Heart & Cardiology/Heart Holter Results


QUESTION: Hello, I am a 56 year old female and a current smoker.  I suffer from anxiety and panic attacks from time to time.  I find that they may be brought on by stress or dehydration but am managing them on my own and not taking any medication for them. I am still getting the palpitations from time to time which I can feel.  They can last sometimes for an hour or two or sometimes on and off for days.  I am currently taking Macaradis HCT and Crestor.   

I had a echo done on my heart in 2009 which came back as normal.  I had the following heart holter results that were done in 2012.  Nothing was done regarding the holter test and I was told that the results were normal.  

Ventricular ectopic activity consisted of 21 beats, of which 18 were in single PVCs, 3 were single VEs.
The patient's rhythm included 21 min 41 sec of tachycardis. The fastest single episode of tachycardis occurred at 1:23:34 p.m. lasting 1 min 2 sec, with maximum heart rate of 135 bpm.
Superventricular ectopic activity consisted of 2039 beats, of which 3 were in 1 run, wr were in artial couplets, 7 were late beats, 1606 were single PACs, 292 were in bigeminy, 107 were in trigeminy. The longests R-R/N-N interveral was 1.3 seconds occurring at 2:15 a.. The superventricular run occurred at 11:02 p.m. consisting of 3 beats, with maxium heart rate of 146 bpm.

Technologists Comments:
The patient was in sinus rhythm with heart rates ranging from 53 - 135 bmp, mean 81 bpm
Rare isolated ventricular ectopy. No couplets or VT.
Frequent supraventricular ectopy including 1 run ( 3 beats @ 146 @ 11:02 p.m.) and 12 couplets. Episodes of bigaminy and trigeminy noted.
No pauses/blocks detected.
Dairy events correlated with NSR and PACs.

My questions are:

1.  Do you agree that there is nothing to worry about with the above results?
2.  How often should I be having a eco done?
3.  How often should I be having a 24 hr holter done?  
4.  Should I be changing my BP med?
5.  Are there other tests that I should be having done?

ANSWER: 1 -There was nothing that required treatment at that time but that was now 4 years ago.

2- There is no required follow up of a normal

3 - It depends on the clinical situation. You need to discuss this with your doctor

4 - Not if your BP is controlled

5 - Ask your doctor about a 64 slice CT to assess coronary calcification in a middle aged smoker.

Good luck!!!

Dr. P

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

QUESTION: Thank you for your quick response time and help Dr. Pearl.  I appreciate it!

I had an ultrasound of my carotid arteries in 2012 as well.  The report showed:

There is a single small focus of calcific plaque in the right carotid bulb and 2 foci of calcific plaque in the left carotid bulb. Left and right vertebral arteries demonstrate normal antegrade flow.  Minimal calcific plaque present in both carotid bulbs.  Doppler vales in both
ICAS consistent with less than 50% stenosis.

My doctor told me that if you took people off the street 50% would show these results and not even know it.  

Is this test good enough to show what is happening in my arteries?  The reason I ask is that it takes almost a year to get a CT scan here.

You were found to have early cerebrovascular disease. You need to optimize your BP and cholesterol profile, keeping your LDL , 70.

You probably also have early coronary disease since it is a systemic disease. As previously mentioned, ask about the heart scan.

Good luck!!!

Dr. P

Heart & Cardiology

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Frank J. Pearl, M.D.


Voluntary Professor of Medicine, University of Miami Miller School of Medicine, Miami, FL. Board certified in cardiovascular disease

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