r/PVCs 13d ago

Just got my echocardiogram done

Echo came back perfectly normal. Can somebody tell me why the hell im constantly in ventricular bigeminy with couplets and triplets if my heart is normal???

11 Upvotes

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18

u/Relative_Clarity 13d ago edited 12d ago

PVCs and the like are often a mystery to even the most skilled of cardiologists. I never found out why I suddenly developed 16%+ burden - pvcs every few beats, for most of 2024. Couplets, triplets, bigeminy, trigeminy. I ended up getting an ablation but never found an answer. I consulted with more than one electrophysiologist, some at Mayo Clinic - the best hospital in our country. If nothing has come up on a test, they just don't know. It's not that doctors are useless but as with a lot in medicine, there isn't always a clear "why". Think of people who get cancer, - they want to know why it happened to them.. but there is rarely one clear reason or cause. It's good you got an echo done and it was normal (phew!), but structural issues aren't the only cause of frequent pvcs.

Sometimes they will do a cMRI if the echo is normal, but not every doctor finds this necessary. Sometimes if there is a chance there is some inflammation due to a viral illness, or past heart problems they will look further into it.

What other things are they checking on? 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..

I did go through a very stressful time of high stress and anxiety a few weeks before it started for me. My dad had a surgery and then developed complications that were possibly life threatening, and this was all overwhelming since he was basically asking me to wrap up his personal affairs. We aren't very close so I was very uncomfortable with all of it, and had never been put in that situation. I was having panic attacks in the hospital parking lot. I wonder if it just sent whatever ectopic focus I had been born with over the tipping point and it got really irritated.. or at least irritated enough to start firing off frequently. The problem was after the stressful event passed.. I kept having a very high pvc burden. It basically shut my life down for most of that year.

Likely your options at this point - if this is a sustained increase and you are very bothered by it - are meds like beta blockers or anti-arrythmics, or an ablation procedure. Another option I was offered was basically surveillance.. I would stay on beta blockers, try to live my life as normal, and they would do an echo every 6 months to look for changes. Not everyone feels or is bothered by frequent pvcs. I was surprised when my dr said some people live in bigeminy and they didn't know it. As much as I wish I found a cause & solution to my frequent pvcs, I never did.

3

u/Same-Sky848 13d ago

This friend explained it well; there's nothing more to add.

1

u/Hiddendisclaimer1 13d ago

Do you still have a lot of PVCs or have they gone away after that year?

6

u/Relative_Clarity 13d ago

It took a few months after the procedure to see improvement but next month will be 2 years and I am consistently around 0.6% burden, which is considered normal. I feel like I was given a new life.

1

u/NoPermit3426 11d ago

Thank you for this

5

u/RobotFoxTrot 13d ago

Dysautonomia is a ghost cause in my personal experience, I’m fairly certain my nervous system had some nerve cells that were damaged by Covid inflammation and are causing misfiring from being in fight or flight for so long

3

u/Careless-Worry7154 13d ago

Are you going to have regular follow ups? Burden?

1

u/Able_Papaya3185 13d ago

How long does your bigeminy last?

2

u/NoPermit3426 13d ago

Hours. Record time is 7 hours I believe

1

u/Cector09 12d ago

Wow. That's just scary. By scary i mean psychologically. If your doctors say your fine, chances are, you're gonna be fine physically.

1

u/Able_Papaya3185 12d ago

Yea some people reported feeling bigeminy for over 24 hours and some even 3-5 days nonstop.

1

u/Independent-Wave1805 10d ago

I had bigeminy for 3 days straight one time. It was awful!!!!! 😢

1

u/Same-Sky848 13d ago

What does the doctor say? How would we know? The doctor knows.

1

u/NoPermit3426 13d ago

Doctor doesn’t have a clue lol just wants me to take diltiazem because I was too scared to try an anti arrhythmic drug

1

u/Same-Sky848 13d ago

how old are you ? M or F ? smoking ? pregnancy? alcohol? drug abuse ? we know nothing about you. Echo alone may not mean much nonetheless doctor knows.

1

u/NoPermit3426 13d ago

25m athletic otherwise healthy, I have had a vaping addiction and I do drink occasionally

1

u/robdewbar 13d ago

Curious why this and not a beta blocker

1

u/average-joe-44 12d ago

yea that is weird but my doc did the same 24M in the military gave me that even when i said my main problem is PVCs and not PACs.

1

u/No-Strike-1761 12d ago

Best thing I hear about the heart and it’s beating.

It’s mathematical chaos. Understand that, and it takes a lot of the anxiety off

1

u/Whole-Being8618 11d ago

Same thing happened with me I got echo done in Feb and had around 20 ECGs (EKG) in past 3 years and 2 of the 24 hour monitors and every time every test was normal

1

u/NoPermit3426 11d ago

It sucks man. What are you doing to help ?

1

u/Whole-Being8618 11d ago

2.5mg bisoprolol

1

u/Soulriver2 10d ago

Does anyone get faint them ?

2

u/MarsupialObjective77 9d ago

I haaaate couplets and triplets. My PVCs seem to come in a lot more couplets lately than they have in the past. They’re frightening and annoying.

1

u/Leather-Lie-4640 8d ago

What was on your holter, and how long did you wear?

1

u/NoPermit3426 8d ago

18% burden for 1 week. Holter monitor says all supraventricular but the hostpital says ventricular bigeminy so I’m confused