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I had a burst of sorta high bloodpressure mid-morning, and that got my stress going, leading to more PVCs than normal. Then another burst of high bloodpressure in the afternoon, increasing my PVCs again. By early evening I had pretty much decided to go to the emergency room. But then I remembered that my cardiology office had a night line for emergency questions. I called, and within about 20 minutes a physician's assistant called back and asked quite a few questions and then began reassuring me that I needed to relax...no need to go to the ER. Told me things that would lead me to the ER (although I pretty much knew them). By the time I was done with the 10 minute call my PVCs had stopped.
... By the time I was done with the 10 minute call my PVCs had stopped.
...but that's what PVCs do. They come and go on their own...or they can be due to impaired coronary flow, among other things, that could represent an emergency.....
If you're concerned enough to call, you need to be examined.
It's better to make the mistake of going to the ER and it turns out you didn't have to than to make the mistake of not going and it turns out you should have.
I wonder what brand of crystal ball that nurse uses?
...but that's what PVCs do. They come and go on their own...or they can be due to impaired coronary flow, among other things, that could represent an emergency.....
If you're concerned enough to call, you need to be examined.
It's better to make the mistake of going to the ER and it turns out you didn't have to than to make the mistake of not going and it turns out you should have.
I wonder what brand of crystal ball that nurse uses?
I don't think you really paid attention to what I wrote.
However, let me state this: my cardiologist has told me -- repeatedly -- that my biggest heart issue is stress.
I don't think you really paid attention to what I wrote.
However, let me state this: my cardiologist has told me -- repeatedly -- that my biggest heart issue is stress.
Yes, I did pay attention-- You said your BP was up and that you started feeling more PVCs (PVCs usually can't be felt, so you may have been having even more than you think)....You think that caused more stress which led to even more PVCs...
That could be, but what caused your BP & PVC count to go up in the first place?....Those both are well known to occur due to increased adrenalin. That could be due to emotional stress but also, and more likely, due to physiological stress-- exercise/work or acute coronary insufficiency.
If emotional stress is the biggest concern for your heart, then you don't have much of a heart condition. A little worrying may make your HR go up from 70 to 90, but exercise can easily make it go up to 130-- and narrowed coronaries may not be able to take that.
I'm not saying stress doesn't count, and it's a good idea for everyone, heart problems or not, to minimize that, but yours was a situation that should have been met a little more aggressively than a pat on the back by a nurse who doesn't examine you.
Like I said-- if you're worried about it enough to call, then you need to be examined... Are those PVCs unifocal? Multifocal? Occurring in salvos (V tach about to turn into V fib)? Are you experiencing an acute coronary event (silent MI)? You can't tell over the phone.
Yes, I did pay attention-- You said your BP was up and that you started feeling more PVCs (PVCs usually can't be felt, so you may have been having even more than you think)....You think that caused more stress which led to even more PVCs...
That could be, but what caused your BP & PVC count to go up in the first place?....Those both are well known to occur due to increased adrenalin. That could be due to emotional stress but also, and more likely, due to physiological stress-- exercise/work or acute coronary insufficiency.
If emotional stress is the biggest concern for your heart, then you don't have much of a heart condition. A little worrying may make your HR go up from 70 to 90, but exercise can easily make it go up to 130-- and narrowed coronaries may not be able to take that.
I'm not saying stress doesn't count, and it's a good idea for everyone, heart problems or not, to minimize that, but yours was a situation that should have been met a little more aggressively than a pat on the back by a nurse who doesn't examine you.
Like I said-- if you're worried about it enough to call, then you need to be examined... Are those PVCs unifocal? Multifocal? Occurring in salvos (V tach about to turn into V fib)? Are you experiencing an acute coronary event (silent MI)? You can't tell over the phone.
1. You don't think I should trust a physician's assistant who can pull up my record as she's talking to me, but I should trust an unknown guy named guido on a forum.
2. I have a Kardia Mobile 6 lead device, so I can tell when it is or isn't a PVC, and my cardiologist agrees.
3. What is it you think you know about my phsyical stamina, Dr. Guido?
I'm a retired physician, having practiced and taught at a large tertiary care hospital in a major city for 40 yrs.
I myself have settled on receiving my own primary care from a nurse practitioner after having experienced care from four different MDs, each of whom failed to review my history adequately and did physical exams that were completely inadequate (I don't know if the incompetence is a result of the change in geography or the way Obummercare has changed the methods & the incentive to provide good care.)...I figure if I'm going to get inferior care, it may as well be cheaper care. At least the NP KNOWS she doesn't know it all. I think their MDs are deluding themselves. At least the NP does a good PE...But I digress...
Everything I said s true about providing good care in the situation you described. To do otherwise would be taking a chance that need not be taken...Just because someone is good today doesn't mean they can't drop dead an hour from now, particularly when talking about PVCs.
What you failed to mention is that you have a remote sensing device that could show the NP your cardiac rhythm in real time. That is the essential part of the exam. If she saw that your PVCs were unifocal, not grouped, not a rapid ventricular response, not near the T wave, no ST segment elevation or depression, etc, then she was justified in saying that you need not go to the ER.
Everyone, even young kids, throw PVCs. We get more of them as we age. Coronary arteries go bad as we age. People with bad coronaries seem to throw more than those with better coronaries. CABG or stenting may or may not improve PVCs. Draw your own conclusions....There mathematicians who have published fancy papers understood by few non-mathematicians showing that PVCs may not need some physical excuse or cause...???....
Unifocal PVCs that do not cause symptoms (syncope, near syncope, chest pain, SOB etc) do not need to be treated. Those with PVCs do have a higher risk of sudden death, but only beta-blockers seem to lower that risk appreciably.
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