PACs are back :(

[Christina L]

Hi everyone,

I am having another episode of PACs - they have lasted about a week. It has been a long time since I have had PACs. Needless to say they are very irritating. I don't know how/why they started this time. However, this time there is something unusual going on besides the irregular heartbeat - a feeling of fullness or soreness in my neck area (?). Has anyone ever experienced this?? It is a hard feeling to describe, but in the night last night, there was almost a throbbing in the neck area that seemed to coincide with my heartbeat. My heart does not feel as if it is pounding at all - still very quiet, except for the PACs and this strange feeling in my neck.

I am going to make an appointment with my cardio for this week - it is time for another "reassurance" checkup for me - even though my cardiologist told me to "have a nice summer, I'll see you in September."

Thanks everyone.

Happy Memorial Day to all and a big thank you to all of our veterans and current enlisted men and women for their service to our country.

Christina L.

 

[tobagotwo]

I had a feeling not entirely unlike that before surgery. It was the way I felt angina - in the throat/top of the lungs, not in my left arm, chest, shoulder or back.

For those who feel it in their throat, some feel it like a lump in their throat, some like the beginning of a sore throat, a tightness at the base of the throat, or the kind of throat/top-of-lung irritation feeling like you've been breathing cold air.

It may not be that at all for you, though. By now, you surely know how angina normally feels to you.

Hoping it's nothing,

 

[Christina L]

You are describing what I am feeling pretty much to the T. What IS angina exactly?? Is it dangerous? What does it mean? Does it mean the heart is under stress?? Does it mean blockage??

I feel that my heart is definitely under stress right now with the PACs and I am majorly irritable because the PACs are such a nuisance and I am reminded constantly of my heart surgery, etc., thus a vicious cycle - causing me to worry-worry-worry!!!

Can angina be a result of stress?

Thanks.

Christina L.

 

[LUVMyBirman]

Hi Christina,

Sorry to hear those "pesky" beats have returned. It's pretty common ...and they are very benign as I am sure you have been told.

Have you been stressed? Maybe pushing the envelope too far? Doing too much? I only ask as this is when my problems surface.

My PAC's started 3 months post op. At 2 years they put me on Inderal LA for migraines. Poof. Gone! I will have a cycle of them around the time of a hormonal fluctuation, stress or when I am very tired. Or......after alot of envelope pushing so to speak Your atrium is most likely compensating from the surgery. Hopefully shrinking. That may be the answer. As for the neck tightness, back shoulder, etc. I am willing to bet that is from the manipulation of the surgery. I still battle this 5 years later. Once had a doctor tell me that "you will feel things more than the average person". Today during our recent highs and low with the storms..I was really feeling some pain in my upper back and chest. Soon as the front lifted. Gone. Yesterday when it was moving through it came in the migraine form.Hummmmmm maybe it's time to move

Report your symptoms to your card. I am certain all will turn out just fine for you.
Take care and keep us posted.

PS. Ask for Xanax girl! It really did help in that time of need!

 

[Christina L]

Thanks, Gina, for your reassuring response to my post. Your thoughts really did put me at ease a bit - thank you.

Interestingly, the PACs started just a few days after that "time" of the month about a week ago. We women know what our hormones do to us all through the month - and sadly, so do the men.

I do think the PACs could be hormonally driven right now - I really don't know what I have been worried about - besides everything!! I am a real worrier - I feel I fret all the time and don't know why I don't have PACs constantly, but underlying, unknown stress had a hand in bringing these on right now also - I truly believe.

The scariest thing for me is the strong beat of the PACs this time around - stronger than ever before and also the wierd feeling in my throat.

I called the cardiologist on-call today (not my regular one) and his only suggestion was to go to the ER if my symptoms got worse or if there was pain. He said that PACs, yes, are benign, but he didn't know what the pressure-feeling was all about going on in my throat/neck area.

I will still be making an appointment this week with a cardiologist to get checked - and hopefully get some reassurance, which will help the PACs to go away - it is like a vicious circle when they come on.

That is interesting about the beta blocker helping your PACs. I will ask the cardiologist about that for me.

Thanks a bunch, Gina, for giving me a little peace of mind here.

Christina L.

 

[LUVMyBirman]

Deep breaths Christina Start keeping a little log for yourself. My husband still has to remind me when I am in panic mode "Gina this happens to you every month you are ok".

 

[tobagotwo]

My cardiologist warned me not to ignore angina, saying that it means the heart is under stress, and I should stop doing whatever was irritating it.

One thing that used to allieviate angina for me was to bring in more oxygen, so I would sometimes very briefly hyperventilate, to up my oxygen saturation for my heart. The other key is the hard one, and you already know what it is: try top relax. Stress is much harder on the rhythm than physical activity.

However, you could also just be tightening up in your throat because you're nervous about the PACs - meaning that it may not be angina that you're feeling at all, but a nervous response of throat-clenching.

After a while, it gets so hard to judge things, when you're so aware of yourself and your heart. I call it acute valvular hyperesthesia, when you finally get so confused you can no longer discern what's a symptom, and what's just indigestion.

I hope it's just a fluke. If not, I hope it's what Gina was posting about. Nonetheless, it's good to hear you're making an appointment with the cardio. PACs may be relatively harmless, but any sudden and continuing rhythm change should probably be looked at: in this case, your sense that your heart is beating harder - differently - and the sudden onset of the PACs. If your pulse isn't normally slow, a beta blocker might be something the doctor prescribes, as Gina suggested.

Best wishes,

 

[Glenda]

I'm sure I missed it somewhere, but what are PAC's?

 

[tobagotwo]

PACs & PVCs

PACs & PVCs

The cheap PAC/PVC tour, as I understand it:

PACs are Premature Atrial Contractions, meaning that the atrial (top) part of the heart has started its beat before the rest of the heart is ready. PVCs are Premature Ventricular Contractions, which means the same thing, but in the lower part of the heart. These electrical misfires can cause feelings of butterflies in the chest, heart banging, or panic. While they are occuring, the heart is not functioning efficiently, although it may be functioning sufficiently.

These disturbances are common in most people, whether there is heart disease present or not. People who have had AVRs or MVRs are particularly prone to them. Another common misrhythm almost everyone experiences is Tachycardia Arrhythmia, a very rapid heartbeat that is a commonplace sign of overstress or overwork. Most of the time, these are harmless and quite temporary, minor glitches in a complex process that provides variable, on-demand oxygen-and-nutrient-carrying blood to an unpredictably active body.

In those who have heart problems or have had OHS, PACs and PVCs may be harmless, or they may be harbingers of other issues. PVCs can lead to unpleasant Ventricular Tachycardia, which can in turn cause potentially fatal Ventricular Fibrillation. PACs can be associated with Atrial fibrillation, which can also stop the heart. Because of this, we need to be more aware of arrhythmias than most people. A visit to a cardiologist may be in order if any arrhythmia repeats or is prolonged.

Even in stable heart patients, that degree of bad progression is not often the case. However, heart patients who are suddenly experiencing any types of arrhythmias should look to find a cause. Fatigue, stress, caffeine, nicotine, or excessive alcohol can all play roles in causing responses like PACs, PVCs, TA, VTach, Afib, or Vfib, as can the heart compensating for internal issues, such as valve leaks, stenoses, enlargement, healing from OHS, or even while returning to a more normal size after VR. For some, the stress of normal hormonal cycles can set them off. A cardiologist would be required to determine if the causative factor is in the heart function itself.

 

[Glenda]

Thanks Bob for the explanation of PAC's. Next time I see someone use this term just maybe I'll remember what it means. You are so knowledgable. I have learned so much from your posts. I'm so thankful that I found this site before my surgery.

 

[Christina L]

My PACs have lessened in frequency and severity today. My neck tightness is pretty much gone - however I still feel as if I have a "little lump" in my throat at times.

I will call the cardiologist to make an appointment tomorrow. I really don't want to, as I am afraid of what the cardio will find - since my surgery there has been no murmur heard at all - I am so afraid that he will hear one now. I would almost rather go through the summer "not knowing" until my previously planned appointment in September. However, I will be positive and hope for the best.

Glenda, PACs/PVCs are such irritating things. They get a person all wound up - I think both in the mind but also the central nervous system gets excited, too, from the irritation of the heart's electrical current. It is like a vicious circle when you get PACs or PVCs - it is hard to calm down and get a grip enough to get rid of them!!

Bob, my last bout with PACs, the cardiologist told me they were benign and asked me if I was in perimenopause - he said lots of women seem to get heart arrhythmias at that time of life. I had PACs before my surgery but never as long as the last two episodes post surgery - and definitely not the throat sensation that I had with this latest bout.

I am hoping that with a little reassurance from the cardio this week and if I keep myself busy, the PACs will go away soon.

I appreciate all your help, Gina and Bob, and a special thanks to Gail - you were so kind to call.

Christina L.

 

[tobagotwo]

It will turn out to be nothing (but go anyway). Think Arnold Schwartznegger: "Dere iss no murrmurr!"

Hormonal changes can certainly bring them on. What a real joy that is to add to the many other lovely symptoms that women get to appreciate at that time in their lives. Gilding the lily, as it were.

As you're still only seven months out from surgery, you're also apt to be more susceptible to them, from that or any other cause. The lump in your throat may just be a nervous response to the excitement, caused by tightening your throat in fear.

I agree. There's little that's harder than getting out of that arrhythmia-panic-more-arrhythmia cycle. I used to play that game at night with afib, prior to my surgery. Sometimes a deep cough can break the cycle. Otherwise, slow, deep breathing, calming thoughts, etc. can help some, but it does take time to get under control.

Best wishes,

 

[Susan BAV]

Hi Christina -

I've been having more PVCs, or whatever, lately too. Maybe because I'm more active. This is also the first heat I've endured since my surgery last October. And, pre-op, heat had become incredibly oppresive for me. I'm anxious to feel better in the heat this summer.

But sometimes I just think I'm having arrythmias and then I feel my pulse (in my throat) and it is just a very strong pulse, something that I haven't felt for many-a-year and that I'm not used to. That nice wide valve in my pump is doing what it's supposed to be doing for me but it's a sensation I'm still not used to. I also still have some tenderness and/or discomfort from the collarbone area (or whatever it's called) up above the top of my scar and certain activites can make it feel achey to me.

I hope your sensation is benign but you're doing the right thing to see your cardiologist.

 

[Christina L]

Thanks Susan and Bob. Susan, you sound so calm with your PACs. Wish I could be the same - they just irritate the heck out of me - probably irritation masking worry!!!

I took a 1 mg Ativan yesterday for the first time in a long time and the PACs almost went to nothing yesterday - of course I was out planting flowers in the sunshine - getting my mind off of them, but last night I felt almost normal again and felt really good physically.

Not so this morning, they are back but not as bad as several days ago. Of course, I see my cardio this afternoon and am certainly nervous about that. I will let you know what the doctor says.

Okay, I will try to be more like Aaahnald S. and repeat over and over "Der isss no murrmurr!!!" Hopefully that will "terminate" the PACs.

Christina L.

 

[tommy]

Christina,

Sorry you are struggling. Glad to see you can produce some humor. Good luck with the cardio today.

 

[ticktock]

Christina
Im hoping you get a very good report today, and assume you will check in here with reassurance for all of us. PAC's are just a pain in the hiney. My Cardio once mentioned, rather off the cuff, well... "you could try taking 400mg of Magnesium daily, it couldn't hurt and I'm finding it helps many patients". That was about 3 years ago and the reduction in my PAC's and PVC's is unbelievable!!! WAY better than Inderal or Toprol, years ago it was Quinidine, I've had 'em all.

You might mention it to your Cardio. It really changed things for me!
Prayers for you!!!

Mindy

 

[Christina L]

Doctor's appointment

Doctor's appointment

went "well." It was a 45 minute wait to see the cardio. First and foremost, he told me my heart sounded great still - no murmur. As for the PACs he gave me sotalol - said that should kick the PACs out of there for now. Told me to take the sotalol only as needed - not every day.

FYI - I asked the doctor about the visual spells that a lot of us seem to have in common on this board - should have known - he had NO IDEA what they would be from and what would cause them. Isn't that something, how so many of us have these spells and hardly any doctor can give us a clear-cut answer on the problem???? This doctor said he had never had a patient with these same visual symptoms. At first he brought up the pump machine maybe causing them, but I told him my visual problems started four years ago - long before my surgery - but whereas I used to have the visual symptoms maybe twice a year, now I have them at least once a month post surgery. Sigh....our quest continues to find an answer.

Mostly my cardio told me to exercise at least three times a week to keep the stress hormones down in my heart, thus maybe keeping more PAC spells at bay. Wouldn't give me any more than 14 Ativan pills but suggested that I drink wine instead as it gives the same effect as Ativan (I know that!). So, here he is afraid I will get addicted to the Ativan, yet pushing me to be an alcoholic. I give up!!

I am majorly relieved - you watch - the PACs will be gone in a couple of days - I hope!

Thanks for all your help.

Christina L.

 

[Christina L]

P.s.

P.s.

Forgot to mention the throat tightness - only telling all of this to help those of you with PACs and same symptoms -

The cardiologist also told me has no idea what caused the throat tightness - how much do we pay these guys??? He said sometimes that a-fib causes that sensation but told me if I did not feel my heart racing, which I did not - just the blips from the PACs, then the throat symptoms were most likely not from a-fib.

Again, he told me PACs are benign, hormonal changes or perimenopause can bring them on more frequently, and that in a person with heart problems such as myself, they are to be expected at times, but not to worry. Okay, I won't worry, not me.

P.S. Asked the nurse about magnesium and she told me how she drinks Gatorade instead of always water - to replete electrolytes - that sounds like a good idea. She said drinking too much water or too little water could cause heart arrhythmias.

Christina L.

 

[Sherry]

Hello, Christina,
I've been following this thread since you first posted. Interested to find out what your doc would say, but it sounds like he didn't have much in the way of concrete info for you, except for the meds which hopefully will help. Let us know. Figures that he couldn't address the visual problems too. I agree -- there are too many of us on this board who have them for there not to be some link. I actually had a stress test myself yesterday, and while I was hooked up during the resting part of the test, the nurse practitioner mentioned my PVCs. Ironically, after she got me going on the treadmill a good pace (uphill), she commented that they stopped Go figure.

 

[Susan BAV]

Christina -

Sotalol was what I was put on for a-fib for the first three months post-op. I don't want to offer any medical advice so please understand that I just feel that I should tell you that my cardiologist told me that to begin that medication, it must be administered in the hospital. I read that on the medication sheet as well. Perhaps it was because of the dose I was on; I don't know. Be sure and read all the patient information on the medication though. Also, I'm not sure but I think that it caused some horrendous joint pain for me as well. It did get rid of the a-fib!