Heart & Cardiology/PVC Concerns


I am a 32 year old male, 6'4", 245 lbs.  I exercise roughly 3-4 times a week lifting weights with some cardio, non-smoker, occasional alcohol (maybe a couple beers per week), taking Lomictal morning and night and 1 MG Klonopin with my morning does and as needed, since early 2013 for mood/anxiety.  I rarely take more than the one does of Klonopin daily.  I began several anti-depressants in late 2012 because I was showing signs.  It took 4 tries to find one that didn't give me side effects or severe panic attacks.  My wife and I mistook my first panic attack, which lead to hyperventilation, as a heart attack and went to the ER.  

I had my first very noticeable PVC in mid-November 2012 and spoke to my doctor about it.  He explained PVCs and sent me on my way.  A few weeks later I returned and had an in-office EKG which turned out fine.  I returned and had a 24 hour Holter monitor which showed a couple premature heartbeats which the cardiologist said were harmless.  I have some PVCs that are very mild and hardly noticeable.  Occasionally I will have a VERY noticeable one that will cause me to stop what I am doing.  This usually results in a quick sweat, a warm feeling and a slight hand tremor.  I'll also check my pulse.  I had one roughly 30 min ago and my pulse stayed around 80 bpm.  It comes at infrequent times, infrequent situations.  I do not get them right before sleep or during exercise.  The noticeable ones seem to come at times of rest or when I am at work at my desk, but they do stop me in my tracks and I always have the natural impression that something is wrong.  

My first question is why did I start getting them just recently?  I can't think of a trigger (job change, extra stress, etc.)  Several of my anti-depressant tries caused panic attacks, added anxiety, etc. but that was after the PVCs started in November.

My second question is I have been mulling over having more tests done; stress test, longer duration heart monitor, etc.

I am not normally an anxious person but these PVCs have been hard to shake, forget about, or live with.  Am I crazy to be thinking about this so much?

Hello Mike,

No one knows why PVCs increase at any time.  Anxiety increases them, but usually they just increase and decrease without observable reasons.  

Remember that 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.  You're not crazy but they are harmless.  Beta blockers reduce PVCs in some people and are very safe if you don't have asthma.  Other meds, like flecainide and sotalol are more effective in reducing PVS in most people and are safe if you have a normal echocardiogram.

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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