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Question: Question on heart, respiration rate, PVCs and MVP

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 victday - Thu Jan 13, 2005 10:07 am

Hi; I think I am very healthy (female age 39, normal weiight/slim) and I am just checking on a few things. I have read about normal heart rate and respiration rate and my question is: Are my lower rates fine? (I do not go out of my way to exercise but I am never tired and have plenty of energy.) I checked these rates while resting in bed and again at my computer in the morning after having coffee. Here is what I got:

In bed: Respiration: only 8 or 9 breaths per minute
Heart rate: 47-53 bpm in different trials

At computer: Respiration: 10-11 bpm
Heart rate: 65

I hope this indicates only being in "good shape" and not a problem. I do have to say that I was also having what I think are PVCs in the evening while lying in bed. I believe they happen more when resting after moving around than while moving around. I went to a cardiologist five years ago due to losing my balance (feeling like the room went sideways brieflly) and he told me only that my blood pressure tends to run low (110/70 or 110/60 and sometimes lower) and that I should drink more fluids (less Cuban coffee, though) and eat more salt. Of course, when he hooked me for an EKG, the PVC-like feeling happened not once while I was there (how frustrating for the patient! ;o) The reason I am labeling these PVCs is because I get a vigorous fluttering feeling in my throat/high chest area and this corresponds to a "missed beat" when taking a pulse. This does not worry me, but it is unpleasant because it feels unusual, as if a bird or small creature is fluttering just above the collarbone.. I understand these are not very harmful, still, I try to control them by remembering to drink more. I admit I am not a naturally thirsty person and sometimes go all day realizing that I've only had two cups of coffee. I know that everyone blames coffee but if I am able to keep these from happening via diet/hydration//adequate rest, I assume it's OK to have my coffee in moderation, too?? (just two good-sized cups is all I ask for.)

Would my nice low blood pressure and heart rate explain why I am colder and less thirsty than most people? I have had thyroid tested and it is ideal (not just OK) and I have no signs of low thyroid except that my extremities cool down (not in summer) pretty fast unless I am really moving a lot. (I am tall, also.) I warm up well enough if walking around doing stuff but just sitting, I get pretty cold unless it's 65-70 degrees+ and I take a lot of hot baths in the winter just to get warm for a while.

Last question: fifteen years ago I was given an echocardiogram that took quite a while (at least an hour) and the result was a diagnosis of mild-to-moderate MVP with some other details given (I've forgotten them by now.) It was nothing bad, though, and I was told to take prophylactic antibiotics for situations like childbirth or dental work. Now I have read that MVP is so common that it is perhaps a variation of "normal." At any rate, though, seven years ago while pregnant I was given another ECG done by what appeared to be a 18 year old technician and it lasted only 15-20 minutes. The report indicated no MVP. My obstetrician decided to be cautions and treat me as if I do have MVP, and recommended that I continue with prophylactic antibiotic treatment since heart valve infection is not something anyone wants to tangle with. I am going to continue as if I have MVP, although sometimes I wonder if I reallly need to take amoxicilllen every time I need a teeth cleaning. My question is: Is MVP something that does not present itself continuously, so that a 20-minute scan might have missed it? They told me that "15 years ago, machinery was not as sensitive as it is today," and I consider that to be beside the point, as 15 years ago was not in the dark ages, and I saw a very detailed report then. Thanks!

Final point if you can corroborate it: While pregnant the last time (I have four children) I had a syndrome each morning wherein I sat at the table reading or eating and my heart rate got very fast and I felt so exhausted that I had to go lie down. (I am not the type to check heart rate but after so many eposides of this I just had to wonder what was causing the overwhelming fatigue. My BP in each pregnancy stayed at the same rate I mentioned above, never becoming high.) A doctor I saw at the time (not an OB but just a psychiatrist - hmm...) insisted that it was due to anxiety (!) (I know all about anxiety and I know when I am having it and when I am NOT having it) but I read that it is common while hugely pregnant for blood to have a hard time getting back up past the uterus while sitting. Sure enough, positions other than sitting with legs bent alleviated this problem. (standing, for example, presented no problem.) It woulld be nice for a doctor to say, "Yes, that symptom was related to pregnancy and blood flow." I am never anxious in the A.M while reading the paper/eating breakfast but I noticed that the need to lie down would increase with each minute of sitting up and the fatigue didn't lessen until resting for at least 1/2 hour. This didn't persist much later in the day and I read that it is a morning circulatory problem. Other than that I had no lack of energy or other discomforts while pregnant, not even a backache, and had large (8-10 lb.) healthy babies. Comments are welcome. Thanks in advance!
 Dr. Yasser Mokhtar - Sun Jan 16, 2005 8:54 am

User avatar Dear Meredith,

You don't have to worry about your respiratory rate or your heart rate (in any situation) if you don't have any symptoms. This means that they are adequate.

Regarding mitral valve prolapse, actually, it has been postulated that some cases of mitral valve prolapse are temporary and could be due to dehydration.

You have to remember that sometimes it is easy even for experienced operators to miss very mild mitral valve prolapse because sometimes it does not occur with every heart beat or the view of the heart is not the best and some people choose not to comment on it if they are not sure.

In cases of mitral valve prolapse, only associated with mitral valve regurge that the patient has to take antibiotics for prophylaxis against valve infection. If the patient does not have mitral valve regurge, it is not recommended to take antibiotics. And for cleaning your teeth, even if you had mitral valve regurge it is not recommended to take antibiotics either. Patients take antibiotics when they are going to have a dental procedure that will cause bacteria to enter the blood as in cases of dental extraction where there is kind of a wound and since the mouth is full of bacteria, some of them will enter through this access and if there is enough of them might cause infection of the mitral valve.

Regarding your extremities getting cold fast, some people have an exaggerated reflex of getting blood vessel constriction when you are exposed to cold weather, blood moves slowly in the peripheries in the cold weather because of the constriction of the blood vessels normally but some people have this constriction exaggerated. All you have to do is wear wool socks and gloves or mittens and make sure that you are warm when you go out in cold weather, if this is really bothering you, you can talk to your doctor about taking a medication on an as needed basis called nifedipine (it is a blood pressure medication that causes dilatation of the blood vessels).

Regarding your pvcs and the coffee, if you feel that the 2 good sized cups that you get do increase your pvcs significantly, try and drink the least amount at which your symptoms are not exaggerated, if your symptoms are ok, then there is no reason why you should not enjoy your coffee.

i can not comment on what happened to you when you were pregnant and i can not say whether or not it was a circulation problem, an anxitey problem or anything else. If you are not planning on getting pregnant once more, i suggest that you don't give it much thought.

Regarding you not feeling comfortable if the patient is above a certain level, there is no need to worry about that if your thyroid functions are normal. Some people prefer higher temperatures and there is nothing wrong with that.

About thirst, this is controlled by centers in the brain which monitor the level of your sodium, some hormones and other things and if they think any of these need to be adjusted, they adjust it by telling you either to drink more water, less water, urinate, eat salty foods, etc... If your kidney functions and your electrolytes are ok, there is no need to worry whatsoever.

Thank you very much for using our website and i hope that this information helped.

Yasser Mokhtar, M.D.

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