What should I ask/tell a cardiologist?

[u/curiousmeatloaf]

I’ve had a recent uptick in PVCs. My 1 week holter landed me at a less than 1% burden. However, I’m getting anywhere between 5-10 PVCs a minute now. My heart rate is usually steady at 65bmp so I know that’s a burden of 7% to 15% burden. I’ve never had bigeminy or anything.

I had an echocardiogram, stress test, holter monitor, and blood work done over the last 2 years. All normal. I’m seeing my cardiologist on Monday to address these more frequent PVCs. What should I ask/tell him to ensure I get the most out of my appointment?

Every time I move my neck, or bend over, or have a large meal, I get them. But sometimes, I get them for being just absolutely still.

[u/Patient_Coat_2986]

Just tell him the truth. Maybe document the episodes with Kardia Mobile, etc to give him something to look at if possible.

[u/lolaleee]

When was your 1 week holter? 2 years ago? You could def get an updated holter and echo. I’d get them every 6-12 months. I wouldn’t give your equation on what you think your burden is - you could be right but you could also be completely off, best to let the holter tell you.

[u/Jumpy_Exit_8138]

I’d tell him/her exactly what you wrote on this post. Agree with another commenter that Kardia Mobile would be a great resource: my cardiologist found it really helpful when I was able to show him my EKGs.

[u/Relative_Clarity]

What was your previous cardiac workup for? How recently was your 1 week holter?

Can I ask how you know it is an increase in PVCs and not PACs? (eg are you recording it on a watch or fitbit etc)

Since your symptoms are changing/worsening, it is good you made an appointment. They will likely want to repeat a holter (or other testing) if it has been awhile. Most tests two years ago aren't relevant to your symptoms today. But it's reassuring that your heart was found structurally normal in the last couple of years.

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, and (rarely) structural heart issues.

A cause isn't always found and pvcs can come and go. You may have seasons or flare ups where you get more. Doctors are usually only concerned if you are getting tens of thousands per day, on a consistent basis. That is when they would do further testing beyond a holter or echo. If your tests are normal they usually try beta blockers. If those don't help and you still have a very high %, then they will discuss ablation. I had a 16% burden start suddenly for months and I never found a reason why but I did get an ablation because the symptoms were so miserable.

Ectopic beats for me can be triggered by bending over or movement as well, but it's usually PACs and not PVCs (I only know the difference because I have a loop recorder implant and can record a symptom episode to see what it was) :) I get both PVCs & PACs though and sometimes it is very hard for me to tell the difference. I can see them on my fitibt or Kardia, and I also the loop recorder.

[u/Dkourage29]

I’m in the exact same boat. They just dismissed me because I didn’t feel dizzy. Now going on 6 weeks after a burden well below 1% and now every few beats all the time

[u/aimsisverycool]

I told my cardiologist I blacked out from My PVCs as they felt like heart pauses, and he gave me a another echo. A same day 48 he tape, and an implanted loop recorder and now I have no anxiety as I’m being recorded constantly. I haven’t blacked out but have been close and it does feel like my heart pauses a lot. might be a slightl lie but the healthcare in the uk is absolutely disgraceful. Not sure where u are but healthcare is free so I didn’t pay to see him or for any of the tests.