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Heart & Cardiology/30 Weeks pregnant with MAJOR PVCs

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Question
Hello. I understand you are unable to give me a diagnosis without seeing me, but I just need some advice/ reassurance.
I am 30 weeks pregnant. I have had PVCs since before being pregnant due to Mitral Valve Prolapse. In the beginning of this pregnancy, I had PVCs here and there. Now, they are all the time. I may have a few times a day when I don't have them, but for the most part it is all day and they come like every 4 beats or so. I saw my cardiologist about a month ago and he was concerned. He did not do any tests though. He just checked my BP, pulse, and listened to my heart. I am scared to death. I am afraid that I am going to drop dead at any moment. I have 4 children plus the one on the way and it frightens me. These PVCs are ruining my life at this point. They are making me severely anxious and irritable. I cannot sleep at night because they are so bad. I feel like no one understands and cannot bring myself to believe they are "normal" or "benign". I have another appt with my cardiologist on the Oct 16th, but cannot wait that long :( Thank you in advance for any help you can give me!

Answer
Hi, I recently wrote the following article on PVC's, http://blog.myheart.net/2014/07/30/pvc-heart-beats-are-they-dangerous/.

With regards to the danger of the PVC's your cardiologist is likely correct in that they are not harmful in terms of bad outcomes in at least the short term. Given the frequency of your PVC's I would recommend an echo to be done to rule out underlying structural heart disease unless you have one already that was normal. Given that you already report mitral valve prolapse i take it you have had a prior echo.

Occasional PVC's are extremely common, in fact seen in almost everyone. In some they are more frequent. When determining if PVC's are benign, the following is a decent approach. Firstly to look for triggers and rule out underlying causes. An echocardiogram can rule out underlying structural heart disease or heart muscle damage. in some patients exercise stress testing may be performed to characterize the PVC's further. Blood tests can rule out common chemical imbalances. And triggers such as alcohol, caffeine, illicit drugs and stress can be modified to see if they are the problem.

If there is no underlying heart disease and no symptoms then the PVC's are generally not treated as there is no compelling reason to do so. In some patients despite no underlying disease the PVC's are symptomatic and medications or occasionally an ablation procedure may be used to see if they can suppress the PVC's and the symptoms. In a small minority of patients the PVC's are so common (nearly every 2nd or third beat over a prolonged period of time) and there is underlying evidence of heart muscle damage that is thought to be associated. There is some evidence that treating the PVC's may reverse the damage. Those patients typically have thousands and thousands of PVC's per day. At that point electrophysiologists should be involved to characterize the PVC's further and discuss treatment options.

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

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

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

Organizations
http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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

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