occurring because I could feel them. At the ER they did a 12 lead and the nurse and paramedic both pointed out PVCs. They did chest rads, blood work, urinalysis, a liter of IV fluids and kept me on a 5 lead ECG for a couple hours while running the tests (again, nothing abnormal on the 5 lead). They also consulted with my cardio clinic and reviewed the records from 2008.

Bloodwork was normal - not dehydrated, no electrolyte abnormalities, no anemia, normal troponin levels. The ER doc said everything was fine, it was just heart palpitations and I shouldnt be worried. Then one of the cardiologists that works with my cardiologist came in, said he reviewed my records and based on everything that's happened he advised me to lower my stress and decrease my caffeine intake.

Here's where I disagree and think the ER wasnt taking me seriously. While I did have stress, anxiety, and caffeine issues back in 2008, I've since eliminated my anxiety, reached an almost zen-like state of mind, and had only half of a can of Pepsi 5 hours prior to the episode. All the doctors really say is that I'm 22 and shouldn't be having problems, that PVCs in most people are innocent and I'm not at any risk from them. I find all that hard to believe when I'm the healthiest I've ever been and then out of nowhere my heart starts a mutiny and takes over 30 minutes before fully "fixing itself". Has anyone else been this young with these kinds of issues? Should I really just shrug it off like my doctors are doing? I work in emergency veterinary medicine and have more knowledge of heart arrhythmias and stuff than the average consumer. I've made an appointment with a cardiologist next week who is also certified in electrophysiology in the hopes that he'll bring a new perspective on what's going on and maybe be as concerned as I am. Any thoughts or advice would be greatly appreciated. It's very overwhelming to think that I have to basically start from the beginning and fight to have someone take my heart problems seriously. I imagine I'll be lurking these boards quite a bit from now on.

Thanks and all comments are appreciated.
~Rio
Paramedic: "We don't usually see 22 year olds with heart problems."
Me: "And I don't usually ride in ambulances. Funny how that works out sometimes."

#2 gschmitt

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Posted 24 March 2011 - 05:38 PM

Rio, welcome to the Heart Board. I think there is still a long way to go before a lot of doctors and nurses realize that women can present a totally different view of heart problems than men. A visit to the ER can be stressful enough without hurried Dx and being sent on your way. On one of my trips to the ER I was diagnosed with a pinched nerve in my neck that was causing my discomfort and given a script for meds for that and sent home. I was back two days later getting a stent. The half can of Pepsi could have been too much caffeine at that time. I have some meds that will cause PVCs of I take that med daily. I have cut that med dose by one third and there is no problem. Check all of your meds and the possible interactions with each other and other foods and drinks.

Jumping on my soapbox here you should not be drinking cola drinks at all IMHO. This advice is for you health in later life as colas can be detrimental to bone density. Also for me artificial sweeteners cause PVCs. A drastic diet change seven years ago and then adding back things one at a time for a month helped me to avoid items that triggered PVCs in my heart. Believe it or not one item I avoid because of this is any member of the onion family. It's just going to take some work and some working with your cardio to get things straightened out.

I spent over 20 years as a paramedic and never saw a 22 year old but did see some heart attacks in people in their 30s. Reading the obits and death causes available I have noticed heart attacks are getting more common in younger people. I saw one cause of heart related death last week that the coroner wrote as the cause of death was refusal to take medications and make life style changes. That could have been my brother who died last year at age 54.

From your posting you are doing what you can so I'll say keep up the work you are doing. Be sure to get back here after your appointment with the cardio/ep and let us know what's going on.

Again, welcome to the board and don't be a stranger.

Gilbert
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Let the Gemutlichkeit roll on. Ein Prosit.

Life is too short to drink cheap beer.

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#3 Rio Dax

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Posted 25 March 2011 - 04:20 PM

I'm definitely going to try to eliminate my soda intake but I work long and late hours and often need caffeine to keep me on my toes. I admit that in the past I used to drink upwards of 6 cans of Pepsi a day but like I said, I've since followed my cardio's recommendations and now have an average of 0-3 cans a day (with 3 being rare and 0-1 being the norm).

Another concern I have is that my uncle (my mom's brother) and his daughter/my cousin (who is younger than me by at least 3 years, not exactly sure of her age) have both been diagnosed with congenital Long QT Syndrome. And looking over some of my old event monitor readings from 2008, I had at least one episode of polymorphic wide complex tachycardia. From everything I've read about these two conditions, I'm at a substantially increased risk of sudden cardiac arrest.

Maybe I'm worrying too much or self-diagnosing myself but I'm not yet willing to chaulk everything up to too much caffeine or stress. I'm really looking forward to my cardio/ep appointment next week and hopefully getting some answers.

~Rio
Paramedic: "We don't usually see 22 year olds with heart problems."
Me: "And I don't usually ride in ambulances. Funny how that works out sometimes."

#4 kalip

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Posted 26 March 2011 - 04:34 AM

Rio

Welcome to the board
I am sure you would get all the support and advice you need here

kalip

#5 gschmitt

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Posted 26 March 2011 - 11:58 AM

I hope you can find something to replace the caffeine. Until then you would be better switching to something like Mt Dew. You can get the caffeine but avoid the more detrimental effects of cola drinks. That said I would also preach to you to avoid high fructose corn syrup and find items sweetened with real sugar as all things were in the past. As folks here will tell you I've got a thing against hfcs. Artificial sweeteners do nothing for you and can have adverse affects on your health. Natural sugars found in fruits could be a start on the road from caffeine.
Life may not be the party we hoped for but while we're
here we should dance.

In heaven there is no beer
That's why we're drinking it here
And when we're gone from here
All our friends will be drinking all our beer.

Let the Gemutlichkeit roll on. Ein Prosit.

Life is too short to drink cheap beer.

Aerobics are for those who don't polka.

#6 Denisefh

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Posted 30 March 2011 - 11:56 AM

I'm sorry you're having all these heart issues. I know the docs don't place much if any danger on PVCs, but it looks like you also have other arrhythmias going on.

Hopefully you'll get some answers from the new Cardiologist you're going to see, since he's qualified in electrophysiology also. Be sure to make a list of all your questions for him and also take in any previous records you think he might be interested in.

I've put up with arrhythmias all my life and they pretty much suck...whether they're serious or not.
Denise
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