AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Expert: David Richardson Date: 7/19/2008 Subject: Feeling of Skipped Hearteat then a double beat.
Question QUESTION: Hi, I am a 45 year old male who is 6 foot and 225 pounds with a BMI of 24. I quit smoking in March. In April I joined a gym and hired a trainer who, believe it or not, I suspect of giving me a hiatal hernia during extreme core training. Anyhow I quit the core part of the training then around July 8th I had a few skipped heart beats. By Saturday July 19th I had several thousand thru the day. I can feel the skipped beats in my chest without feeling for my pulse. I saw my GP on Monday July 21st who ran an ekg showing a few PVC's and told me I had a stage 1 AB Block whatever that is. He prescibed me on Metoprolol 50MG ER tabs. This has reduced the skipped beats to only a few hundred a day that aremainly in the evenings. ( I have no pain or dizziness and no longer panic from the chain of them that last up to 2 minutes.) My blood pressure remains about 109/75 to 128/90 with pulses staying in the 70-90's. This came on fast. Is there a chance this is caused from allergies or something? I apologize but I do not have insurance due to my wife is pretty much unisurable. Any suggestions would be greatly appreicated.
ANSWER: Dear Mark,
Skipped heart beats are normal cardiac activity, normal in the senses that about half of us have them, that they are easy to understand as normal from knowledge of the heart's electrical system, and that they don't mean you have heart disease or will in the future develop heart disease or any catastrophe. They don't come from allergy, they're normal.
Stage 1 AV block is no problem either. I means the time needed for the electrical signal to move from the upper chambers of the heart (Atria) to the lower chambers (Ventricles) is a little longer than usual.
Please don't hesitate to write back any time you think I could help. Lose some weight if possible.
David Richardson
---------- FOLLOW-UP ----------
QUESTION: I very much appreciate such a fast response to my question Mr. Richardson. One last question. Just for grins I counted the missed heart beats this evening for one hour while taking the Metoprolol and still had 387 skipped beats in that one hour. Each one makes a little bump in my chest that I feel. Do you think this might go away over time? Hey Im greatful to be alive dont get me wrong but...sheesh....these bumping feeling really take awy alot of your daily joy. Thanks again sir for your time.
Answer Dear Mark,
Skipped beats tend to slowly subside, usually in 10 years or so.
There are medicines more effective in decreasing the frequency of PVC's than is metoprolol. My favorite is flecainide, pretty effective in reducing PVC's and safe for someone whose heart structure and function is normal. Your heart's structure and function are normal, because your excellent exercise ability proves that. But flecainide is probably expensive. May be worth the money since your daily joy is impaired by the PVC's.
Best wishes. Please let me know how you get along.
