Heart & Cardiology/PVCs or Panic


Hello how are you? Last time I sent you a question it dealt with dropped heartbeats (i.e., Wenckebach). The cardiologist viewed my 48 hr. Holter results and stated they were nocturnal and the pause time was insignificantly short. He also did not state that they were Wenckebach.  In 48 hrs. I had 8 dropped beats and 9 PVCs. I clearly have panic/anxiety over my heart concerns and have had every cardio test possible without actually do an angiogram. Test are as follows, in order over the last year.

-ECG x10 plus in the last 2 years (negative)
-Stress Test (positive)
-Thallium Test (positive ECG, but iimaging showed perfect flow)
-48 hr. monitor (2 dropped beats and 8 PVCs, no concern by cardiologist)
-Echocardiogram (no issues)
-Echo Stress Test (both parts negative)
-48 hr. monitor (8 nocturnal dropped beats with 9 PVCs, no concern by cardiologist)

Cardiologist stated I have a good pumping heart and should not be worried to work out, what so ever.

I have been on Cipralex but off of that for over a year plus now. I also have Crohn's disease and was on Remicade treatment for over a year but stopped the treatments due to the fact that my body was reacting in a negative way during the infusions (i.e., hives, allergic reaction, shortness of breath). Can Remicade cause any issues with all this???

I recently started 25 mg of Zoloft, 4 days, and am getting feelings of my heart being rushed with sensations (PVCs or adrenaline???), heartbeat accelerates, warm/tingling sensations over my body (specifically chest, shoulders, arms, and wrists), and massive fear/panic.  These feelings were present before I started the Zoloft. My GP believes that these sensations could be me feeling the PVCs and then panicking or simply adrenaline being released nd then having the panic set in.

Can panic/anxiety do all these things??? Should I trust all the cardio results???

Any feedback would be great.

Thank you


As you know, 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.   Anxiety and panic make them more frequent.  Alarm at the dreadful ill effect of Remicade would make PVCs more frequent, but would not cause them.  The accelerating heart and the warm/tingling feelings can certainly be the result of panic.

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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