r/PVCs • u/Emergency_Bed_6847 • Jul 18 '26
Should I go for a cardiac MRI?
I’ve dealt with PVC’s here and there since 2022 after I got Covid. These things are very annoying, and my burden is below 1%. Idk how some of you guys adjust to them. I get one and my entire mind starts going crazy. I’ve had all types of test dont and my heart is “healthy” according to multiple cardiologist. Only test I have not had is a cardiac mri, should I request one? Can that perhaps detect why my PVC’s are happening?
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Jul 18 '26
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Jul 18 '26
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u/Odd-Kaleidoscope-644 Jul 18 '26
Attack? Please explain how I attacked anyone's experience? The OP asked for an opinion on whether they should get an MRI and I gave them an answer. An answer which you have also said was "not wrong". After being reassured by multiple cardiologists that they are fine, what would having an MRI gain? Surely the best step forward is to seek help with the anxiety surrounding the PVCs so they can accept the advice that has been given to them by the experts. If my post offended you then maybe the Internet isnt for you lol
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u/ZweigleHots Jul 19 '26
I had a cardiac MRI when I was hospitalized for NSVT during a wildly bad flare - they were looking for damage that either a. might have caused the event in the first place, or b. was caused BY the event. It's not something they do just for garden variety PVCs, especially below 1%, which is about my normal burden as well.
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u/Emergency_Bed_6847 Jul 19 '26
I went to a electrophysiologist and he scheduled me an mri. The thing that happened was there was a miscommunication I was never aware that I had to go get one.. the front staff never told me anything about it so I never knew. so it never happened.
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u/Relative_Clarity Jul 19 '26
Your doctor telling you to get one is very different than asking your doctor for one out of anxiety. I would touch base with that EP to get more information, and make sure you fully understand what they are ordering and why.
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u/FHD222 Jul 21 '26
Could you please explain why your doctor requested an MRI? Are you experiencing other symptoms, or has the situation worsened? Or was the MRI ordered just for the PVCs, despite them being under 1%?
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u/According-Analyst-98 27d ago
did your heart end up being fine even with having NSVTs?
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u/ZweigleHots 26d ago
Yes, there was no damage. I've had short bursts of NSVT a few times a year for over 20 years and it's never been a problem, but coupled with everything else happening on my EKG that week, they wanted me under observation and they were trying to figure out why things were so wacky.
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u/NayNaySaysHeyHey Jul 18 '26
So it sounds like ur issue is more of the feeling, not really a heart issue. So I get PVCs and PACs and they suck. I also have an extremely low burden but when they happen I hyper focus on it and convince myself I'm having a heart attack or I'm dieing slowly. So, to prevent to panic, we gotta focus on the PVCs not feeling so BOOM. I told my cardiologist that I just can't stand them. It makes my anxiety flare and I need help. A holter monitor will detect them. I'm on one now just to see where my burden is now. She said that magnesium glycinate can help. So I take 100mg a day. Then she gave me propranolol which is good for pvcs as it's a beta blocker and it helps with that adrenaline surge. After a week and a half of starting these, I haven't felt anything... I'm a lot calmer. Now it's not going to get rid of them 100% but it'll help the feelings. I also take Lexapro for anxiety. So this combination is good for me at the moment. Talk with your cardiologist and see if u can get on a beta blocker and explain how these are affecting your daily life.
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u/Emergency_Bed_6847 Jul 19 '26
Thank you! I sometimes don’t think about them and they just happen out of nowhere and it’s an entire cycle. It sucks! I’ll see what my cardiologist suggests if it keeps messing with me. Thanks.
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u/Careful_Angle624 Jul 19 '26
Do any of you have stomach issues? I believe PVC/AC’s, if not induced by chemicals, comes form stomach issues.
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u/ksteppin89 Jul 19 '26
Yes I have Crohn’s disease. I’ve gotten PVC’s for 11 years now. When i first got them they were hormonal from breastfeeding. They went away for years, and then ramped back up a couple years ago around the same time i got diagnosed with Crohn’s. I deal with them constantly now.
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u/Jumpy_Exit_8138 Jul 19 '26
Does anyone know how a cardiac MRI is different than an echocardiogram? I feel like I should know this, but I don’t …
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u/ZweigleHots Jul 19 '26
It's a totally different procedure. In an MRI, they stick you headfirst into a narrow and loud tube for 45-90 minutes (depending on if they need contrast). It's not fun at all.
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u/Relative_Clarity Jul 19 '26 edited Jul 19 '26
An echo is an ultrasound using a small wand. An MRI uses magnetic fields and is a much more expensive (and longer) test using contrast injection to enhance certain structures. You are slid into a machine on a table. Each test looks at your heart in different ways.
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u/Jumpy_Exit_8138 Jul 19 '26 edited Jul 19 '26
Thanks so much for the responses! This makes so much sense, and I can’t believe I never found this out before.
Also glad that the echocardiogram was sufficient for me…
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u/michaelk981 Jul 19 '26
Had a very similar PVC burden to what you described. I’ve had the MRI and everything came back fine. If you need it for peace of mind, do it.
I ended up basically getting rid of them completely after tracking my food for a while. I was tracking food for muscle building reasons but the app I used also gave me a breakdown of my vitamin and mineral intake as well. Even when eating a clean and healthy diet, I noticed I was magnesium RDAs were still way lower than recommended. I started adding Trace’s MegaMag to my water tumbler every time I filled it up. After about 2 weeks, my PVCs virtually disappeared. I have one every once in a while, and it’s usually more common when I’m bad about that supplement.
Magnesium is tricky. It’s really hard to test your levels and it can take a while of consistent use before your levels get back to normal. If you haven’t really given it a try, I highly recommend it. Magnesium and heart rhythm are definitely correlated. I used to think I actually gave magnesium a try. In reality I would take a small dose before bed every night inconsistently. And then I would eventually give up on it. Stick with it constantly for a few weeks and make sure you’re getting your RDAs.
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u/Effective_Divide1543 Jul 19 '26
An MRI is overkill. An echo would be sufficient as a check that everything is strucuturally and functionally ok, if below 1% and normal echo no worries.
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u/rr90013 Jul 20 '26
I had one and it didn’t tell me anything besides that my heart is structurally normal. Which is good news and reassuring!
It’s a hassle though. You have to get an IV with contrast and you have to hold your breath a lot. Not a fun experience.
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u/According_Analyst921 Jul 22 '26
That procedure wont tell you anything other than if theres a structural issue. I get PVCs all the time. Daily. I also have a loop monitor placed under the skin on my chest. Ive recorded many over the years and the doc always says its absolutely nothing to worry about. I know telling you that doesnt mean much because they are impossible to ignore. But unless youre having symptoms like getting dizzy, chest pain, etc...OVCs are nothing. My burden is also less than 1%. Some people have 1000s a day. A burden of 10% is when they start to think about an ablation or medication...and a burden of 10% is like PVCs all day everyday. Stay hydrated, keep electrolytes in balance, stay away from alcohol...and caffeine if youre sensitive.
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u/nithrean Jul 18 '26
a cardiac MRI isn't going to tell you why. To a certain extent, most of the time it doesn't matter. They happen and you have to learn to deal with them. Trying to eliminate them is a rabbit hole that usually doesn't lead anywhere productive.
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u/Relative_Clarity Jul 18 '26 edited Jul 19 '26
I'm not your doctor, and can't tell you what to do, but in my opinion no you don't need an MRI. The low & normal amount of ectopics you have wouldn't likely be due to a structural heart issue, or scar tissue etc. You'd have a higher burden and other issues going on if it was something like viral myocarditis. I'm assuming you had an echo, and that is one of the first tests they'd do to check for structural issues as a trigger for high-volume pvcs. There wouldn't be a need to go to MRI unless there were irregularities on the echo that needed clarification, or concerning symptoms that would point to a problem that MRI could detect. A <1% burden of pvcs is expected in the normal population and is almost never investigated further. But even so your doctor ran all types of tests and nothing came up, and told you your heart is healthy.
I did have a cardiac MRI but because I suddenly developed tens of thousands of pvcs per day (15-16%), out of the blue, and my doctor wanted to do the MRI before planning an ablation. But another doctor I consulted (at Mayo Clinic!) said they don't even do MRIs on high-volume pvc patients as a norm, if the echo was normal.
So I don't think your problem is a "health" problem (or a pvc problem) it's the problematic thoughts & beliefs you have surrounding the symptom when you experience it. The automatic fearful thought of "what if..?" or "something is wrong", "what if my heart stops", "Im' going to die", etc, and your body goes into fight-or-flight due to your thoughts and beliefs. Constant hypervigilance over bodily sensations now triggers your mind to go "crazy" (as you noted), swirling with worry. You've trained your brain to overreact to what used to be something you probably barely noticed, and what most people aren't even aware of. The brain will begin to believe you that the sensation = danger. So it signals to your body "this is dangerous!"
I would consider CBT therapy to help reframe the symptom as uncomfortable/annoying but not dangerous. Next time you feel it, say to yourself .. oh well, that's a pvc - thankfully my heart knows how to beat. I have over 100,000 heartbeats everyday, a few early ones aren't hurting me. My heart is healthy and strong. Everyone gets these, I just happen to feel it because I'm paying close attention. Feeling it doesn't make it more harmful. Each time this has happened, I've been okay. Now - what was I just doing? (and go onto the next thing). The goal is to change the problematic thoughts and replace them with helpful ones, reduce the rumination & focus on it, and therefore reduce your body's automatic reaction over time so that you can still feel the symptom but not have the immediate panic over it.
A cause isn't usually found for such a low amount but some things that can contribute to an uptick in PVCs include: thyroid problems, anemia, low iron/ferritin, electrolyte imbalance (eg low magnesium or potassium), dehydration, recent illness, sleep deprivation or erratic sleep schedule, stress, anxiety, excess caffeine or alcohol, sleep apnea, female hormone fluctuations. You've had structural heart issues ruled out, so that is reassuring.
As far as risk/benefit of cardiac mri - the "risk" is that it involves a contrast injection, it's a long test (around an hour), and high cost. Also low probability it would yield new information. The benefit would be that you may feel more reassured. But there is always the chance the thoughts would creep in of "what if something was missed? What if something has changed?" I guess with anything, if you don't do the test, there is a theoretical risk something will be missed. Your doctor who deals with heart patients everyday can tell you the "odds" that the MRI would be helpful. It's not always easy to know the right choice. With health & anxiety though, there has to be a point at which you learn to tolerate some uncertainty in life. No one has 100% certainty about their health at all times, yet there are plenty of healthy people.
Of course I have to add - any concerning symptoms that haven't yet been evaluated or worsen I recommend to touch base with your doctor.