Now I am not talking about seeing someone that you have a crush on and your heart, figuratively speaking, “skips a beat”, I am talking about when it literally skips a beat…and you do feel a little flutter in your chest, which can happen at any time. Most often when that happens, something is occurring in your heart which is known as a premature ventricular contraction (a PVC). It can happen to anyone at any time, but there are certain things that can put you at risk and can make you have them more frequently.
What are PVCs?
Premature Ventricular Contractions (PVCs), are an abnormal (or extra) beats that can cause a disruption in the normal contractions of your heart. Basically, these extra beats, can cause a problem with the impulses that normally occur in your heart; it is a domino effect, and when the other beat occurs, it throws everything out of whack and most often your heart misses a beat altogether. It is normal that these beats happen, and if you are, in general, a healthy person, there is nothing to worry about. But, if you do have an underlying heart disease or heart problem, and these beats are more frequent, it is something that you need to talk to your Healthcare Practitioner (HCP) about. When PVCs are occurring you will feel a fluttering in your chest, a pounding heart rate, or you will feel like you missed a heartbeat, but there are usually no other symptoms.
What causes PVCs to happen?
Well, as I’ve described before, there are four chambers of the heart: the right and left atria, and the right and left ventricles. The Sinus node (SA node) os the pacemaker of the heart and it sits within the right atrium, it shoots off electrical impulses that allow the cellular pathways to create contractions in the other atrium and ventricles, thus causing a heartbeat which pumps blood out to the lungs, brain, and the rest of the body through your arteries. With PVCs the contraction of the heart is started in the ventricles, and it initiates a heart beat sooner than the heart is ready. When this system is messed with, there can be missed beats, or an irregular rhythm and less blood is pumped out to the body than during a normal heart contraction.
PVCs can be brought on by underlying cardiac/heart disease, electrolyte imbalances in the body (like if you are extremely dehydrated from a hard workout and your potassium or sodium levels may be low OR if you take diuretics), high levels of stimulants (like caffeine or taurine/guarana/ephedra), anxiety and heavy exercise (strain on the heart), certain medications (like decongestants), and any injury to the heart/cardiac muscles (from coronary artery disease, cardiac surgery, myocarditis- infection of the heart), or high blood pressure. Also heavy use of alcohol and illegal stimulant drugs (cocaine, meth, crack, bath salts, etc) put you at a much higher risk.
Are there any complications?
If you do not have underlying cardiac disease, normally it should not be a problem. If you do have cardiac disease, or use stimulants (legal or illegal) despite feeling the PVCs, you are putting yourself at risk for arrhythmias (abnormal rhythm of the heart beat) and a lethal arrhythmia which can lead to sudden cardiac arrest/death.
*If you ever feel faint, light-headed, lose consciousness, or heave chest pain with these irregular beats, you should seek immediate medical attention and/or call 911/emergency services.
How will I be diagnosed?
Your HCP will perform a few tests if you come in complaining about PVCs or if you think you are having them, they will most likely draw some blood to check your electrolyte levels and make sure that they are all normal levels. Also you may have:
-An EKG: an Electrocardiogram which is a 12 lead assessment of the electrical impulses of your heart. 12 little stickers are placed on the skin on your chest, and little plastic/metal leads are connected, you will be asked to stay still for about 30 seconds, then a print out of your hearts impulses comes out. It shows what is going on and is not very invasive at all, and a snap shot of your heart.
-A Holter Monitor: A monitor with about 5 leads is attached to your for 1 to 2 days, and is worn under your clothing, it constantly checks the rhythm of your heart and if you feel symptoms, you push a button, and all of that information is downloaded by your HCP so they can correlate symptoms and your heart rhythm.
-An Event Recorder: Similar to a Holter monitor, but worn for a month, and it only records when you have an arrhythmia, and it sends signals to your HCP when you have those events, and it helpful at showing when arrhythmias happen at unexpected times (like during sleep.)
-Echocardiogram: basically an ultrasound of your heart through your chest wall, there is some lubricant applied to your chest, and a hard plastic wand is moved over it to show how your heart is functioning and can give a 3D view of the actual functioning of the heart. It can help to diagnose if you have any structural abnormalities.
Are there treatments?
Most often, they are benign, meaning they come randomly and do not do any damage, so there is no real reason to treat them. But if they are causing problems and your HCP feels that there should be a treatment, usually they will suggest lifestyle changes such as exercising, eating healthy, increasing your water intake, cutting out alcohol/tobacco/caffeine/other stimulants. The other treatment, is to decrease your heart rate by taking a beta blocker, which is a medication given to slow heart rates and decrease blood pressure. Sometimes, depending on the origin of the PVCs other anti-arrhythmia drugs may be administered.
What can you do to prevent them?
Primarily, you can take note of when they occur: during stress? After cigarettes? When you drink? After using drugs? WHen working out? And alter your lifestyle to include making healthy lifestyle changes, including cutting out tobacco, decreasing your alcohol intake, increasing your water, and eat a healthy diet. To cut down on stress, you may want to include adding yoga or meditation to your daily routine, or taking to your HCP about other ways to de-stress. If your PVCs occur with regularity after something easy to cut out (like smoking) then problem solved, but the tests run by your HCP will better help you to figure out the source of the PVCs.
Yours in Good Health