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Doctors Lounge - Cardiology Answers
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| Kate1982
- Sun Dec 10, 2006 6:15 am |
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Hello, I am a 24 year old female. I have been experience palpitations since I was a teenager. They would feel like a flutter and usually would be one beat several times a day for about a month, then they would stop for several months. I noticed that excessively drinking caffinated pops would often trigger them. Because I had previously been diagnosed as having a Mitral Valve Prolapse by several doctors after having scarlet fever at age 10, I attributed them along with my exercise intolerance to that and the caffeine.
A few years ago I had another episode of palpitations except at one point instead of having one flutter, I had several in a row and felt dizzy and short of breath. It lasted several seconds then stopped.
Recently I have been experiencing a rapid heartbeat, which my doctors determined was a normal sinus rhythm, dizziness, and a pounding heartbeat as well as the occasional palpitation. They believe it to be POTS. I have stopped all caffeine several months ago. I have also had several EKG's, 2 chest x-rays, several thyroid tests, a holter monitor, and an echo. Everything except the holter came back normal (showed palpitations) the doctor didn't even find the MVP anymore.
I have heard that several palpitations in a row, 5 or more, is indicitive of ventricular tachycardia. However, I have also heard that ventricular tachycardia is a fast regular rhythm and ventricular fibrillation is the fluttering rhythm.
My question is: is several palpitations in a row serious as in ventricular tachycardia or is it usually something more benign and how worried should I be considering my previous episode? AlsoIf my heart is structurally normal and I have stopped all caffeine what can I do, short of medication, to stop these palpitations from occuring? I'm sorry this is so long, just wanted to make sure you had as much information as I could remember. Thank you for taking the time to read and answer my questions.
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| Dr. Chan Lowe
- Sun Dec 10, 2006 3:52 pm |
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 The beats that you describe as a flutter are likely premature ventricular contractions (PVC's). These occur when the bottom pumping chambers decide to beat on their own rather than in conjuction with the top chambers. If we were to put a holter monitor on everyone, we'd find that most people have some PVC's. These are harmless beats. Often, things like caffeine will "excite" the heart and cause a few more PVC's to occur, much like you describe.
As the heart rate increases, normally the speed of the heart overrides these PVC's and they decrease in frequency. PVC's that increase with an increasing heart rate may not be normal and should be evaluated. Ventricular tachycardia is when the ventricals decide to beat on their own for several beats in a row (technically >3 beats). Essentially it is a series of PVC's one right after another. Ventricular tachycardia if short may not be noticable, or if prolonged can ultimately lead to fainting and death if not corrected. The range is quite varied. If you feel as if you are having runs of these beats I would strongly recommend you be evaluated by a cardiologist.
There are other heart rhythm's that can cause palpitations that should be checked for as well. One notable syndrome is Wolff-Parkinson-White syndrome which can cause a different form of tachycardia. EKG's should pick these up.
I'm not a cardiologist, so that's about as complex as I can get for you. As far as other things you can do, cutting down on caffeine will help. I'd recommend you be evaluated by a cardiologist to get more information about what is going on with your heart.
Hope this helps.
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