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Forum Name: Arrhythmias

Question: my irregular heart beat is now normal. do I still need test.


 jburch - Tue Sep 16, 2008 2:46 pm

A couple weeks ago, I had a constant fluttering in my chest. After ruling out thyroid, potassium, salt, and electrolytes, my doctor did an EKG that showed I was skipping heartbeats and for long periods of time. My doctor had reviewed the EKG with a cardiologist and determined that I should have a stress test and echocaridiogram done. I had the fluttering constantly for about 10 days, but now I haven't had this feeling for about two - three days. My pulse seems regular now. Is it still necessary to have these test completed? I am on medicine for high blood pressure and triglycerides. My blood pressure seems to vary between borderline (130/85) and low (90/60).
I am a 40 y/o female with no prior heart issues.
Thank you.
 John Kenyon, CNA - Fri Oct 03, 2008 9:44 pm

User avatar Hi there -

When a patient presents with palpitations that wind up being premature heartbeats such as you were having -- and which most people have at times, some more than others, depending on the circumstances -- it is often more of a problem for the doctor than the patient. While I commend your ability to look past this generally normal, if annoying, phenomenon, it may be that the cardiologist coincidentally saw something on your EKG which he felt warranted the stress test. If so you ought to have been told, and frequent premature beats in themselves are not generally considered a reason to persue further testing, but some doctors are more bothered by this -- and still believe the old school idea that frequent premature ventricular contractions have some potential significance, even though it's been determined over the past 20 years that they do not, even while they are happening.

It strikes me as a little odd that blood tests were done first to rule out causes of PVCs and then an EKG was done which showed they were, in fact, taking place. This, if it actually happened in this order, is backwards.

All that being said, I would go with the stress test or at least the echocardiogram. The latter does make sense, in that it could rule out (or in) some structural abnormality, usually a totally benign one such as mitral valve prolapse (MVP) which can cause some people to have more frequent (and so more annoying) "spells" of PVCs. While this is generally "useless" information, it can be very reassuring to the patient (or, sometimes, the doctor), as it is almost always a benign and convenient explanation for episodes of palpitations such as you experienced (and I take it this has only happened the one time).

If the echocardiogram shows nothing, and if there is no family history of premature heart disease (meaning close relatives with heart disease prior to age 60) then the stress test would seem unimportant, but it also couldn't hurt anything.

If the cardiologist did see something he felt was a potential problem, it would help rule this out and clear the air. A patient really ought to be apprised of what's going on, but some doctors have their own peculiar ways of working through these things.

I strongly suspect the tests will show nothing, but either way it's a win-win, as negative results would be welcome and if something were found, it could then be followed and managed as needed, even though, again, this seems like a very unlikely outcome.

I hope this is helpful. Please follow up with us as needes.
 <SickOfBeingSick> - Wed Nov 12, 2008 12:58 am

I agree with the doc on this one. Listen, Im now 24 y/o. I've had an arrhythmia since 2000 when I was 26. Who knows how it was brought on... heredity, workout pills when I was in my teens that had ephedrine ine it or whatever. Point it is I started with just atrial flutter and atenolol helped. I eventually was diagnosed with afib on top of the flutter and had my E.P tell me that I was the word case he ever seen.

So they put me on flecanide and metoporol, and that worked for a while - then wuit. I had it. I got tired of feeling wore out, my hair and nails appeared to not be growing at all anymore, literally had no color to me. I had black and hispanic guys I worked with joke with me saying 'what happened to you, you are whiter than Casper. Man you need some sun." And I didn't realize it, but it was true. Saw my mother for the first time in a while and she said something along the lines of "I need some sun." The flutter and fib were constant and never went away. My body just rejected the flecanide and metoporol cause they got used to it. So I opted for rf ablation. I've had 2 zaps now, and feel wonderful. I need one more and am hoping to get it done before the end of the year so I don't have to pay another deductible.

Don't mess around, if you want a permanent fix if your problem persists, definitely get rf ablation or cryoblation. There are bests and worsts of both. RF ablation has a higher success rate of not returning but has a wider uncontrolled area of zapping, where as cryoblation is more precise in the area its targeting to ablate and getting the bad area - but has a lower percentage as far as arrhythmia returning later. If your a doctor, I believe I stated that pretty accurate, but feel free to correct me if I am wrong in describing what I just mentioned.

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