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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Original Post - Oct 7, 2009 - 04:13pm PT
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Anyone else here on the taco have this? I was diagnosed last week. The flutters sometimes scare me. My EKG was great though with my resting heart rate at 48. I ran 6 miles today and ever since my heart is skipping approximately 3 beats per minute. I can literally feel my heart stop. Doctor says I'm fine but this is not normal. I feel good though. I've changed my diet. No more candy and coke for breakfast. Yes, I clearly did this to myself. No more caffiene. I'm eating very healthy. Did you have to slow down because of this? Supposidly there may be a period when I don't feel this at all. I can't wait. I'm a little freaked. I guess this is my wake up call.
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Roman
Trad climber
Bostonia
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Damn that sounds scary
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Ghost
climber
A long way from where I started
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Talk to Tami.
Or just wait for a while, and she'll surely show up here.
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Brian Hench
Trad climber
Anaheim, CA
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You didn't necessarily do it to yourself. Sometimes these things are caused by viruses and sometimes they are idopathic, meaning there is no apparent cause.
Stay away from pseudoephedrine, as it is known to cause heart palpitations.
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Roman
Trad climber
Bostonia
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No blowing cocaine either Beatrix!!!!11111!!1 :)
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 7, 2009 - 04:26pm PT
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Yuck. None of that mess in this body. Hopefully tami will show.
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Two Pack Jack
climber
The hills
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yep, I got em.
From my experience, I just eat plenty of potassium, do stress relief activities (meditation and yoga), and it has helped me a bunch. For me, it's something with the nervous system and the way nerves fire can cause them. Plus, just chill out. Whenever it happens it scary cause you can fell your heart literally stop, but you just gotta chill. It'll come back.
And if not, I'm psyched to meet DaVinci and Einstein, cause I would totally kick their asses in chess.
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 7, 2009 - 04:51pm PT
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HAHA! Nice! I was on a peak the other day thinking that I was just a few steps away from seeing my dead ex boyfriend. :-)
I do notice that the contractions are more frequent when my resting heart rate is higher. I "try" to meditate by my mind wanders. I need to work harder at that. Yoga is great. Tai chi before bed is soothing.
I keep checking to see if my heart remembered to start back up again after it stops. So far so good!
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 7, 2009 - 05:02pm PT
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Its ok! I feel really good. It's just the whole heart stopping thing that is making me anxious. :-)
I hope your Dad is ok.
Dude that costume rocks. If I'm not at sushi or J-tree we should try to end up at the same party this year.
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GOclimb
Trad climber
Boston, MA
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I have 'em. At the most frequent, I was getting them about one every 45 seconds or so. Scared the crap outa me. However, the doctor assures me they're not serious. Ran a bunch of tests to rule out anything more serious, but it is what it is - just PVCs.
In my case, they were brought on by stress. Ironically - the stress of my dad having a life-threatening ailment: a heart problem that nearly killed him!
I cut back a little on caffeine, but really they got better on their own, particularly as my stress levels settled back down. I still feel them occasionally, but they're not as bad.
GO
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 7, 2009 - 05:44pm PT
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Thank you.
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GOclimb
Trad climber
Boston, MA
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No prob! It definitely scared me most when it happened when I was climbing. But like I said, nothing ever came of it, and it pretty much receded into the background on its own.
I know this sounds silly, but I also think that the stress of being stressed about it made it happen more frequently. So be good to yourself - it's good for you!
GO
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Rcklzrd
Trad climber
San Juan Capistrano
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Just wanted to let you know that I have had them for many years now. I too had anxiety when they first started happening. The anxiety would then cause adrenaline to kick in and of course my heart would start racing. And that would give me more anxiety, etc., etc. But then I was able to get to that place in my head where I just told myself that it was no big deal, my heart wasn't going to stop,don't think about it, and I'm still here today!
Good luck getting over the anxiety of it.
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Mighty Hiker
Social climber
Vancouver, B.C.
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What did your MD recommend for treatment?
Several friends in later middle age - 60 or so - have developed heart irregularities of one sort or another in the last few years. One had to have it treated by a catheter they insert into your heart, where they then 'burn' some of the nerves that are causing false-firings. Another had a sort of pacemaker put in, to provide a jolt when/if needed. Another still not sure what is needed.
All three very fit and active, without other conditions.
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klk
Trad climber
cali
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what tami said--
you have a resting pulse of 48, sounds like you've been living a suspiciously healthy life.
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perswig
climber
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One of our techs (in great CV shape) started VPCs out of the blue. It was a while before she convinced herself to see an MD, so in the meantime we'd hook her up to our ECG machine periodically and watch them go by. Hers were monofocal and usually single, with rare runs of 3 or more.
If I recall, her doc did a good screening workup - CBC, chem panel and in particular electrolytes, a thyroid panel, and I think a resting cortisol to rule out Addison's dz - all normal.
As she started to track the episodes, it became clear they occurred more often after she ate chocolate. She didn't drink coffee or tea, but she was apparently sensitive to methylxanthines, maybe as a primary cause, or maybe exacerbating an underlying sensitivity. I don't think she ever had an echo; her symptoms lasted longer than you'd expect for a viral myocardiitis-type deal, but eventually resolved on their own.
You say it feels as though your heart 'stops' - any mention of AV block in your workup?
Hope this resolves soon.
Dale
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 7, 2009 - 06:33pm PT
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I do have a slow resting rate! I was completely floored when I saw the EKG results. I'm extremely happy with that.
My Kaiser doc did not recommend anything. Basically she told me not to worry about it. She is basing this on the fact that my EKG looked so good.
The anxiety is like a viscious circle. Sounds you guys know. Some days I don't think about it as much. Today is not one of those days and I feel is constantly, probably because of my run. Thankfully I have no other symptons. For those of you who have it, did you have to decrease your cardio activity? Did you notice an increase in the palps after exercise? I know everyone is different but it gives me some comfort discussing this with those of you who have expereinced it.
No mention of AV block. They didn't proceed with anymore tests since the EKG was good. I am going to ask for a full workup just for peace of mind. Issues of the heart are not to be taken lightly. Awwwww. . .that almost made me sound romantic. hehe
KLK, I do a ton of mountaineering and running. I'm also an asthmatic. I have to work harder than most to breathe just on a regular basis, even sitting down. My doc thinks this is why my hr is so low.
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klk
Trad climber
cali
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bk--
yeah, you do a lot of alpine, live at altitude, and it's the end of summer season. your aerobic shape is why yr doc seems pretty unconcerned. i certainly wouldn't quit doing yer aerobic work. it sounds like you're going to outlive all of us.
of course, had you cultivated more bad habits, you'd now have something to throw overboard.
just give up the java.
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GOclimb
Trad climber
Boston, MA
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For those of you who have it, did you have to decrease your cardio activity? Did you notice an increase in the palps after exercise? I know everyone is different but it gives me some comfort discussing this with those of you who have expereinced it.
At first, yes, I did decrease my cardio, because, frankly, I didn't know what was going on, and was scared of what might happen if I pushed my heart. But after a bit of research on my own, some hand-holding by the docs (they agreed to run some tests when they were pretty sure they weren't necessary), I relaxed, got on with my life, and all has been well.
GO
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Ken M
Mountain climber
Los Angeles, Ca
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Beatrix, you are describing a benign (non-dangerous) condition. You did the right thing, in going to your doc for evaluation. They HAVE done the appropriate evaluation for this, you need nothing else, from what you say.
(I am a doctor, and have evaluated and treated hundreds of folks with this--it is common)
As you, and many people have mentioned or implied, adrenaline (epinephrine) is often the culprit. Adrenaline is often described as the "stress hormone", as it is released in response to stress, to boost our bodies responses (this is what allows frail women to lift cars off their children). Anything which is chemically similar to adrenaline will have a similar effect. Ephedrine, pseudoephedrine (Sudaphed), caffeine, Xanthines, are all examples.
A very common type of medication that is often involved in causing problems, are many of the asthma medications. The worst is probably albuterol, as it is quite similar to adrenaline (an older, OTC inhaler still around, Primatene Mist, is actually an inhaled form of actual adrenaline, itself). You may be on a controller medication, and some of them contain a long acting version of albuterol...and example would be Advair or Foradil. Some people can be quite suseptible to these making the PVC's more prominent. You may want to discuss alternatives with your doc.
One other issue: PVC's, themselves, are a normal thing. Most people having an EKG will demonstrate one or more. Up to 10/minute are considered NORMAL. Thing is, most people do not feel them, and never know they are there! There are medications that can suppress them, but these are generally used only when they are driving a person crazy, as the medications have side effects, and some we don't like to use in asthmatics.
One last thing: the sensation of your heart "stopping". A PVC is a heartbeat that occurs EARLY (Premature Ventricular Contraction). There are exquisite mechanisms that control heartrate. When a contraction occurs that is early, the heart then immediately takes a "compensatory pause", to even out the time between heartbeats to the average heartrate.
So, if the regular heartrate is 1/sec, and a PVC pops up at 1/2 sec after the previous hearbeat, there will be a pause of 1-1/2 sec, before the next heartbeat. This is often experienced by those who can feel them (and most CANNOT), as a "heart stoppage", but it IS NOT! In fact, it is actually a definitional type of thing, that a pause follows a PVC....if there is no pause, it is probably not a PVC, and some other possibilities must be considered.
Virtually always, the simple EKG answers the question of what is going on, as it appears to have done here. There are MANY resources on the web talking about all these things.
Personally, I've found having a person obtain a clear understanding of what is going on, HUGELY reduces the anxiety of the experience...which is one of the things that keeps the whole thing going on.
Best of luck with this, and hope you and your doc are able to resolve this for you expeditiously.
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Brian
climber
Cali
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Procrastinating now, so can't give the full story.
Short story is, ended up in the ER about 5 years ago with full on atrial fibrillation. Docs converted me back to sinus rhythm with some meds, kept me fore a few days of observations and let me go.
Lots of anxiety to be sure, both about 1 young kid at home and another on the way, and about my ability to continue an active life.
Since then I have had the "million dollar workup" (nuclear imaging of the heart under stress, echo, sonograms, etc., etc.) I've gotten third and fourth opinions, from teams of specialists at UCLA, and everyone has said the same thing: there is nothing wrong, keep living your life.
I know the anxiety is hard to deal with, as several folks have said. My climbing partners will attest that I still have a habit of checking my pulse pretty regularly on long slogs at altitude. However, I think this is some of the best advice you could get: "Personally, I've found having a person obtain a clear understanding of what is going on, HUGELY reduces the anxiety of the experience...which is one of the things that keeps the whole thing going on." At this stage you, and I, have had the docs check things out. There are no guarantees in life, but if the doctors (the experts in this case) tell me to keep climbing, I'm going climbing.
Yes, I still get PVCs with some regularity--as said above, everyone gets them, but it is just stress buckets like you and me that feel them and fixate on them--but I just remind myself that everything has been checked out, a dozen times.
I still see a cardiologist once or twice a year for a holter monitor, and I am on 325mg of aspirin as a precaution, but since the initial event I've run an half Ironman, climbed big walls, spent a season in Chamonix, led some of my hardest old-school mixed nasties, made a (failed) free attempt on Moonlight, etc., etc.
I know it is scary, but if the best experts tell you to keep living, keep living. Good luck getting used to it. I know it can be hard, but you will get there.
Brian
PS--I'm 41 now, so the initial event happened around 36! Totally blew me away given my cardiovascular fitness, but there you go, life surprises you sometimes.
PPS--I'm also off coffee, which I still miss after 5 years (although I do treat myself to small amounts very, very rarely). Fecking peppermint tea is no substitute at 3:30am alpine starts... !
PM me if you want more information or someone to relate to.
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Ed Hartouni
Trad climber
Livermore, CA
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I'm 55 and was diagnosed with "ectopic hearbeat" at 28...
haven't really done anything about it in that time... still here... good to be vigilant but most likely not a problem.
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doc bs
Social climber
Northwest
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Dr KenM is right.
PVCs are normal. We all have them and three per minute is the ussual. You can check you friends and family members and they will likely have some too, sit still and feel there pulse for 1-10minutes.
In fact "AV block" can be normal too (someone else worried about that too). AV block is normal in resting atheletes whose resting heart rate is in 40s or 50s. If you do pushups or jog to get your heart rate over 60, the block goes away!
When I am anxious, I like to go out a play or run for an hour. When I get my runners high, I am not so anxious. Climbing is even better for this:)
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Paul_in_Van
Trad climber
Near Squampton
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MH,
What you are describing is called cardiac ablation. Used to treat AF in either intermittent or chronic situations. Neat tech.
Interesting note, in about 1% of cases people retain water, which can collect in the lungs and cause complications. Not sure how often this potential issue is discussed. I've got two close family members who had this in a week and half last month (the ablation, only one of them had water retention issues).
PVCs are thankfully way less worrisome.
Cheers
P
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 10:30am PT
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Hey thanks everyone. My doctor did perform the EKG but really did not go into any detail about what is happening. I learned more here. This sensation that I'm feeling as I type I believe is driving the anxiety. Gonna dive into work to take my mind off of this and then go climbing after work. I'm so thankful for those of you who have given me advice here, offered me some peace of mind and insight.
This tickle, or bubble popping sensation that I keep feeling (even right now) in the upper part of my chest is still making me want to run out of the door of my office, jump in my Jeep and speed to the hospital. I hope this stops soon. Not my heart but the palps. :-)
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leinosaur
Trad climber
burns flat, ok
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I wonder if someone with a resting HR as low as yours is more likely to be aware of the PVCs since your compensatory pause as described above might be nearly 2 seconds : 47 bpm = 1.23 sec/beat X 1.5 = ca. 1.9 sec - with low "normal" HR being 60-100 your pauses are longer than "usual". Ken?
Congrats on your outstanding cardio fitness and good luck with this issue - I bet you'll make peace with it pretty quick.
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shellon copeland
Social climber
reston, virginia
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Hi I am and RN and worked in CCU (coronary care unit/intensive care) and you should probably see a specialist called an Electrophysiologist this is a cardiologist who went further and spent like 3-5 years just studying and practicing the electrical parts of the heart. If you look up on google for electrophysiology of the heart it will show you the pathways etc. You sound like you are in great shape and also probably need an echo to see if there are any structural changes to the heart. But dont be very nervous many many people have this and is very very treatable. good luck and let us know how you are doing.
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Ken M
Mountain climber
Los Angeles, Ca
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//"I wonder if someone with a resting HR as low as yours is more likely to be aware of the PVCs since your compensatory pause as described above might be nearly 2 seconds : 47 bpm = 1.23 sec/beat X 1.5 = ca. 1.9 sec - with low "normal" HR being 60-100 your pauses are longer than "usual". Ken?"//
I would think that to be the case, although I'm personally not aware of any studies on the matter.
one of the things that drives the people with this sort of thing crazy, is the ambiguous things they hear:
Sounds like standard PVC's, nothing to be worried about---better see a doc
Doc checked it out, it's ok----better see a cardiologist
Cardio checked it out, it's ok---better see an electrophysiologist
EP checked it out, it's ok---better get another opinion
2nd EP checks it out, it's ok---better go to Mayo
The first step is the correct step. No one else here has seen you, or your EKG. If you don't trust your doc, you have a bigger problem, but easy to solve. If you trust your doc, then trust them, and follow their advice. We have all the time in the world to give lengthy explanations, but they know YOU.
And think about your asthma medicines........(palpitations are the most common reason for people discontinuing albuterol, in my experience)
Regarding compensatory pauses, I may not have been clear in the significance: If a compensatory pause is reliably present with the ectopic beat, it is a PVC. The point is, it is a definitional thing...if one can define a person's ectopy as a unifocal PVC at a rate of <10/min, then one has defined the situation and the severity, and the diagnostic job is just about done. What they have is no longer in question, the cause and the possible treatment are left, but the issue of danger is settled.
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Jaybro
Social climber
Wolf City, Wyoming
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I have an irregular heartbeat I have two different drummers, one only supplies intermitant contributions, lots of people are like that. It's cool, doesn't get in the way. i've run 48 Marathons and ultras.
A resting pulse of 48 is not unusual for a runner.
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GOclimb
Trad climber
Boston, MA
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Radical wrote: I don't think a PVC should be that noticeable personally although I guess some notice them.
I don't know if they all present this way (or if this is what Beatrix feels) but with me, what was most noticeable was not the pause, but the early beat. And the reason it was so noticeable was the POWER of it. It felt like all of a sudden I had a heartbeat that felt twice as hard as a normal one. It took my GF lying on my chest listening to figure out what it was. It sounded like:
lub-dub.....lub-dub.....lub-dub-LUB!........................lub-dub.....lub-dub
GO
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 01:56pm PT
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Yes GO! Exactly. I believe the early beat is that pounding, fluttery feeling that I feel. When I check my pulse as this happens, that is also when I feel the pause. It's calming down as the day progresses. YAY!
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Beatrix Kiddo
Mountain climber
Littleton
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Topic Author's Reply - Oct 8, 2009 - 04:39pm PT
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YIKES!!!!!!!!
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GOclimb
Trad climber
Boston, MA
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I have had my hand on some hearts, even literally around some hearts, where the PVC doesn't produce a pulse.
That's fascinating! I didn't know that could be the case. As for me, I can actually feel the PVC pulse in my wrist or neck. I can't actually feel the three parts like my GF could hear in my chest, but it just feels like a stronger/harder pulse, followed by a longer pause, followed by a regular pulse.
When it was at its worst, that feeling of the stronger/harder pulse would literally vibrate my body a little, and wake me up as I was falling asleep. Now I just ignore it, and it seems fairly uncommon anyway.
GO
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GOclimb
Trad climber
Boston, MA
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Radical - my apologies, I actually mis-remembered things a bit. Last night, as I was falling asleep, I paid attention, and managed to catch a couple.
So it's *not* the way I described. Rather it feels like:
beat... beat... beat... b(weird flutter).......BEAT!... beat... beat
And sounds like:
lubdub... lubdub... lubdub... lubdublub....... LUBdub... lubdub
It wasn't the beat before the pause that was the strong one - it was the one AFTER it.
GO
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Tradmedic
Ice climber
Thunder Bay, Ontario
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Oct 11, 2009 - 10:59pm PT
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Beatrix
Sounds like there are some well informed replies to this thread. One thing that I have seen mentioned that may be playing an effect is the medication you may be on for your asthma. Ventolin, or salbutamol usually has a very minimal side-effect profile, but it does play a little with your electrolytes (it's what plants crave, heh heh heh). It can lower your potassium, usually a healthy diet will more than compensate for this but with increased activity, diarrhea, vomitting (more indirectly) may help push you into decreased potassium levels.
PVC's can often be benign, keep your doc in the loop, and watch for whatever may provoke them and/or when they aren't as predominant.
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Gimp
Trad climber
Grand Junction
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Oct 12, 2009 - 10:34am PT
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Do not like giving out medical advice over phone or net since you never really know the details but do have one comment in regard to the problem you posted.
Based on the performance level you describe PVC's would not be unusual. However, you can put your mind a lot more at ease by talking to your doctor about getting an echocardiogram/ultrasound of the heart. If your ejection fraction is normal then you (no such thing as 100% in this world) probably have no worries.
SLP
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Jaybro
Social climber
Wolf City, Wyoming
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Oct 12, 2009 - 11:33am PT
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Maybe it stems from guilt for murdering your boy friemd?
I have a very similar heartbeat pattern to what Go climb describes.
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leinosaur
Trad climber
burns flat, ok
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Oct 23, 2009 - 11:42pm PT
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radical - interesting perspectival analysis; this thread has been a fun adjunct to some rhythm reviews for my PALS certification today - best of luck with your 23:59 center - yet another reason the change of nomenclature to ED from ER is appropriate - the truly acute stuff definitely merits a whole Department. Too bad about the "other ED" co-opting the initials.
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Omot
Trad climber
The here and now
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Oct 24, 2009 - 03:20am PT
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Interesting topic. Sounds like a lot of progress has been made in understanding arrhythmia since I was diagnosed with PVC 30 years ago (I'm 48 now). They first appeared when I was running a lot and had my resting pulse down under 50 bpm. The doc said it was my slow pulse that made them more prevalent, and that they were no worry. Sounds like a similar situation to yours.
They are definitely stress related with me. I'm not in the shape I was 30 years ago, but I still get them from time-to-time (once every 1-2 weeks?). They really increased (more frequent and longer duration) when I got laid-off, and I went back to see a doctor just in case. An EKG and ECG showed I was ok, and since then I became one with my unemployment and really relaxed, like more relaxed since I've been probably since grade school, and they went away for the most part.
When they happen though, they do take my breath away, as they are very noticeable. Anyway, I'm one more data point that these things won't kill you. Don't let it keep you from getting out!
Enjoy,
Tomo
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