frequent PACs and enlarged atrium

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Hi guys,

I'm 39 years old male and have had some issues over the last few weeks with ectopic beats. I've also been under a lot of stress and anxiety which I think doesn't help . Anyway went to the doctor and got full blood work , an echo and a stress echo. Blood work came back fine . Stress echo was negative and states mild billowing of the mitral valve but no prolapse and trivial regurgitation. Everything else was normal with good excercisr tolerance METS 13 . Went and had the echo done . It also said the same thing about the valve but said they were still operating normally . The more concerning thing though was a mildly dialated left atrium . Both right and left ventricales are fine and operating normally with EF of 65 %. The doctor didn't seem all that concerned about the dialaoted left atrium . Can anyone provide anymore info ? Is this something serious or should I just let it go like the doc said .

Also what do I do about these ectopics ! They have killed me the last fees weeks . I've tried a beta blocker which seems to work but it drops my heart rate down into the 40s !


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    Hello, I understand your problem - believe me. I have been having the irregular ectopic beats on and off for several years. Over the last year they have become more and more frequent. I've had the Echo cardiogram, stress test etc. I've even worn an EKG monitor (holter monitor) for a month. It recorded many PVC's as they were referred to - pre ventricle contractions. My cardiologist told me that they are benign and nothing to worry about. The Echo showed minor irregularities with my heart, age related, but nothing serious and nothing that would cause the irregular beats. I am on beta blockers too. I take Carvetalol which is a blood pressure med and also a beta blocker. I've taken that for several years with no side effects. It is supposed to be one with few side effects. To try to help with the irregular beats, my cardiologist switched me to something called Metoprolol which is a blood pressure beta blocker plus something that is supposed to help regulate heart rhythm. That one was terrible for me. I felt awful. I felt like I was going to pass out many times while taking it. I finally went back to the Carvetalol (which is the generic form of Coreg). It works fine for me, but I still was having the irregular beats. And they cause me such anxiety and depression. I know how it effects your quality of life. I decided to visit my primary care doctor thinking this must be some kind of chemical imbalance or something. He told me that my blood work was fine. Nothing that would cause irregular beats. Potassium levels, electrolytes all were fine. He told me that he thought I might have something called GAD - General Anxiety Disorder. Which sounded like what I go through. Sometimes feeling down and depressed, but over nothing in particular. He prescribed a mild anit anxiety medication called Sertraline - which is the generic form of Zoloft. I am taking 25 mg which is a low dose. He told me that it helps regulate serotonin levels and to give it a few weeks to work... and after 3 to 4 weeks, the palpitations have pretty much stopped. I have a follow up with him on Wednesday. But I think this is working for me. So you might check with your doctor to see if you might be experiencing anxiety - and maybe a low dose of an antidepressant would help with your ectopic beats. I know how they feel and how they add to anxiety. Good luck to you.

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    • Posted

      thanks for the reply . yeah im at a loss for what to so really . eveeyone around me seems to think im stressed and have anxiety which is why all this is happening . to be honest i have been stressrd and worries about health issues for a while and i almost put these pulpitations down to stress as well . but after this echo finding and even though the doctor said dont worry about it i cant shake the feeling that something must be wrong with the heart. last night i thought i was having a heart attach and was trying to reach out for my phone to call 911 but couldnt move only then to wake up and realise it was a dream. thats the state in which im in right now. i tried a beta blocker which seems to work but then im anxious about an overly low herat rate which then brings back ectopics again . its a visious cycle ! horrible

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  • Posted

    I know the panic feeling. I have been awakened in the middle of the night with the hard and irregular heart beats. I once got up and drove to the Emergency room to get checked out. They hooked me up to the EKG machine. I was there for more than an hour - and of course not one happened. I felt like a fool. So many times after that, I just suffered through them - even when I strongly felt like I should go to the hospital. I just kept telling myself that all was okay. I've looked at utube videos from a doctor in the UK at York Cardiology Clinic. He discussed the ectopic in much detail. It will usually put your mind at ease because he stresses that most all of those are harmless. But still it doesn't make you feel any better because they really mess up your life. I worry about planning activities because I worry that will be a day when they are bad. And sometimes they are and I just put up with them and keep it to myself. I try to not show anything is wrong. So I am thankful for the Zoloft so far. My doctor explained it to me as an imbalance with the serotonin levels. Sometimes your body gets rid of that chemical too quickly. Something to do with keeping you calm and keeping your adrenaline in check. When the palpitations start, you get anxiety - which causes more palpitations. It gets into a vicious cycle. So the Zoloft is supposed to help keep the serotonin levels where they should be. I'm not one that likes to take medications, but if it works I'm all for it. So far this is working. He told me that there are many kinds of anti depressants and strengths and if this one doesn't work or gives adverse side effects, he can try another kind, or increase or decrease the dose. It's worth a try to get rid of the irregular beats.

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  • Posted

    Sam, which beta blocker, and what dosage?

    I was originally prescribed a beta blocker along with other BP meds, just for blood pressure, and quickly found that the regular dose made me feel like a zombie, but 1/4 the usual minimum dose worked just fine for me, with minimal side-effects. The doctor makes fun of me but it works for me. You might consider reducing your dosage - slowly, one needs to make changes slowly with beta blockers.

    I also have some unspecified arrhythmias which have felt absolutely horrible at times, but six different doctors have simply shrugged at them after multiple EKGs, Holter, and event monitors. I guess they're right because I'm still here, but I sure doubted it at times.

    I've also found benefits from foods high in nitric oxide (NO), which you can search up. This does not seem to be in anyone's book, but I thought I felt some improvement after some, so made a habit for a few weeks of adding a little arugula to my meals, and symptoms that had been torturing me for several years abated wonderfully - OK I still need my tiny dose of beta blocker, but together I found real improvement.

    Good luck.

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    • Posted

      the cardiologist i first who fluffled me off in 10 mins said take some flecadine . i saw the side effects on the net and i did not fancy a sudden cardiac death ! so went back to my regular doctor who suggested trying some atenolol 50 mg . i took half of that dose so 25 mg in thr morning and it seems to work pretty well for 6 or 7 hours . then it wears off and the pulpatations come back . and my heart rate at night drops to 45 and bp 90/70 so i didnt want to take the other half of the dose at night incase the heatt beat gets too low

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