Heart Scare

[mountainsoft]

My wife and I were taking our blood pressures the other night with our home BP monitor. When it was my turn we noticed the "beep" it makes with each heart beat sounded really erratic. I waited a while and tried again, same thing. BP was fine, but the pulse was really off. It still worked fine for my wife, so we ruled out a faulty machine. Other than the irregular beeping I felt fine and didn't have any symptoms.

The next morning I called an advice nurse who sent me to urgent care. Always fun, hours of waiting. Eventually they sent me down for an EKG and I was able to see a doctor. They diagnosed me with PAC, or Premature Atrial Contractions. Basically, my heart beats too soon, then pauses to get back on rhythm. Instead of "beep, beep, beep, beep", mine goes "beep, beep, pause, beep, beep, pause".

Thankfully, the doctor said it's fairly common and as long as I am not having any symptoms it is nothing to worry about. She checked with a cardiologist who hinted it might be a side effect of the Losartin I take for BP.

Anyway, they sent me home, no treatment needed, but I've been a nervous wreck for two days, even after getting a green light (all the "What-If" scenarios playing in my head). I finally got a good night sleep last night after being so stressed out.

All the blood work came back perfectly normal, and I never did have any symptoms. Despite the healthy diagnosis, it still feels scary to have an abnormal heartbeat and wonder what that's all about or what it could potentially lead to later on. I'm not feeling very invincible anymore...

My wife had to get a pacemaker a few years ago, my aunt got one last month, and my mom just had to get a pacemaker last Monday. So I guess I'm a little jumpy that I was next in line...

 

[Teacher Terry]

When I was 50 I was diagnosed with a too fast erratic heartbeat and HBP. A beta blocker fixed both.

 

[tmm99]

I don't think PAC is serious at all. It happens to a lot of people of all ages just like PVC (Premature Ventricular Contraction) which I have had since my 30s. (PAC may even be more common than PVC.) At one point (in my 30s), PVCs happened a few times a minute (confirmed by a 24-hour halter monitor.) I had an ultrasound done as well. I'm in my 60s now. From my non-medical understanding, both PACs and PVCs are benign conditions.

Do you drink a lot of coffee or beverages with a lot of caffeine? Are you suffering from a lack of sleep? Minimizing caffeine and taking a magnesium supplement ease my PVCs to non-existent or almost non-existent. And sleeping plenty helps too. Also, PVCs only happen at rest and not when I'm exercising and my heart is working harder. I think I would worry if I started PVCing during a workout.

As you already had other tests to exclude any other conditions, I wouldn't worry much about it if I were you. Every doctor I've encountered who I mentioned my PVCs to, treats it as something that I shouldn't worry about.

 

[mountainsoft]

I don't think PAC is serious at all. It happens to a lot of people of all ages just like PVC (Premature Ventricular Contraction) which I have had since my 30s. At one point (in my 30s), PVC happened a few times a minute (confirmed by a 24-hour halter monitor.) I'm in my 60s now.

Thanks. That's reassuring.

Do you drink a lot of coffee or beverages with a lot of caffeine? Are you suffering from lack of sleep? Under a lot of stress? Minimizing caffeine and taking a magnesium supplement ease my PVC to zero or almost non-existent. And sleeping plenty helps too.

No coffee, but I drink cola and iced tea regularly. Neither is all that high in caffeine, but I drink them constantly.

 

[tmm99]

Thanks. That's reassuring.



No coffee, but I drink cola and iced tea regularly. Neither is all that high in caffeine, but I drink them constantly.

I believe cola and black tea are pretty high in caffeine although probably not as much as coffee. I think they make caffeine-free cola too. Maybe you can experiment with reducing the amount of caffeine intake and see if it helps with your PACs? My PVCs get bad even with green tea which has a much lower caffeine content than black tea, so I limit my intake.

 

[ShokWaveRider]

I have PACs too. Cardiologist told me to stop taking my pulse (that is how I noticed them), seriously that was his advice. Booked me in for a checkup 1 year later. BTW I already have a pacemaker.

 

[Sojourner]

No coffee, but I drink cola and iced tea regularly. Neither is all that high in caffeine, but I drink them constantly.

I believe cola and black tea are pretty high in caffeine although probably not as much as coffee. I think they make caffeine-free cola too. Maybe you can experiment with reducing the amount of caffeine intake and see if it helps with your PACs? My PVCs get bad even with green tea which has a much lower caffeine content than black tea, so I limit my intake.

As someone who's suffered from frequent PVCs for years, I would strongly recommend eliminating caffeine from your diet, as tmm99 suggested. Caffeine is highly irritating/stimulating to the electrical system of the heart. Try slowly cutting back on all caffeinated drinks (colas, teas, etc.), reducing intake down to zero over the course of a few weeks, and see what happens. I suspect your irregular beats will greatly diminish.

 

[Luvtoride]

To OP, please go see a cardiologist. The answer/ advice you got from an Urgent care doctor and someone “asking a cardiologist “ should not be the final diagnosis.
I have had Atrial Fib for many years which was first picked up by a nurse when I was getting ready to donate blood. I have never felt my irregular heart beat as it does not cause a rapid heart beat.
About 9 years ago I had a heart attack (mild one but still scary) at which time my cardiologist decided I should have a pacemaker implanted as my already low heart rate would be even further reduced by Blood Pressure meds he wanted me on post heart attack.
I know that any self monitoring device I.e.at home Blood pressure cuffs, Apple Watch, heart rate monitors will never give accurate readings of patients with A fib. My A Fib is well controlled by meds and regular visits with my cardiologist and Pacemaker readings. Although I’m not familiar with the specific conditions mentioned here, I wouldn’t take it lightly and I would highly recommend seeing a cardiologist to get it fully vetted and any necessary treatment or meds prescribed.
Stay well and good luck.

 

[Sojourner]

From my non-medical understanding, both PACs and PVCs are benign conditions.
[...]
Every doctor I've encountered who I mentioned my PVCs to, treats it as something that I shouldn't worry about.

Yes and no. The latest thinking about PVCs (according to my cardiologist) is that they are considered a low health risk if they account for fewer than 10% of one's total heartbeats, a moderate risk if between 10% and 20%, and a high risk if 20% or higher.

For most people, the 10% threshold would be about 6-7 PVCs per minute, on average, or around 9,000-10,000 per day. That's far, far more than most people with PVCs ever experience. For people with substantially fewer PVCs than that, they are primarily a nuisance condition that isn't considered dangerous enough to warrant riskier or more invasive treatments, such as ablation.

Beyond getting checked out by your PCP, the next step I'd recommend for anyone suffering from frequent PACs or PVCs is to see a cardiologist. Many primary care physicians are not up to speed on the latest standards of care when it comes to these kinds of arrhythmias.

 

[Ronstar]

OP - I wouldn't rely on a diagnosis made solely by an urgent care dr and his/her opinion of an ekg.


I had an irregular heartbeat detected during my August 2020 medicare wellness exam. Dr. said my ekg looked like I was having a heart attack. They scheduled a nuclear stress test. I had an irregular heartbeat during the stress test and was diagnosed as having premature ventricular contractions by the cardiologist who reviewed the test. The cardiologist said that the rest of the test was fine and the PVC's pose no danger.

I also suggest OP go to a cardiologist.

 

[braumeister]

I also suggest OP go to a cardiologist.

I think that's good advice in any case.
I've been referred to cardiologists several times by different doctors when they looked at my ECGs. In every case, the cardiologist looked at it and said "I'll bet you're a runner, right?" When I said I was, the response was "Don't worry about it, you're fine."

So the OP might be fortunate enough to have a similar experience, and the visit would then provide some reassurance, replacing any current anxiety.

 

[HenryD]

To OP, please go see a cardiologist.

+1 on this.

 

[Ronstar]

... In every case, the cardiologist looked at it and said "I'll bet you're a runner, right?" When I said I was, the response was "Don't worry about it, you're fine.".....

The stress test tech asked me the same question at the beginning of my stress test when she saw the first ekg in the test. She said that is common for runners to have PVC's.

 

[Charlotte]

Even better than a cardiologist, look for a cardiologist who specializes as an electrophysiologist.

I have PACs, PVCs, also PAT (paroxysmal atrial tachycardia). I take medication to control them because they bother me so much. Started out with a beta blocker but eventually moved to flecainide, which seems to do the job for me.

I definitely understand how upsetting it is to have your hearts electrical system act funny.

 

[MarieIG]

Another proponent of being check out by a cardiologist.

 

[Buckeye]

When I was 50 I was diagnosed with a too fast erratic heartbeat and HBP. A beta blocker fixed both.

My resting heart rate became elevated and it would spike without much provocation but thank goodness my doc figured out it was due to low ferritin levels. Starting taking ferrous sulfate pills and my heart rate was back to normal (resting and during exertion) in about 10 days. Thank goodness it stabilized because I was miserable when this was going on. Horrible feeling.

 

[aja8888]

No historical heart issues.....But,

At 75 years old, and out of the blue, my heart rate would jump to 200+ beats per minute. When that happens, you feel lightheaded (at a minimum). After a few times of this happening, I went to see a cardiologist. I ended up wearing a heart monitor for 10 days and was diagnosed with SVT (Super Ventricular Tricardia).

That entailed an ablation to shut off the electrical circuit that was causing this. The Doc found out which one it was and shut it down with an RF energy blast (pretty tricky stuff!).

All is good now at 78.

Go see a cardiologist and have your heart checked out as recommended above.

 

[razztazz]

Here's a vote for seeing a cardio type. On 30 Sept 2019 I was at the GP's getting my annual blood tests done. I had been thinking of getting a treadmill test just to stay out in front of any under-the-radar problems that might be forming. I had just turned 62.

During the visit I mentioned to the doc my super low BP and super slow heart rates of about 40 years standing. He said if you don't have symptoms you're OK. Just means you're in great shape and your system has no trouble pumping blood around. Then he gives a listen. i.e. Deep breath in/out etc. Then he says "Nice strong heart beat. No problems there." When he said that I thought to myself: I don't need a treadmill test. I'll do that when I turn 65. Eight months and 3 days later I have a super heart attack. Lost 50% function and now have three stents and a pacemaker/defibrillator installed.

Had I had the treadmill test I would have had a better than 99% chance of detecting the offending blockages. I'd still have three stents but with no heart damage and full function. A big difference.

 

[daylatedollarshort]

I had a related condition and was told by a cardiologist "it was normal - lots of people have it." A little digging and I found out I was low in magnesium, so I changed my diet to get much more magnesium, which fixed the issue forever.

Link - Successful improvement of frequency and symptoms of premature complexes after oral magnesium administration, "Premature ventricular and supraventricular complexes (PVC and PsVC) are frequent and often symptomatic. The magnesium (Mg) ion plays a role in the physiology of cell membranes and cardiac rhythm." https://pubmed.ncbi.nlm.nih.gov/22584491/

There is another paper on Pubmed showing improvement with taurine and l-arginine. You can have tests for these and other nutritional related factors to see if any of those might be your root issue.

 

[jabbahop]

changing caffine didn’t seem to affect my PACs. Magnesium supplements help a bit.

As others have said my cardiologists are not worried about my PACs. I have an embedded heart recorder they installed during my second ablation for proximal Atrial tachycardia (200-250 bpm) that was typically triggered by intense exercise.

My mom has Afib (and a large number of ablations) so they check the heart recorder to make sure I don’t start having AFIB episodes since those can be more problematic.

Glad you are checking into it but it sounds like it shouldn’t be a source of worry.

 

[mountainsoft]

Thanks for the advice and reassurance everyone. I've never had an issue before and didn't have any symptoms when I heard the odd heart rate on our BP monitor. Blood work and EKG at the doc all looked great, except for the PAC. During the time between getting the EKG and seeing the doc it had already stopped. She said my heart sounded normal, even though they caught it on the EKG. A couple days later I took my BP at home again and the heart rate sounds steady and normal again.

Anyway, I'm not going to worry about it for now. Anything medical related makes me a nervous wreck. Life is too short for that kind of stress.

 

[Chuckanut]

I have a few heart problems, none of which affect my life.

On the EKG one line that is supposed to point up, points down. That is often an indicator of lack of oxygen to the heart. But, after an exam and the brutal treadmill testing which I passed with very good results for a 60+ guy, the doctor declared me an outlier.

 

[mountainsoft]

Follow-up on the heart scare...

My PAC was becoming an almost constant thing, and overall I still just didn't feel right. I was tired all the time, got chills often, my hands and feet would get numb and tingly, occasional blurry vision, body aches, etc.. Last week we sat down to watch a movie and I got a strong pressure in my chest and around the upper part of my back. I felt heat and tightness in my neck, my feet went numb. It was really scary so my wife called 911. The paramedics came out and checked me out. Did an EKG and said they didn't see any sign of a heart attack but recommended I go to the emergency room to get checked out in more detail. So I got my first ride in an ambulance. Combination of fear and novelty.

I got to the ER around 9:30pm and they put in an IV line, took blood, ran another EKG, and did a chest X-Ray. The ER was full that night so they booted me out to the waiting room where I sat for 16 hours. People where literally camping out on the waiting room floor. It was miserable. About 11 hours in they called me back, only to say they had the wrong patient and sent me back to the waiting room. Of course, someone else had taken the one comfortable chair so I spent the next 5 hours in a cheap plastic chair.

Periodically they took my vitals and drew more blood for three Troponin tests (looking for enzymes from heart damage).

What was now the next day they finally discharged me and said everything looked good. No sign of a heart attack or any heart damage. Said I was a low risk candidate and repeated "not to worry" about the PAC's.

After 30+ hours without sleep I crashed when my wife picked me up and I finally got back home.

The next day I felt pretty good, despite the sleep deprivation. I had missed my Losartan dose while at the hospital, so I took one for the new day. The following day I started feeling bad again, all the same symptoms. I made a follow-up doctor appointment, but the doctor called in sick the day of my appointment. So I wasn't able to get in till Monday.

While I waited for my new appointment, I decided to pause taking the Losartan since that was the only thing that changed on the day I felt good. To my surprise I felt much better. I didn't notice any PAC's Saturday, and only a few on Sunday. My doctor didn't hear any PAC's when I had my appointment Monday. I have had a few minor skips since then, but am mostly back to a normal rhythm and feel so much better.

I can't help but think the majority of my issues were caused by the Losartan. What's odd is that I've been taking Losartan since April without any side effects, then it all just hit me a couple weeks ago.

Anyway, my doctor took me off Losartan and put me on Amlodipine instead. Only two days in, waiting to see what kind of side effects I have with this one. He also ordered a wearable heart monitor just to make sure I don't have aFib or a more serious rhythm problem. Still waiting for that to arrive.

It has been a crazy, and at times very scary, couple of weeks. I never thought I would be so thankful to be alive.

 

[tmm99]

Wow, you've been through a lot in a very short time. The ER visit sounded hellish. Not an ideal time to visit ER with the pandemic going on, I guess.

It does sound like Losartan is part of the problem if it's not the whole problem. The scary part is (and the good part at the same time is) that you noticed that Losartan was making you sick, but not your doctor(s). I hate to think what would have happened if you didn't forget to take Losartan and never realized that that might be the problem. My family doc ordered a 24-hour holter monitor right away when he noticed hesitant heartbeats when he checked my heartbeat, so I hope that shows some info (or nothing abnormal, as you're off Losartan.)

Take care!

 

[jabbahop]

sorry you are going through this. Ordinarily I would be livid about the ER treatment you received but the pandemic must be hell on those that work there given how long it has been going on.

Hopefully changing meds helps you. I know early on I tried several meds for my SVT and had a variety of undesirable symptoms where others tolerated them well. I know my mother has had a 4 year journey with AFIB and I think went through 5 or 6 meds before finding one that didn’t make her feel worse than taking nothing.