[Casper664]

Hey all!! I have a question I hope someone will be able to answer or at least relate to. So, much like everyone else here, I have PVCs and PACs daily...usually only around 100 (not bad at all!). Now, there are SO many different feelings they can give off. Most of them are just flutters/small skips. But once and a while, I get these CRAZY big ones. or at least I hope these really ARE PVCs or PACs. That is my question in a nutshell...how do you know whether or not those ginormous things are really PVCs or PACs? How can I know for sure? Now, these often come when I'm working out (which is why its so scary and I wonder). I mean, these don't feel neccessarily the same as the day to day normal PVCs/PACs. ITs not really a THUD that I feel..its more like a holy cow wtf was that. Almost like a kick..takes my breath away..I clench my chest...and think..wow...what was that. Now, when I had my stress test, I had a 'medium' PVC which felt kinda similar, but these ones I experience here and there are like 50x as severe it seems. I've been doing VERY well with all of the skips lately...been even going to the gym..but today..I walked 12 laps around the track..jogged one..and then BOOM...it hit me and I stopped asap bc those ones are so scary. Now I know its ok to get PVCs during workouts, but ones this severe? do these sound like PVCs still? If so, why are they so BAD!?

[Jeff]

Hi Casper - Glad to see you back. But also, not so much (because I know it means you're having mroe symptoms).

Neil (a member here) has mentioned these really big PVCs, too. The thing about PVCs is there's a finite "size" they can be. Your hearts atria and ventricles can only hold so much blood, and your heart's valves prevent it from being able to overfill.

That being said, here are the only two things I can think you may be experiencing:

1. Esophageal spasm. I've had a few of these (or that's what I've hypothesized it is), and to me they feel like a small explosion in my chest. Like a firecracker. Big thud, a brief bit of pain. I got one recorded on my event monitor and it was clearly something muscular because the EKG strip picked it up as a huge electrical discharge, but it was also clearly nothing to do with my heart, because the rhythm of my heart was completely unchanged before and after, all waves (P,QRS, T) were all as they should have been.

Now you know I've had millions of PVCs, so I know where they are in my chest, I know how they feel. This felt like that, and in the same place - only WAY bigger and more violent.

2. A run-of-the-mill PVC, but it came after a short burst of PAT. So your heart was beating really fast, low volume per stroke, and then it reset itself and gave off one, big PVC, which is what you felt. and it felt stronger because of the fast rate and low output from the moments before.

Just try to keep in mind that your heart's valves and thick muscle tissue won't allow it to have a heartbeat any bigger than it's capable of having.

Hope that helps.

Jeff

[Casper664]

Thanks so much Jeff!!!! Yeah, these things are a bit violent, so perhaps they are esophegeal spasms...They do appear to be in the same spot of my PVCs/PACs...lol funny how we know where they are exactly Thanks for your knowledge!! has Niel posted anything on here about these bigger PVCs? i'd be interested to see whats been talked about..maybe see if its similar to what im experiencing p.s....I really love this site.. I don't write much on here, but I check it every week! its such a great source for info and I find a lot of comfort in it

[Jeff]

Yeah, and I think his username is "neil" so it should be easy to find. Also, I think I posted a scan of my esophageal spasm on my EKG, so you can see how the heart rhythm was unchanged but it's pretty clear something big was going on.

[jkfrench]

Hi casper664
My doctor told me that it is all in the timing of the PVC. They can feel different and that is normal. Sometimes if the PVC comes really really early I notice a huge thud (my boob shakes, that's how hard it is) and sometimes I notice a longer very uncomfortable pause. Sometimes I feel them in my chest and somtimes I feel them at the top of my stomach. Those feel different too. So I don't think it is anything to worry about. Jodie

[Jeff]

Casper, I couldn't find my ECG on the site but I found the file on my computer, so I'm posting it here. If you look, you'll see that the QRS complex and it's frequency are completely unchanged before and after the negative spikes, which says to me that while it DOES have to do with electrochemical discharges and muscle contractions, it's nothing to do with the heart.

Now having said that, I think Jodie also gave some very valuable input. Excitable heart cells in different parts of the heart can cause PVCs that fall at different times in the cardiac cycle or cause the PVC to propagate differently through the heart, which can affect how that PVC is felt (or make your boob shake, as in Jodie's case ).

[jkfrench]

okay Jeff, I'm not as technical as you but the point is still made. (and probably better understood if you were a woman)

[Jeff]

Hey, absolutely. I wasn't trying to be a post-topper, honest - just posting that EKG I thought I'd posted before and couldn't find it. And then I had this visual of all these poor women with stuff shaking on them because of their heart skips. So I had to include that smiley face.

I'm no doctor, so I'm no more qualified than anyone else to offer an opinion. Plus, I think that the more people there are to offer their ideas, the better off everyone's going to be, because each person can kinda compare symptoms to what other people are feeling.

[jsuter69]

Oh my gosh...lol...I'm sitting here reading these posts...with concern...then I read Jodies reply...I'm sorry but I can't stop laughing...sorry Jodie!
Some of us ladies aren't as "gifted"...lol
But anyway I'm just sitting here wondering how we can tell the difference between a PVC and a PAC? But I do get those stupid long pauses....the kind that feel like a normal sinus rhythm is out of the question?

[Jeff]

Some people can tell the difference, some people can't. And some people can tell the difference sometimes.

I'm in that third group.

A lot of times I barely even notice a PAC because every muscle in the heart is contracting as it should, so nothing feels out of the ordinary. But a PVC feels like if my heart had legs and was walking, it got it's foot caught on a bump in the sidewalk and got tripped up for a second.

As for your long pauses - until I had them diagnosed and had a bunch of chances to be relaxed when I felt them, I thought mine were also long pauses, with huge, thumping PVCs in between. And it wasn't that at all - it was 5-6 really fast beats that I wasn't feeling because the stroke volume was so low, and then my heart would go back to a normal rhythm but pause to make sure all the muscles were on the same page, which gave the big thud. On an ECG the rhythm looked totally harmless but scared the living chit out of me when I felt it.

Now that's not to say you aren't having really long pauses. Those happen, too. I just wanted to float this out there to let you know it might not even be a pause that you're feeling.