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Some "light" info on cardiac physiology and PVCs

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Posted 4/13/2008 8:53 AM (GMT 0)
Sarita,

Thanks for the reply!
I see an wonderful MD., F.A.C.C who specializes in device implants, laser lead extractions, pacemaker implants, AICD's, Tilt Table Exams, Bivent ICD implants, cardioversions, loop recorder implants and Electrophysiology. He also specializes in diagnostic and interventional catheterization including stents, TEE(Transesophageal Echocardiology) and heart biopsies and is a member of the International Society of Heart Transplantation. (he's also the Assistant Professor at the University of Utah School of Medicine) His partner specializes in ablations of the ventricles and assists in cardiopulmonary transplants. Between the 2 of them, I don't feel I could ask for better care and I don't think there's much concerning the heart that they don't cover! :)

Over the years I've spent alot of time with them and about 4 years ago we became engaged in a pretty in depth chat about genetics and arrhythmia's namely because my mother, brother, my daughter and I, all have pretty consistant PVC's (all of us), IST (mom, daughter and I) and years of notable potassium deficiency (all of us) with no known contributing etiologies. Of interest to me is also the fact that we all have "sinus arrhythmia" on our EKG's.
Anyway, tt was their opinion at the time that we may have an possible (suspected, as read on my report) "genetic mutation" causing deficiency at the voltage-gated K+ ion channel level.
As far as the arrhythmia's are concerned, it was my understanding that this can cause problems with a cells depolarization returning to a resting state amongst other things. I wish I could have written it all down at the time...it really was so interesting to hear.
During another discussion I was off handedly offered a heart biopsy, (well, we could do a biopsy and see what's going on if you want) along with numberous other tests, (can you say guinea pig :) but I kindly declined the invitation after considering the fact that my mother is almost 70 and she is doing just fine! Whatever the problem is, I don't feel it's life threatening and sometimes, as much as I hate to admit it, ignorance really is bliss!

You hit the nail on the head with the low blood pressure and beta's for me. I've tried both Metoprolol and Sectral. I bottomed out and couldn't even function on an shuffle level...lol. It was awful! I was also offered Tambocor (Flecainide) but I refused that without thought. I just had my annual and our next plan of attack if the PVC's come back in the 10's of thousands, is to go for the ablation.
I am multifocal, so my odds of complete success are pretty dismal...but...as you know, these darn things make you crazy and I can't fathom living even another month having them like I did last year.

You made me laugh about the MCATS! I actually did pretty well considering and stressed the whole time during the prior years leading up to it.
I left when I had a devastating crisis happen to my daughter that couldn't go without my full devotion. I don't regret giving it up...sometimes I guess things just aren't meant to be, and when I hug my daughter and now, my grandchildren, everything is beautiful, and it was all worth it.
I've tried to keep up to date, (I landed in a slightly different form of the medical field,) but I'm afraid that I would have to start all over at this point! The discoveries, research and medicines that have come about the last 20 years are astounding! I was looking back at some of my old work a few years back and it seems prehistoric! I'm so tickled to see people like you...and am so touched by the level of dedication it takes now more then ever!

Hang in there...I'm sure you'll be a wonderful MD one day! Besides, you already have one of the finest qualities, a great bed side manner!

BTW...have you thought about what area your going to specialize in? I was heading/hoping to become a Trauma Surgeon. I put in some time in the ER at the UMC of So. LV and loved it!

Hope your well!
Julie aka Jewels
Posted 4/14/2008 3:55 PM (GMT 0)

Jewels,

Isn't Sarita da bomb?  We ADORE her over on the "bad belly" boards.  And here she is, spreading her goodness all over these forums!

You guys have lost me here with the medi-speak.  Although I did perk up over the magnesium conversation.  Way, way, way back in my 20's, I did take mag supplements for the PVC's and if memory serves me (questionable), it did help a bit.  Would a routine blood test show if you are short on mag?  Can you take too much and actually kick off a pattern of PVC'S?  I ask because a few months back, I was taking mag for the IBS - about 800 mg a day.  I only took them for about a week and to be honest, I'm not sure if the PVC's started right afterward or much after. 

Sarita, Sis has CML.  We are stunned.  She is the MOST healthy 54 year old woman I know.  In fact, my other sis and I are always complaining that we are the unlucky receipients of all the health problems in the family and she somehow escaped.  Color us ashamed! 

I've found, after 25 years of psychotherapy, that talking about "things" only goes so far.  It helps, I guess, but to be honest, I don't FEEL stressed about the "issues".  I have researched all the ailments currently affecting the family and feel prepared for what may come.  I've been out of work SO MANY TIMES before that it's almost a normal state for me.  My career is the type that is the first to go when times get tough so I'm used to getting laid off when the economy goes toes up. 

BUT, I was reflecting on when the PVC's started this time and the one thing that stands out is the death of my 20 year old kitty.  I KNOW how stressed  I was those last few weeks before I had to put her down because I could FEEL the physical stress in my guts (the constant pang) and in my heart (racing from fear that she would die right on my lap).  For three days before I had to put her down, I cried harder than I have in about 20 years.  And the day she passed, I thought I was going to vomit from the amount of crying I did.  Tremendous sadness followed for weeks, accompanied by sleep-deprivation (couldn't stop thinking about Kiwi every time I put my head on the pillow - "did I do the right thing putting her down?").  The PVC's started about two weeks later.  Guess this is as possible a catalyst as any, huh?

Posted 4/21/2008 6:25 AM (GMT 0)
Gutsy, you are my best cheerleader in the world! Just wanted to check in with you...how are those PVCs? How are YOU, beyond your PVCs? And your sister?

I have no doubt that your PVCs are related to the stress. When I say that, I mean this: sudden stressors will increase your cortisol levels, which will increase cardiac output and all kinds of other things, and this can lead to PVCs. So it's not "in your head," like some might say. It simply means that yes, being under very stressful conditions will actually produce very troubling physiological symptoms like you describe. I feel for you, chica. Please let me know how you are doing!
Posted 4/21/2008 5:26 PM (GMT 0)

Glad you're back! 

I decided to bite the bullet and have an other echo done.  Had that on Friday.  I won't know anything until the end of the week but the tech said I had a "beautiful heart".  I don't think she was referring to my "charitable spirit" as I'm fairly certain that can not be seen on an ultrasound!  Beyond that, she was non-committal, as they usually are.  I know I will feel better if the test proves there is nothing "sinister" going on with the old ticker!

I found an iron supplement in the health food store that claims, in big bold letters on the box, that it is NON-CONSTIPATING!  The list of ingredients reads like a natural laxative.  So I've been taking that for the last three days and so far, no problems.  I am hoping this might correct that heart rhythm.  If it doesn't, doc is happy to switch the beta blocker to something else.

OF COURSE, my heart beat was PERFECT during the whole test!  Maddening!  It's like bringing in your car to the mechanic because it is making a "noise" and looking the fool when the car behaves perfectly!  I have noticed that I have very few of these renegade rhythms when I am lying down or resting on the couch watching the tube.  Yesterday, a friend stopped over for a visit and the heart went crazy.  Just hanging out and chatting with a gal-friend seemed like too much stimulation.  How nutty is that?

I guess the good news is that sis has started Gleevec and seems to be managing very well.  We won't know anything until her next blood test but for now, we can calm down a bit while she receives treatment.  Ma and Pa are still crazy as loons, driving the doctors INSANE down there in Florida with their refusal to cooperate with even the simplest tests (take home blood pressure machine and holter monitors). Oi Vey, Sarita, the stories I could tell!  Would have you splitting your seams!   I am learning to accept that I can't FORCE them to behave.  There is alot of "letting go" that has to happen here! 

So that's the poop, so to speak.  I am devoting this week to "making" a job for myself.  Only four months of unemployment left so I have to get myself in gear!  Thanks for your wonderful support!  I'll let you know what the test results show!

Posted 7/7/2008 5:08 PM (GMT 0)
your post has been edited due to healing well forum rule #19. Do not use the forum to give professional medical advice. If you are a medical professional, please remember the forums and chat are for patient support and not to be used for distributing professional medical advice and/or using the forum to represent your professional services.
 

Post Edited By Moderator (els) : 7/9/2008 2:28:45 PM (GMT-6)

Posted 7/17/2008 5:23 PM (GMT 0)
Hello there everyone! I practically CRIED when I found this site and realized I am not the only one in the world going mad over my PVCs! I don´t know ANYONE who has a problem with arrhythmia so my family and friends listen to me complain and their eyes get big but they don´t know how to help me.

Briefly my med history: Started having scattered PVCs in my early 20s, was tested and found to have a healthy heart. The cardiologist told me that I didn´t need meds and not to worry. So I didn´t. From time to time I had brief bouts but nothing to write home about. I got pregnant when I was 37 and the PVCs went through the roof. Unfortunately, I miscarried at 8 weeks and surprise, surprise...the PVCs went away immediately.

So... fast forward to this past May--I´m now 39 years old. All of a sudden out of the blue I started having runs for hours and hours. Sometimes they were coming every other beat. I had a holter test and despite my fears it came back as "low risk." Then in June I literally felt them non-stop for almost 12 hours and ended up in the ER. They were coming almost every other beat... but again, no one seemed too worried. (I have no other symptoms and again, all the tests related to my heart showed that it was healthy.) Unfortunately, I have low blood pressure and cannot tolerate beta blockers, so they put me on an IV and a German anti-arrhythmic drug called Norfenon. This immediately helped and 24 hours later I was having one PVC every five minutes. The following morning I did a stress test and the doctor was very optimistic because it came back completely clean--I didn´t have a single PVC before, during or after the test.

So it's been more or less and month and I´m still on the Norfenon--150 mg pill every 8 hours. I feel much more stable although I still have runs--almost always at night and they wake me out of sleep. Also, sometimes I feel dizzy with the meds which is disconcerting. I repeated the holter test a week ago and despite a night of several yucky runs, again the cardiologist assured me that my arrhythmia is low risk and I need to focus on decreasing my anxiety about it. He recommended exercising 30 minutes per day and taking Omega 3 supplements.

It´s amazing to think that after all these years that these pesky PVCs can be so scary--but I never imagined that they would get so completely out of control! I agree that now they make me want to jump out a window (not really! :)) because they are so bothersome and they don´t let me enjoy my life...

Sarita (or other members), I have a question for you! I´ve been thinking about going on the birth control pill because it has occurred to me that by stabilizing my hormones, maybe I can get back into a PVC-free zone. What do you know about taking the BCP to stabilize PVCs? The cardiologist said we could try it but I´m not sure if it´s a good idea or a bad one. Any experiences out there?????

Post Edited (kimita) : 7/17/2008 11:29:54 AM (GMT-6)

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