Heart & Cardiology/PVC's and Anxiety

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Question
I'm just looking for a little bit of general information about PVC's in the hopes of easing my mind a little bit!

Here is the background info - I started feeling what the doctor diagnosed to be PVC's this past Friday (Today is Tuesday.) We think they were triggered due to a combination of some new medications I started last week for an infection, mixed with alcohol and some anxiety. They think the PVC's have persisted on because of my extreme anxiety as a result of the weird thumping sensation in my chest.

I have suffered from anxiety for some time now. My anxiety is brought on by health issues and a fear of dying. I literally ALWAYS automatically think the worst! My dad recently died very suddenly of a very long word that I could never pronounce but it was heart related - essentially, he was exercising and his heart beat got so chaotically out of rhythm that he collapsed and the ambulance didn't get to him quick enough to get the rhythm back to normal in time. Needless to say, this event in my past has increased my anxiety about the PVC's by a thousand percent! It has become a vicious cycle for me...I'm told my PVC's will likely go away if I just quit thinking about them and stop worrying, but I can't stop worrying and thinking about them until they go away...I'm left worrying that I'll be stuck dealing with this for the rest of my life. I got myself so worked up about this that I worried myself sick, my heart rate was quite high, thus making the PVC's even worse. I am now back on my anxiety medication, my heart rate is down but probably considered to still be on the slightly high side...I understand that in order to fix the PVC problem, I first have to get my anxiety under control, correct? I am a very young and active female - played sports my entire life and have continued exercising at least 3-4 times a week after my college athletics career ended. They did an EKG the other day just because of my family history and everything looked perfectly normal.

My questions - How long is too long for these to persist? Or is there a "too long" I'm going on day 4 of PVC's off and on. My anxiety is still very present, which I am working on.

If these do persist for some time, do I need to worry about my heart weakening or cardiomyopathy?

Am I okay to exercise normally with PVC's?

Going back to my dad's death, is it possible that due to the irregular heartbeats, my heart could get so out of rhythm that this could be fatal? Especially when exercising when my heart rate is already up?

Do I ONLY need to be concerned if the PVC's are accompanied by other symptoms, such as dizziness or lightheadedness? Anything else? I'm told to just quit worrying about them but when would I NEED to be worried?

Basically, I'm just looking for some reassurance here that I'm not dying! That these things are, in fact, normal. And, possibly any suggestions to get these things to go away...is to stop thinking about them/quit worrying basically the only thing I can do? So easier said than done! :( Thanks a bunch!

Answer
Hi, i recently wrote this regarding PVC's, http://blog.myheart.net/2014/07/30/pvc-heart-beats-are-they-dangerous/ also have a read of several of the recent questions i answered and see if they are informative to you also, i think they will help to answer some of the questions you have.


How long is too long for these to persist? Or is there a "too long" I'm going on day 4 of PVC's off and on. My anxiety is still very present, which I am working on ?

Im not sure the anxiety is underlying the PVC's although the PVC's are certainly a cause of anxiety in many people. Sometimes reassurance as to the benign nature of most PVC's is enough to deter the anxiety although it persists in some people, which is understandable, particularly if you are very sensitive to the sensation of the skipped beat. Sometimes PVC's can last a few days or sometimes lifelong. Depending on the presence of a trigger such as alcohol or stimulants, this should be stopped to see if the PVC's resolve.

If these do persist for some time, do I need to worry about my heart weakening or cardiomyopathy?

That main factor here would be the PVC burden, i.e what percent of all heart beats is a PVC. This is more of a concern in people with burdens of 20% or greater, i.e. 1 in 5 beats all day and night. In which case if there is a weakness detected in the heart muscle then the PVC's could be underlying it. Although many with that high a pac burden will have normal heart function.

Am I okay to exercise normally with PVC's?

I haven't seen you and don't know the full specifics of your case, but in general yes, especially if the dr you saw thinks its ok. If the PVC's persist i suggest you have a few basic tests such as an echocardiogram to ensure a structurally normal heart. I'm not sure if you have underlying risk factors for coronary disease, but if you are a young female that is exercising without symptoms then thats very unlikely. The physician you saw should determine the need for further testing.

Going back to my dad's death, is it possible that due to the irregular heartbeats, my heart could get so out of rhythm that this could be fatal? Especially when exercising when my heart rate is already up?

Your father likely had ventricular fibrillation, and the most likely circumstance would be underlying coronary artery disease. The PVC's you have are an entirely different issue and i doubt there is concern for serious heart rhythm disturbance.


Do I ONLY need to be concerned if the PVC's are accompanied by other symptoms, such as dizziness or lightheadedness? Anything else? I'm told to just quit worrying about them but when would I NEED to be worried?

Im not sure of your PVC burden, if they persist and are more than just a few PVC's here and there,  then its reasonable to obtain a monitor to see the frequency. If they persist and you need further testing such as echocardiography and that also is normal then you pretty much dont need to be worried. Of course associated dizziness, light headedness, shortness of breath, or functional limitation is different and should be looked in to.


Basically, I'm just looking for some reassurance here that I'm not dying! That these things are, in fact, normal. And, possibly any suggestions to get these things to go away...is to stop thinking about them/quit worrying basically the only thing I can do? So easier said than done! :( Thanks a bunch!

I realize you must be anxious because out of nowhere suddenly you have PVC's. The overwhelming majority of people with PVC's do not have anything to worry about, don't need further testing, and can be reassured, and that is highly likely in your case. Its not possible for me to fully reassure you as i haven't deal with your specific case. The Dr that has seen you will likely be aware of the circumstances in which a PVC requires further investigation. If he/she feels that you only need to observe you can likely be reassured.

Hope that was helpful,

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Mustafa Ahmed MD

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Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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