Heart & Cardiology/PVCs after exercise
Dear Dr. Ahmed,
I have been experiencing PVCs on/off for 20 years..first noticed them at age 19. There has been a new occurrence as of the last 4-5 weeks. Typically after exercising (cardio workouts for 30-40 minutes, I will get several PVCs after I stop exercising, typically in the 2-5 minute period after I stop exercising. They are not consecutive PVCs. I get little or no PVCs during exercise.
Is this alarming or a foreboding sign in your opinion? I'm not sure why all of a sudden they are occurring regularly in the 2-5 minutes after exercising. I only get 3 to 8, and like I said they are not consecutive.
Lastly, recent studies have suggested that PVCs may indeed indicate a (small) risk of developing heart disease and/or sudden death. If true does the amount of PVCs matter, or is it simply the presence of PVCs? In other words is a person with 5 or 50 PVCs per day at more risk than somebody with zero? Or are they talking about a much higher amount of PVCs per day with regards to increased risk of heart disease?
It's confusing and since I have PVCs is a cause for concern and worry.
Thank you very much,
Hi James, http://blog.myheart.net/2014/07/30/pvc-heart-beats-are-they-dangerous/
The discussion as to the significance of PVC's can go on for a long time, but ill try answer a few key points to address the questions you had and hopefully help to point you in the right direction.
PVC's in recovery, or even during exercise can be a risk factor for heart disease. But typically this only holds true for those with risk factors for disease. For example if a person had risk factors such as abnormal function on an echo, known coronary disease, etc.. then PVC's in that person would act as a risk marker for worse outcomes. If you have been considered no risk for example normal function, no abnormal heart testing, and no clear risk factors nor heart disease, the PVC's are not likely to be of significance. Basically, in those with frequent PVC's (often hundreds to thousands a day) close attention should be paid to treating risk factors for cardiac disease.
I don't know if you have had an exercise treadmill test before, however it may be useful in this setting to characterize the frequency, and morphology of the exercise PVC's. To be honest though just 3-8 PVC's is a very low PVC burden.
When it comes to whether PVC burden is associated with worse outcomes, yes there is some evidence that a high PVC burden (such a >20% of all heart beats is associated with worse outcomes, including the development of heart failure, however a tower levels i.e 10 vs. 50 per day, there is no evidence for 50 being worse.
If i were you i wouldn't worry too much. I would go see a specialist and ensure relevant testing is performed to put you in a low risk group and therefore reassure you that you truly are low risk. However the best prognostic indicator here is that you are doing regular cardio for 30-40 mins! which will essentially put you in a group of people that are known to do well.
Hope that was helpful.