[mnm1207]

I am 25 years old and have been having these issues for awhile now. I have had a holtor an echo and blood tests. My holtor showed some PVCs and PACs and I am always low on Potassium according to my blood work. For the past three weeks I have been consumed by feelings that my heart is going to go into sudden cardiac arrest and I basically can't function. I haven't been able to go to work, and I can't stop thinking about it. I told me husband that I wanted to buy a difibulator and now he thinks that I am crazy. What makes it worse is me going on the internet and reading about SCA and the statistics that when it happens you die. I can't go on any beta blockers because my blood pressure is normally on the low side. (90/50) I have been feeling faint and my heart just races for no reason. What are the chances that I will go into Vtach, anyone have any advice?

[Jeff]

Hi mnm1207,

I'm sorry you've been feeling this way. I know exactly how you feel. In fact, I almost laughed a little when I read about you wanting to buy a defibrillator! I used to want to buy several! And yeah, my wife thought I was crazy, too. I wanted one for the basement, one for the main floor, one at my business. I used to (and still do, sometimes) pay close attention to the front doors of many stores and buildings to see if they have the sticker with the lightning bolt and those three magic letters: AED

I think it's great that you've had the holter and echo - the echo must've showed no structural abnormalities, no evidence of prior heart attack, that kind of thing.

How many PVCs and PACs did they find on your holter, and was that day a pretty average day for you as far as PVC/PACs go?

Stick with me, mnm - we'll figure out a way through all this. Promise.

[mnm1207]

Hi Again-
Of course I did not have many attacks of PVCs/PACs when on the holtor. I did have a bout of sinus tach and my heart rate was at 163bpm. The sinus tach is a normal thing for me, happening at least twice a week on good weeks. I am so scared that sinus tach will lead to Vtach or me walking up my apt stairs is going to cause it. I feel like every Dr I go to just wants to put me on xanax or some anxiety med that does not make me feel any better. I just want to know that I can live my life and not suddenly die from a bad beat. I read too much on the internet about young people just dropping dead from SCA and that did it for me. I am now officialy freaked out and I want my life back. It also makes me nervous because my blood pressure is always so low and I am low on potassium and those were two of the reasons for sca. Am I going crazy? I just want to put my mind at ease and now that I am not going to have SCA. I am tired of my heart racing and I want to sleep. It seems that when I do fall asleep, a beat jolts me awake right as I nod off. My holtor also showed that my heart beat was at 43bpm while I slept, isn't that too low?

[Jeff]

The thing that I think is an important feature for most types of arrhythmia is that they don't usually just kill someone out of the blue. It's true, some people just fall into SCA and that's the end. However, most of them had some kind of problem that had probably been going on for awhile, and either they didn't get it evaluated by a doctor because they chose not to (or maybe were afraid to), or because they just didn't feel it. Lots of people don't feel their PVCs.

That we can feel them is both a blessing and a curse. I don't need to tell you why it's a curse, but the blessing part comes because you're able to monitor your own condition, and you can tell when it changes, gets better, gets worse, etc, and you can take appropriate action to fix the problem, like going to a doctor.

As for sinus tach causing Vtach - that seems highly unlikely. Here's an article to read: overdrive supression

The article describes how a high heart rate (like sinus tach) actually prevents the PVCs because the ventricles, even though they want to depolarize early, just can't depolarize earlier than they are forced to because of the sinus tach. So I think you're in the clear there. And because you haven't even had any couplets or triplets, let alone any NSVT, I think you're a long way away from ever having to face a bout with VT.

The usual progression as I've seen it (though I'm not a doctor) is that someone has PVCs, then it progresses to trigeminy, then bigeminy, then couplets, then triplets, then non-sustained Vtach (NSVT), then Vtach. It sounds like you're still at step one of that chain - and lots of people never go any further than that. And even those that do, it usually takes decades, and they still can continue to live normal, productive lives.

On my bad days I'll have in excess of 15,000 PVCs in a day, along with some bigeminy. I also can have short bursts of PAT (aka PSVT). I think one of the turning points for me was when I found a doctor I trusted - my cardio and her PA are both really bright, listen well, and are open to evaluating what treatment I would like to pursue (and in my case, most often that's no treatment at all).

And I've been assured that I'm going to live a long life. But the biggest thing is, I believe her.

And I've been where you are as far as researching arrhythmia issues and it sometimes making things worse, not better.

Hopefully this helps at least a little.

-Jeff

[mnm1207]

Thanks for all the feedback. This forum is wonderful!! Are you familiar with EKG's? My EKG said slow r wave progression, but my cardio waved it off as not important. I don't want to look anything else up on the net, because when I do...all of the bad stuff pops up. I just want to get out of this rut of thinking I am going to die tomorrow, it is hurting my life and relationships. Thanks again for your careful listening.....I need it right now!

[Jeff]

I've been in your shoes, so I know exactly how you feel.

And yeah, don't research too much about r-wave progression, because if you're like me, you find all the worst stuff and somehow it all fits your circumstances, convincing you that you should walk very softly and slowly to bed, and just sleep for a month.

Here's what I understand about slow r wave progression - it can mean all kinds of things, and it's the cardiologist's job to use his/her training to look for the other markers that would signal that there's a problem. If those other markers are not present, then the cause for the slow r wave progression is likely nothing to worry about.

And the great thing about EKGs is how much information they really contain - I never realized it myself until I started researching it. There's been so much research and so many studies done on populations of people with certain QT intervals, QTc intervals, PR intervals, RR, ST segment, you name it, that a trained cardiologist can look at the results of an EKG and mentally check off about 20-30 things that they see which tell them whether or not there's a problem. It's quite impressive, really.

And so you know - there are completely benign reasons for slow r wave progression. My guess is your cardio recognized yours as being one of those, because none of the other markers showing a problem were present.

Hope that helps.

[mnm1207]

One more question, as I feel my pulse (which I tend to keep doing over and over) it feels like normal beats and then a couple fast beats and it keeps doing this. Is this dangerous? It is making me nervous right now.

[Jeff]

Check to see if those fast beats are happening with your respiration cycle. In other words, do the fast beats happen when you're breathing in? And does your heart rate slow down when you exhale?

If so, it's a sign of vagal tone, and that's actually a good thing. Not only is it not harmful - it's normal.

[jkfrench]

Hi!
I just wanted to add my two cents. I won't repeat Jeff's wise words of wisdom. He covered most everything there is to cover for you. But, I too at 25thought every day I was going to die. I was a happy young woman. I worked out, I traveled, I didn't have a care in the world. Until..that first skip. Then my life changed. Here I am, 20 years later still some days thinking I might die lol.
BUT, I haven't and neither will you. It seems that people that come to these forums are very bright. We need to understand why we won't die. Unfortunately for me, every time I go though a rough period, I need to understand again. I can tell you first hand that going on the internet and reading is a big no no. We have powerful minds and reading over and over all the negatives about these conditions can train our minds to believe we will die. Then physically we really do feel worse. Here is a perfect example...My last bad episodes of heart skips, pauses, racing and such was in February. I was very sure that I would not survive it that time around. I went to the doctor, got the monitor on. I went back the next day and I was so exhausted from telling myself that I really did have a heart problem that I could barely get out of the car. I thought I was going to collapse. Really...I went into the office gave him my monitor and drove home.
I am at home unable to leave my chair just knowing that he was going to call me with something really wrong this time. 2 hours later, he called. My heart pounded as he talked to me. He told me that I had 288 PVCs and that nothing at all looked life threatening. What??? I couldn't belive it. I thought I was having thousands. I hang up. Suddenly, I want lunch! Then a few hours later, I'm ready to go out because I feel so good. My mind controlled that entire situation. That is what yours is doing too. Your heart checked out fine. Great News! Get some additional reassurance from the doctor or here at the great forum but stop reading and looking for things because if you are anything like me you will convince yourself that you are sick and you aren't.
Those feelings that you are consuming yourself with are just that...feelings. Try to let them go. (I know hard to do) My heart has raced, skipped, paused and still does. It will not lead to v-tach. It won't. My doctor assured me of this. Your blood pressure is low like mine. I have started to salt things more generously and it really helps. Plus I drink a half of cup of low sugar gaterade in the morning first thing with a bananna. Take a vitamin too if you aren't doing that. This has helped my skips as my potassium runs on the low side too.
You are a healthy vibrant and I'm sure beautiful woman! We are here for you and that is all you need!
Jodie

[Jeff]

Oh yeah - I forgot about addressing the potassium - good call, Jodie.