Heart & Cardiology/PVCs


Hi Dr. Richardson;

I am a 39 year old female, 5'8, 120 pounds, always been very active. Blood pressure is usually about 110/70, but it was a little higher in the ER. My normal heart rate is in the low sixties, but it was around 100 and blood pressure came back at 126/82, so I assume it's still around 110/70 when I'm not freaking out. Anyway, a couple months ago I had my first experience with PVCs. I was on vacation and ended up in the ER because I didn't know what was going on. The doctor saw a few PVC's on the ECG machine, the 12 lead EKG did not catch them and I was told the EKG was normal. I also had a chest Xray and blood work. Everything came back fine and I was told it was anxiety. I went home and about a week later had another round of PVCs, got scared again, went to the ER where I live. I had all the same tests and everything came back fine. The doctor told me there is nothing wrong with my heart and prescribed Xanex for anxiety. He told me he gets PVCs and they're nothing to worry about.

I have noticed an absolute correlation between trapped air and the PVCs. I simply do not get them unless I have air bubbles moving up, which I have been told are affecting the vagus nerve and sending a signal to the heart. I am working on the anxiety and trying to deal with the stomach issue. Do you see any reason for additional testing, or is the normal EKG enough based on my symptoms? I really believe this is stemming from a stomach/anxiety issue, but because I have anxiety I tend to worry anyway. I don't want to pursue additional testing if there is no reason because I get extremely nervous going to new doctors and I will basically have to start all over dealing with the anxiety.

Out of curiosity, is there any genetic link with PVCs? My mother, brother, and Aunt all have basically the same symptoms as I do. My mother has had an EKG, chest Xray, and blood work and everything came back normal as well. My Aunt was just at her PCP last week nervous about something and she was having PVCs. The doctor was completely unconcerned and gave her something for anxiety. I know anxiety runs in families, so I would imagine that is actually what we all have in common.

Thank you so much for your time!

Hello Lisa,

Premature beats are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.  Bubbles of air going up esophagus can induce PVCs, since the heart is just anterior to the esophagus.  The vagus is not needed for this to happen.  Anxiety makes PVCs more frequent.

Genetic maybe, but more likely environmental, in that anxious people tend to make their family members more anxious just because they observe anxiety in their relatives.

Please write back if this note doesn’t answer all your questions.

David Richardson  

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


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.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

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.

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