Doctors of VN

#1
VolinArizona

VolinArizona

not in Arizona anymore
Joined
Feb 16, 2006
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#1
So, need some insights into questions I should ask my cardiologist on Monday during my first appointment with him.

Background:

32 years old
male
5'10" 205 (down 12 pounds in 12 weeks ON PURPOSE with diet and exercise :birgits_giggle:)

Had a 4-5 month bout with health anxiety last year that I overcame.

Came back 2-3 months ago.

Started having some heart palpitations a couple months ago, and could feel the skipped heartbeats when I'd check my pulse. The skipped beats only really happen when I move around a bit.

Kept weightlifting and doing intense cardio sessions. Never had chest pain or lightheadedness. Lots of anxiety about the skipped beats though.

Went to PCP last week - EKG looked fantastic (very minor right bundle branch block that was nothing). Made me wear 24 hour holter monitor. Had 350 PVCs over 24 hours (not bad they said). Usually benign. They said I had 125 PVCs between 6am and 7am but I think that's a mistake.

Doc refers me to cardiologist because I have a strong family history of mitral valve prolapse. No idea if I have it. However, doc said nothing is alarming, but doing this to rule out the bad stuff even though the only reason I'm being referred is due to family heart history.

SO, I go Monday for the first appt with cardiologist.

What should I ask? What should I expect?

I assume we will do an echo at some point - maybe a stress echo?

Had a clean stress test last year, but I don't remember many palpitations last year.

Anyway - what should I ask? Also, does this sound serious or benign?

THANKS
 
#2
#2
Not officially a doctor yet, but I'm fairly close, certainly enough to where I feel confident answering your questions without looking like an idiot.

First, the one to worry about, based on your descriptions and what you've said doctors have said/noticed, it's not serious. Most likely precautionary. I would say 95% precautionary. The alternative is its some extremely rare situation fit for an episode of House (and there's a reason those situations are on TV.) Based on family history, I'd bet all my student loans on precautionary.

As far as first visit asking, a good doctor should pretty much answer all the basics to start. If he doesn't give you an idea of what it might be, the simple stuff is the way to go. What do you think is causing this? Is this something that might worsen? etc. But, my feeling is he/she will be able to answer anything you come up with and then some.

If you get more complicated information that doesn't make sense and they don't explain it well, or you just want another idea of it, post it and I'll explain it as best as I can or get in touch with someone who I know can.
 
#3
#3
I'm no doctor but I feel like I can definitely tell you some things to help you feel at ease.

I am 21 and have experienced crippling anxiety over heart worrying. Which is irrational according to the doctors. I kept getting ekg's that were "beautiful" and blood test after blood test that looked good. So finally with me still not being satisfied due to worrying myself crazy I scheduled a cardiologist appointment. He listened and and said it sounded great and ran his own fancy ekg himself which he said looked beautiful. So as I'm leaving he says "you'll be wearing a 14 day monitor that is the newest in technology. It keeps up with it in real time" So of course that stressed me out. I wore it for 14 days and felt like sh** a few times while wearing it and I hit the record button when I felt it every time. Well after 14 days were up a few days later they called and said every thing looked great. They explained that when they actually capture what you're talking about it tells them a lot more than us average guys may think and they said I had nothing to worry about. So I guess moral to the story is don't stress it.
 
#4
#4
I had pretty much the same symptoms you had about 12-13 years ago (late 30s now). I had my first palpitation when I was 22 after a movie and it was really scary. It felt like my heart stopped for a second then beat really hard, and I sort of lost my breath for a second. It didn't really hurt but was definitely uncomfortable. After that I started having panic attacks a lot and I did wake up late one night with chest pains and I was sure I was having a heart attack. I went to the ER and they sent me away saying I was fine.

All that went on about 3 years, even wore a monitor that found nothing, and finally one EKG at my PCP caught one of the palpitations. I went to a cardiologist who did an echocardiogram and found I had mild prolapse. I had to take a beta blocker for a while and had to take antibiotics before teeth cleanings for a few years but now I'm pretty much "cured". I still get the occasional flutter and kind of get the gasp of breath thing but otherwise I'm fine.

As far as questions, I would just ask the basic stuff about your heart health, ask about stress factors (which tend to make MVP way worse), ask about diet considerations that might make it worse, and I'd be sure to discuss the exertion/exercise. I was basically told that as long as I didn't have discomfort/chest pain/etc. that I was free to run/workout as I could stand it.
 
#5
#5
<<Not a doctor - just a heart patient. They can do what is called a MUGA, which measures the ejection fraction of your heart. It tells you the percentage of blood that your heart ejects every time it beats, and it is very accurate. with it, you can measure yours against that of a normal healthy heart. I do recommend walking for thirty minutes every day. Screw three times a week. Go every day. There is no way not to shed pounds if you do. I wish you the best of luck.
 
#6
#6
VolinArizona said:
So, need some insights into questions I should ask my cardiologist on Monday during my first appointment with him.

Background:

32 years old
male
5'10" 205 (down 12 pounds in 12 weeks ON PURPOSE with diet and exercise :birgits_giggle:)

Had a 4-5 month bout with health anxiety last year that I overcame.

Came back 2-3 months ago.

Started having some heart palpitations a couple months ago, and could feel the skipped heartbeats when I'd check my pulse. The skipped beats only really happen when I move around a bit.

Kept weightlifting and doing intense cardio sessions. Never had chest pain or lightheadedness. Lots of anxiety about the skipped beats though.

Went to PCP last week - EKG looked fantastic (very minor right bundle branch block that was nothing). Made me wear 24 hour holter monitor. Had 350 PVCs over 24 hours (not bad they said). Usually benign. They said I had 125 PVCs between 6am and 7am but I think that's a mistake.

Doc refers me to cardiologist because I have a strong family history of mitral valve prolapse. No idea if I have it. However, doc said nothing is alarming, but doing this to rule out the bad stuff even though the only reason I'm being referred is due to family heart history.

SO, I go Monday for the first appt with cardiologist.

What should I ask? What should I expect?

I assume we will do an echo at some point - maybe a stress echo?

Had a clean stress test last year, but I don't remember many palpitations last year.

Anyway - what should I ask? Also, does this sound serious or benign?

THANKS
Click to expand...

What is your caffeine intake? With your working out, any kind of supplements?
 
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#9
#9
VolsSportsFan said:
I had pretty much the same symptoms you had about 12-13 years ago (late 30s now). I had my first palpitation when I was 22 after a movie and it was really scary. It felt like my heart stopped for a second then beat really hard, and I sort of lost my breath for a second. It didn't really hurt but was definitely uncomfortable. After that I started having panic attacks a lot and I did wake up late one night with chest pains and I was sure I was having a heart attack. I went to the ER and they sent me away saying I was fine.

All that went on about 3 years, even wore a monitor that found nothing, and finally one EKG at my PCP caught one of the palpitations. I went to a cardiologist who did an echocardiogram and found I had mild prolapse. I had to take a beta blocker for a while and had to take antibiotics before teeth cleanings for a few years but now I'm pretty much "cured". I still get the occasional flutter and kind of get the gasp of breath thing but otherwise I'm fine.

As far as questions, I would just ask the basic stuff about your heart health, ask about stress factors (which tend to make MVP way worse), ask about diet considerations that might make it worse, and I'd be sure to discuss the exertion/exercise. I was basically told that as long as I didn't have discomfort/chest pain/etc. that I was free to run/workout as I could stand it.
Click to expand...

Your description of the feeling during the skipped beat is spot on. Skipped beat then a stronger beat.

Did your prolapse cause the pvcs?

Also, how often were yours happening?
 
#10
#10
Same feeling I feel. It scares you because it definitely grabs your attention, but in an otherwise healthy heart they are usually benign. As many tests as you've probably had you can probably safely assume you're in the otherwise healthy heart category.
 
#11
#11
VolinArizona said:
Your description of the feeling during the skipped beat is spot on. Skipped beat then a stronger beat.

Did your prolapse cause the pvcs?

Also, how often were yours happening?
Click to expand...

According to him, yes the prolapse caused the pvcs.

I'm trying to remember, but it would go through phases. If say it happened once then it would probably happen several times in a 3-4 hour period, but then might not happen again for a week. I don't remember ever finding anything that would cause it to happen more other than it seemed like I would get in a cycle where one would happen, I'd freak and stress out, and it would make it worse.

In a 3 year period, I had 2 attacks that were bad enough that it made me go to the ER. The first was the one I already referenced, the other was at work and it felt like my body was shutting down. The funny part (in hindsight, not then) was I waited so long at the ER that the panic attack and symptoms passed so I left without ever seeing anyone.

Honestly the panic attacks were by far the worst part, way worse than the actual skipped beats. I got to where I was scared to go out or go do anything. I avoided sporting events and such because crowds and loud cheering would start to freak me out. If I did go to a game or a movie, I'd try to sit near an aisle so I could exit quickly. I also had to fly once while having an attack right before takeover and that was a 2 hour hell.
 
#13
#13
You shouldn't have to ask too many questions. Expect an echo. With a normal EKG and Holter, and assuming a normal echo, you are most likely experiencing some anxiety/panic-type reaction, and the fight or flight adrenergic response is only intensifying your disconcerting heart beats.

If, indeed, everything looks OK, I can recommend a couple of good resources to deal with anxiety without medication.
 
#14
#14
VolsSportsFan said:
According to him, yes the prolapse caused the pvcs.

I'm trying to remember, but it would go through phases. If say it happened once then it would probably happen several times in a 3-4 hour period, but then might not happen again for a week. I don't remember ever finding anything that would cause it to happen more other than it seemed like I would get in a cycle where one would happen, I'd freak and stress out, and it would make it worse.

In a 3 year period, I had 2 attacks that were bad enough that it made me go to the ER. The first was the one I already referenced, the other was at work and it felt like my body was shutting down. The funny part (in hindsight, not then) was I waited so long at the ER that the panic attack and symptoms passed so I left without ever seeing anyone.

Honestly the panic attacks were by far the worst part, way worse than the actual skipped beats. I got to where I was scared to go out or go do anything. I avoided sporting events and such because crowds and loud cheering would start to freak me out. If I did go to a game or a movie, I'd try to sit near an aisle so I could exit quickly. I also had to fly once while having an attack right before takeover and that was a 2 hour hell.
Click to expand...

I've had something similar to both of you. First time it hit was freshman year at UT. Second time was during grad school. It actually just started up again recently, too (I'm 32 now). Mine seems to be a stress response. When I've been under a bunch of prolonged stress it pops up. I got a full exam by a cardiologist the first time it happened and there was nothing they could see that was wrong, so I just try to ignore it now.

I feel you on the anxiety from it though. The first time it happened I had my only panic attack and thought I was dying. Went to the ER and all that. Had bad anxiety from it for awhile like you're describing but then basically decided that I'd rather die doing what I wanted to instead of living in fear of it all the time. After nothing bad happened I slowly got used to it, and now it's just kind of uncomfortable.
 
#15
#15
#16
#16
VolinArizona said:
So, need some insights into questions I should ask my cardiologist on Monday during my first appointment with him.

Background:

32 years old
male
5'10" 205 (down 12 pounds in 12 weeks ON PURPOSE with diet and exercise :birgits_giggle:)

Had a 4-5 month bout with health anxiety last year that I overcame.

Came back 2-3 months ago.

Started having some heart palpitations a couple months ago, and could feel the skipped heartbeats when I'd check my pulse. The skipped beats only really happen when I move around a bit.

Kept weightlifting and doing intense cardio sessions. Never had chest pain or lightheadedness. Lots of anxiety about the skipped beats though.

Went to PCP last week - EKG looked fantastic (very minor right bundle branch block that was nothing). Made me wear 24 hour holter monitor. Had 350 PVCs over 24 hours (not bad they said). Usually benign. They said I had 125 PVCs between 6am and 7am but I think that's a mistake.

Doc refers me to cardiologist because I have a strong family history of mitral valve prolapse. No idea if I have it. However, doc said nothing is alarming, but doing this to rule out the bad stuff even though the only reason I'm being referred is due to family heart history.

SO, I go Monday for the first appt with cardiologist.

What should I ask? What should I expect?

I assume we will do an echo at some point - maybe a stress echo?

Had a clean stress test last year, but I don't remember many palpitations last year.

Anyway - what should I ask? Also, does this sound serious or benign?

THANKS
Click to expand...

Have you had a sleep study?
 
#17
#17
I was born with a mitral valve prolapse and didn't find out till I was around 20,when I went in the Navy and they said don't worry about it till later in life and i didn't

I've had a lot of the same symptoms you have described and thought it was the mitral valve causing it,so I went for years till I started having regular chest pains,I finally went to to the ER and they sent me to a heart doctor and after several test Doctor Ramaprsad told me I needed a aortic valve replacement,so it wasn't the mitral valve at all that was causing my problems

the Doctors and Nurses all laugh at me and tell me I had the true open heart surgery,which I don't see the humor in it at all :)

listen to what your doctor tells you and ask questions, do I like i did and make a list of your concerns,so you don't miss anything,just be sure to tell them what all your experiencing,that is the main thing as far as how often the palpation's and such occur and what you are doing at the time

and my Uncle did work as a emergency medical crew or ambulance crew,He told me years ago not to worry about it to much and he was right,at times before i had the surgery,I would worry about it and could actually feel my heart start doing the palpation's and such

I mean if I had a bout of heart burn,I would worry and thought something was bad wrong and could actually feel the palpation start up,till it would dawn on me to eat an antacid

from what you have said,just relax and try not to worry about it,do what your doing and get it checked out for sure,your Doctors will tell you what is going on and believe me,I know what your going thru,the anxiety,thinking am i going to have a heart attack and all that,that kind of thinking just makes it worse,trust me on that,unless somebody has gone thru it,they don't understand the anxiety involved

and I had that aortic valve replaced around 15 years ago and I can still work myself up and cause the symptoms at times,till i think relax,calm down,you know what your doing to your self,i just close my eyes and take a couple of deep breathes and think of something different,like bunny rabbits fornicating LOL or what ever gets you thinking about something else
 
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#18
#18
Not to hijack, but since we are on the topic of cardiology, a patient I'm taking care of tonight has Takotsubo Syndrome.. AKA Broken Heart Syndrome. I've read up on it since I came in tonight. Pretty interesting.
 
#19
#19
VolinArizona said:
So, need some insights into questions I should ask my cardiologist on Monday during my first appointment with him.

Background:

32 years old
male
5'10" 205 (down 12 pounds in 12 weeks ON PURPOSE with diet and exercise :birgits_giggle:)

Had a 4-5 month bout with health anxiety last year that I overcame.

Came back 2-3 months ago.

Started having some heart palpitations a couple months ago, and could feel the skipped heartbeats when I'd check my pulse. The skipped beats only really happen when I move around a bit.

Kept weightlifting and doing intense cardio sessions. Never had chest pain or lightheadedness. Lots of anxiety about the skipped beats though.

Went to PCP last week - EKG looked fantastic (very minor right bundle branch block that was nothing). Made me wear 24 hour holter monitor. Had 350 PVCs over 24 hours (not bad they said). Usually benign. They said I had 125 PVCs between 6am and 7am but I think that's a mistake.

Doc refers me to cardiologist because I have a strong family history of mitral valve prolapse. No idea if I have it. However, doc said nothing is alarming, but doing this to rule out the bad stuff even though the only reason I'm being referred is due to family heart history.

SO, I go Monday for the first appt with cardiologist.

What should I ask? What should I expect?

I assume we will do an echo at some point - maybe a stress echo?

Had a clean stress test last year, but I don't remember many palpitations last year.

Anyway - what should I ask? Also, does this sound serious or benign?

THANKS
Click to expand...

Do you drink a lot of caffeine? It can cause anxiety and palpatations.
 
#20
#20
kiddiedoc said:
You shouldn't have to ask too many questions. Expect an echo. With a normal EKG and Holter, and assuming a normal echo, you are most likely experiencing some anxiety/panic-type reaction, and the fight or flight adrenergic response is only intensifying your disconcerting heart beats.

If, indeed, everything looks OK, I can recommend a couple of good resources to deal with anxiety without medication.
Click to expand...

Currently going to counseling sometimes just for better coping mechanisms
 
#21
#21
VolsSportsFan said:
According to him, yes the prolapse caused the pvcs.

I'm trying to remember, but it would go through phases. If say it happened once then it would probably happen several times in a 3-4 hour period, but then might not happen again for a week. I don't remember ever finding anything that would cause it to happen more other than it seemed like I would get in a cycle where one would happen, I'd freak and stress out, and it would make it worse.

In a 3 year period, I had 2 attacks that were bad enough that it made me go to the ER. The first was the one I already referenced, the other was at work and it felt like my body was shutting down. The funny part (in hindsight, not then) was I waited so long at the ER that the panic attack and symptoms passed so I left without ever seeing anyone.

Honestly the panic attacks were by far the worst part, way worse than the actual skipped beats. I got to where I was scared to go out or go do anything. I avoided sporting events and such because crowds and loud cheering would start to freak me out. If I did go to a game or a movie, I'd try to sit near an aisle so I could exit quickly. I also had to fly once while having an attack right before takeover and that was a 2 hour hell.
Click to expand...

Describing me to a T. I'm dealing with it better than before. Getting pvcs anytime you get up can scare you though!
 
#23
#23
VolinArizona said:
Currently going to counseling sometimes just for better coping mechanisms
Click to expand...

bunny rabbit's :) if you were like me,I usually had em when I was sitting around doing nothing and there would be a palpitation and then I'd start worrying about my heart and then the what ifs and all that

if you can , do something to take your mind off it,I do know how hard that can be
 
#24
#24
VolinArizona said:
Describing me to a T. I'm dealing with it better than before. Getting pvcs anytime you get up can scare you though!
Click to expand...

I forgot to add, for me when I would feel a skip happening, coughing seemed to help. I have no idea if that really does anything, but for me it seemed to help and now it's too late because it's a reflex :).
 
#25
#25
Update:

Last Monday, the cardiologist listened to my heart every which way. Said nothing alarmed him or concerned him. Also said nothing alarming in my health profile.

He is reviewing my holter from my PCP. He said he'd like for me to do a stress echo just to rule out all bad things. Said it's kind of the final word on this for me - if my heart is structurally fine, then I shouldn't worry about the PVCs. Problem is - the echo isn't until September 21st and I hate waiting that long.

In the meantime, I quit checking my pulse and reading Google - helped tremendously with anxiety and I actually wasn't feeling as many skipped beats. Went on a short vacay with the wife and thoroughly enjoyed it.

However, both Weds and Sun nights I had a short experience of a weird WHOOOOSHING in my chest. No pain, no shortness of breath. Just freaked me out. And today my anxiety is high and the PVCs are back something fierce. Feeling pretty tired, too. Probably just the anxiety about the heart.

Trying to get them to move procedure earlier, which the scheduler seemed like she could get done for me.

Thoughts, doctors?
 
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