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Heart & Cardiology/are multiple ectopic heart beats ok?

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QUESTION: Dear sir,
I have currently been experiencing palpitations.
Most often these are single thuds which cause me to feel like I've missed a breath then a heavy beat and a slight and brief light headed sensation.
However, because this scares me I have started to check my pulse, on occasion I will get a run of these beats together.. sometimes 3 or 4..sometimes around 7 or so.

I have had a resting ecg 4 months ago which was recorded as normal and was told that my heart is fine purely on that test.

I was am very fit and active 37 year old until these began and I have started to worry Considerably.

I do smoke and these multiple beats often happen as I take my first drag on a cigarette.
Does this indicate to you anything that should cause concern or can I relax a little.
Many thanks for any advice you can give.

Kindest regards

Daniele

ANSWER: Hi,

Generally extra beats such as PVC' or PAC's are not too much to worry about. These are the most likely cause of the sensation of the palpitations you describe. They are usually more anxiety provoking than dangerous. Its good that your resting ekg was normal. If the frequency of the palpitations is increasing and the symptoms more prominent, its reasonable to obtain a holter monitor to characterize them further and also define the need for further testing. I would remain relaxed, and discuss with your gp is a holter monitor may be of use.

Hope that was helpful,  

---------- FOLLOW-UP ----------

QUESTION: Dear sir/madam,
Sorry to be a further pain...
I have recently become concerned that the vein on the right side of my neck is visible when I turn my head to the left.
I seems to protrude a little but is straight. I presume that it is my external jugular vein and stretches from my clavicle to about an inch from my jaw line.
I haven't noticed it pulsing and isn't noticeably painful but when pressed in any part gently it swells...is this normal?

I have been a little sedentary for around a year but was previously extremely active in sport and fitness.
I am a 37 year old male and have smoked roughly 20 a day for 20 years.

I note that I was seen in accident and emergency 3 weeks ago for severe back pain...because I also had chest pain they did an ecg, urine and blood tests including reactive protein testing.
I was told that all was normal except a high bilirubin level which was 22...2 years prior it was also 23 and I have suspected Gilbert syndrome.

I have no major sweating or breathlessness on exertion but am quite anxious about the distension in this vein.

Any insight would be greatly appreciated.
Kindest regards

Daniele

Answer
Hi,

You are right that the vein is likely the external jugular vein. The swelling when pressed is normal. I would suggest you undergo a standard physical exam to make sure the rest of your cardiovascular exam is normal. Also I'm not sure if you had an echocardiogram as if that was normal then thats also reassuring. Having said that, this could be a normal finding also and doesn't necessarily mean anything bad.

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

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http://blog.myheart.net

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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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