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 .