Any of you youngsters dealing with PVC?

[CRJR45]

Premature Ventricle Collapse ? I just had a surgery and they almost rescheduled it because my heart was only registering 40 beats a minute instead of 76 , as normal for me .
Dr put me on Metoprolol and has me on a monitor . Just wondering if this was affecting me out west last year , I felt like a had just run a marathon , I had zero energy and my heart rate would not increase .
Kind of felt like a flutter .
Anybody ?

 

[Marbles]

Do you mean Premature Ventricular Contractions? That makes since with what you wrote and would be what PVC typical refers to regarding the heart.

Yes, it can effect your performance, but hard to say anout things in the past, question really is how do you feel now.

Metropol is a solid first choice as is the monitor.

Have you had an echocardiogram? If not, ask your doctor about checking for cardiomyopathy as well.

Good luck, hope they get you straightened out.

 

[CRJR45]

Yes , thanks for the correction . I have an Echo scheduled for next week . I will ask about the cardiomyopathy as well , thank you !

 

[5MilesBack]

my heart was only registering 40 beats a minute instead of 76 , as normal for me .

76 is "normal" for you.....resting rate? I have no idea but is that considered a normal resting heart rate? Does it increase with age?? Mine is always 55-58. A rate of 40 would definitely be a concern to me.

As for PVC's, I get them all the time. Always have since maybe my mid 20's. Sometimes it feels like my heart is kicking to get out of my chest. Big thump or two. They generally don't last long. They happen at other times too, but lifting weights or working out definitely brings them on for me. Dr's have never been too concerned about them. I also had a bout of PAC's about a year ago. I thought it was Afib so went in to have it checked. They said the PAC's aren't too concerning either, just uncomfortable.

 

[Marbles]

Yes , thanks for the correction . I have an Echo scheduled for next week . I will ask about the cardiomyopathy as well , thank you !

The echo covers that, so your doc is on it. Cardiomyopathy is just a fancy way to say a heart that doesn't squeeze like normal.

PVCs effect everyone differently, most adults have some, most of us don't notice them. Some people feel them but nothing more, and some peoples hearts really don't like them. They are only concerning if they cause a problem, in other words, if they cause a problem, they should be treated, but if they don't cause a problem, they should be left alone.

On heart rate, you have two different rates to consider, one is the mechanical rate, basically how fast is your pulse. The other is the electrical rate, or how fast is the control system trying to go.

In your case, it sounds like your PVCs are not generating a pulse (or at least not one strong enough to feel). So if say every other beat is a PVC your pulse can be in the 40s while your electrical rate is in the 80s.

The electrical system is composed of cells that basically form its wires, and as a back up, every cell can generate a heart beat. PVCs are caused by a cell in the bottom chambers (the ventricles) going off when it should not. Because the chambers do not fire through the normal electrical pathway, and/or because they come earlier, sometimes the muscle doesn't squeeze very well.

Metoprolol helps calm those cells in the bottom down. Sometimes it is not enough, but it is the correct place to start as the options get more risky from there and the goal is to expose you to the lowest risk possible.

70s is a pretty normal resting rate. People who are athletic, particularly if they started being athletic youg, tend to have much lower resting rates. Typically awake resting rates of 60-100 are considered normal. But, down into the 40s is actually pretty common. It is another thing that depends on the person and how they feel.

 

[CRJR45]

76 is "normal" for you.....resting rate? I have no idea but is that considered a normal resting heart rate? Does it increase with age?? Mine is always 55-58. A rate of 40 would definitely be a concern to me.

As for PVC's, I get them all the time. Always have since maybe my mid 20's. Sometimes it feels like my heart is kicking to get out of my chest. Big thump or two. They generally don't last long. They happen at other times too, but lifting weights or working out definitely brings them on for me. Dr's have never been too concerned about them. I also had a bout of PAC's about a year ago. I thought it was Afib so went in to have it checked. They said the PAC's aren't too concerning either, just uncomfortable.

Yes , 76 has been my normal rate for a long time . I have been told before I have an extra beat or a ghost beat , but never to this extreme . I feel it mostly when I lay down to sleep . Kind of like fluttering .

 

[CRJR45]

The echo covers that, so your doc is on it. Cardiomyopathy is just a fancy way to say a heart that doesn't squeeze like normal.

PVCs effect everyone differently, most adults have some, most of us don't notice them. Some people feel them but nothing more, and some peoples hearts really don't like them. They are only concerning if they cause a problem, in other words, if they cause a problem, they should be treated, but if they don't cause a problem, they should be left alone.

On heart rate, you have two different rates to consider, one is the mechanical rate, basically how fast is your pulse. The other is the electrical rate, or how fast is the control system trying to go.

In your case, it sounds like your PVCs are not generating a pulse (or at least not one strong enough to feel). So if say every other beat is a PVC your pulse can be in the 40s while your electrical rate is in the 80s.

The electrical system is composed of cells that basically form its wires, and as a back up, every cell can generate a heart beat. PVCs are caused by a cell in the bottom chambers (the ventricles) going off when it should not. Because the chambers do not fire through the normal electrical pathway, and/or because they come earlier, sometimes the muscle doesn't squeeze very well.

Metoprolol helps calm those cells in the bottom down. Sometimes it is not enough, but it is the correct place to start as the options get more risky from there and the goal is to expose you to the lowest risk possible.

70s is a pretty normal resting rate. People who are athletic, particularly if they started being athletic youg, tend to have much lower resting rates. Typically awake resting rates of 60-100 are considered normal. But, down into the 40s is actually pretty common. It is another thing that depends on the person and how they feel.

Thank you again for the explanation . The Metoprolol seems to be working , are there any long term detriments to taking it ?

 

[Marbles]

Thank you again for the explanation . The Metoprolol seems to be working , are there any long term detriments to taking it ?

Not normally, like everything, it can have odd side effects, but if you are not having them now, then you probably will not have them.

Some people feel tired on it, but that is different for everyone. With feeling tired, some people gain weight. Sometimes it doesn't get along with asthma very well, but it is one of the beta blockers most likely to be ok with asthma. Some people have periferal circulation issues on it, but that shows up pretty quick and is not subtle (if you haven't already noticed an issue, then don't worry about it).

Some people loose the top end of their athletic performance, as metoprolol calms down the electrical system it also slows down the normal heart rate and if you cannot get your heart rate as fast, you loose that top capacity. It really depends on the person though, most people never notice this, including athletes. But, the higer the dose needed, the more likely this is (max daily dose is 400 mg, rarely is anyone on that).

It becomes a trade off. For example, if you feel good most of the time, and can still do most things you want, but notice a decine in sprinting ability, it probably is not worth switching to a high risk medication like amiodarone or having an ablation. However, if being on metoprolol makes it were you cannot do things you value, then you might find it worth the risk (but that should be discussed with a provider who's care you are under).

Sometimes people end up with a electrical heart rate that is too slow, normally this corrects once metoprolol is stopped. Rarely someone needs a pacemaker.

When you compare that to say amiodarone, which needs labs and an EKG ever 6 months for monitoring and can cause life threatening ventricular issues, life threatening liver failure, pulmonary fibrosis, and skin permanently turning blue/gray or an ablation which being invasive and requiring the intentional distraction of heart tissue has a risk of creating problems and doesn't always work, I would go with metoprolol (or another beta-blocker or calcium channel blocker) as long as possible. You may never need anything more, unfortunately no one has a functional cristal ball.

 

[CRJR45]

Thank you .

 

[CRJR45]

Ok , just to follow up here , I wore a monitor for a week and it shows I experienced a 30 percent rate of PVC's while on the Metoprolol . The Dr said anything over 10 percent was considered abnormal ?
She cancelled the metoprolol and sent me for a consult with a doctor that specializes in electrophysiology ?
This is a nurse practitioner for my cardiologist , so I have my doubts?

 

[Marbles]

Ok , just to follow up here , I wore a monitor for a week and it shows I experienced a 30 percent rate of PVC's while on the Metoprolol . The Dr said anything over 10 percent was considered abnormal ?
She cancelled the metoprolol and sent me for a consult with a doctor that specializes in electrophysiology ?
This is a nurse practitioner for my cardiologist , so I have my doubts?

30% is high. Talking with Electrophysiology (EP) is a good idea. They (EP) are the experts on this stuff. The NP probably has a good idea of how that EP likes things done, there are multiple correct ways to get to an end here. Style often varies, and getting things set up to fit the style of the subspecialtist (EP in this case) someone needs can save time. Not much worse than having someone wait to see a subspecialties only to have do something I could have done weeks earlier as that delays care.

For full disclosure, given your concern based on license, I'm an NP, not a physician.

 

[manitou1]

i have been on Metoprolol for about 18 years now.
Was in the military at the time and wife and I went for a hike. My heart rate would not slow down after the hike.
148 resting heart rate. I spent seven days in a cardiac institute. They could not ID a cause and chalked it up to long term stress.

Metoprolol controls my HR now and keeps it normal but boy howdy does it take a bit to get my oxigenation going at elevation! It takes a good climb or two to get the heart going right.

I did finish out a 35 year military career but the Metoprolol sure made things interesting.

Yes, it makes you tired. Causes dizziness at times too. You will gain weight just walking by a glass if water.

I hate the stuff, but it sure beats feeling like I just ran three miles 24/7.

 

[CRJR45]

30% is high. Talking with Electrophysiology (EP) is a good idea. They (EP) are the experts on this stuff. The NP probably has a good idea of how that EP likes things done, there are multiple correct ways to get to an end here. Style often varies, and getting things set up to fit the style of the subspecialtist (EP in this case) someone needs can save time. Not much worse than having someone wait to see a subspecialties only to have do something I could have done weeks earlier as that delays care.

For full disclosure, given your concern based on license, I'm an NP, not a physician.

It was more past experience and the fact she seems very young that brought me doubts .
She changed my lisinopril dosage from 5 mg to 10. For what reason I’m not sure . like a dummy I took it. Woke up in the pool one day after standing up too quick , or laying on the pool cover I should say. At the next visit, I told the nurse that checked me in about it.
But this nurse practitioner never brought it up or asked me what I was taking for the lisinopril , ( I’m taking 5mg every other day) just sent me to a specialist. Seemed odd , no disrespect meant .

 

[Marbles]

It was more past experience and the fact she seems very young that brought me doubts .
She changed my lisinopril dosage from 5 mg to 10. For what reason I’m not sure . like a dummy I took it. Woke up in the pool one day after standing up too quick , or laying on the pool cover I should say. At the next visit, I told the nurse that checked me in about it.
But this nurse practitioner never brought it up or asked me what I was taking for the lisinopril , ( I’m taking 5mg every other day) just sent me to a specialist. Seemed odd , no disrespect meant .

None taken. Past experience is a very good thing to make judgements based on.

 

[Huntingfarandwide]

Following.

 

[CRJR45]

Not sure whats going on with my heart . I went to the Electrophysiologist and had one PVC , so he could really do nothing . He suggested I buy a smart watch to record whats going on , so I did .
According to the watch I have periods that I experience 40 % PVC's and AFIB on a regular basis . I sent them some data but have not heard back from them . I scheduled another appoint in two weeks , maybe something to report then .

 

[Huntingfarandwide]

They come and go. I have days where they are really center stage and then maybe go a few where I did not have any.

By chance have you been tested for Sleep Apnea?

Mine started when I was diagnosed...the better I sleep at night the less I have PVCs.

 

[CRJR45]

They come and go. I have days where they are really center stage and then maybe go a few where I dint have any.

By chance have you been tested for Sleep Apnea?

Mine started when I was diagnosed...the better I sleep at night the less I have PVCs.

I do not have sleep apnea , my seem to come at the worst time . When I’m trying to walk or exert myself , they go crazy .

 

[Huntingfarandwide]

I have been dealing with mine for about a decade. My suspicions are that I developed them through sleep apnea... Although I don't have medical proof.

I have been with a Heart Specialist for the entire time and get a monitor patch to wear every January for a week just to keep an eye on them. I have just learned to live with them.. As my Specialist says.. Live with them until they become disabling, then we will plot a course of action. Unfortunately the course of action would be ablations which would not be reversible.

I don't let them slow me down. I hike, exercise, ride my bike, etc... getting into shape and staying fit will help these also.. It has for me.