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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22777
Experience:  Over 20 yrs of Family Practice
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I got the results of my holter back and it said I had 542 PVCs

Customer Question

I got the results of my holter back and it said I had 542 PVCs and 2 ST displacements. There were a few other tihngs noted but these two are bothering me the most. What exactly is ST displacement and are these findings dangerous? I had an echocardiogram and it was normal just showed trace regurgitation in the mitral valve. Thank you!
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
First off--your age, gender, and medical conditions/medications? Why was the Holter done?
Expert:  Dr.S.A.Alam replied 2 years ago.

Dr.S.A.Alam :

Hello, Thank you for your question,

Dr.S.A.Alam :

ST deviations means that ST segment of the ECG has changes

Dr.S.A.Alam :

either elevation or depressions.

Dr.S.A.Alam :

It was present in only two occasion so is is not significant in a 24 hour holter test.

Dr.S.A.Alam :

I am more concerned about your PVC's

Dr.S.A.Alam :

these can prone your to arrythmias which can be life threatening.

Dr.S.A.Alam :

So your doctor needs to start you on medicine like beta blockers.

Customer: replied 2 years ago.
I am 36, female, on amoxicillin currently thats it, and I was having palpitations with occasional pains in chest.
Customer: replied 2 years ago.

My regular GP told me that that number of PVC's could be caused by stress but it wasn't dangerous.

Expert:  Dr.S.A.Alam replied 2 years ago.
Hello,

Thank you for your reply,

ST deviations means that ST segment of the ECG has changes
either elevation or depressions. These are seem in heart ischemia. Holter is not very good tool to detect heart ischemia as ST changes are often misread. Main use of holter is to check for abnormal arrhythmias.
It was present in only two occasion so is not significant in a 24 hour holter test.
I am more concerned about your PVC's
these can prone your to arrhythmias which can be life threatening.
So your doctor needs to start you on medicine like beta blockers.
PVC's can be caused by stress but if they are present in such large number then they can put you at risk of arrhythmias and need medicine like beta blockers to keep them under check.
To check for heart ischemia as you have chest pain more sensitive test will be exercise stress test and stress echo cardiogram in your case.

I hope this helps.
Let me know if you have more questions.
Expert:  Dr.S.A.Alam replied 2 years ago.
Hello,

If you have more questions let me know.

Click ACCEPT button if you have received your answer. Thank you.
Customer: replied 2 years ago.

Can anxiety cause PVC's because I have been anxious latey?

 

I'm concerned now because my GP said it was nothing to worry about but you are telling me otherwise. She said people can have thousands of PVCs a day and it can be totally benign. Should I see a cardiologist?

Expert:  Dr.S.A.Alam replied 2 years ago.
Hello,

Thank you for your reply,

Anxiety, stress can lead to PVC's.

Main concern if PVC are occurring more often is that R wave of the next QRS segment may fall too close to the T wave and it can lead to arrhythmias like VT and VF which are pretty serious.
If you were more than 60 years old then i would have said that around 500-800 PVC's are normal but in young people this number of PVC's are not normal and need further evaluation. Heart valve problems and other structural problem in the heart can lead to high number of PVC's so you need echocardiogram to rule it out.
It is correct that PVC's are benign but only when they are less in number.
Many people have thousands of PVC's and live normally, specially old people.
We just put them at beta blockers to prevent heart arrhythmia's so your doctor may use this very same strategy.

I hope this helps.
Customer: replied 2 years ago.
I had an echocardiogram 2 weeks ago that was normal just trace regurgiation in Mitral valve. Does that change anything?
Expert:  Dr.S.A.Alam replied 2 years ago.
Hello,

Thank you for your reply,

This rules out most structural heart diseases. Trace mitral regurgitation is normal in most population and does not needs treatment.
You may just need beta blockers, as it will keep your heart rate under check due to stress and anxiety and also help to lessen the risk related to PVC's.
542 PVC's means that you are having around 22 PVC's per hour.
This comes in category of grade 1 or occasional PVC's.
Reducing stress and beta blockers are best option for your.

I hope this helps.


Expert:  Dr. Chip replied 2 years ago.
I--I would like to respectfully XXXXX XXXXX the other expert. I think your PVC's are benign and don't need treatment. The ST changes may or may not signify anything so I would get a stress test to check for ischemia.
Customer: replied 2 years ago.

Dr Chip,

 

Can they detect ischemia on an echocardiogram? I had one done and it was normal.

Expert:  Dr. Chip replied 2 years ago.
Well--how about on your regular EKG that you must have had before the Holter--were there any abnormalities like ST changes other than the PVC's?
Customer: replied 2 years ago.
I had an EKG done 2 months ago and they said it was pretty much normal. They didnt even mention the PVCs then. I had a stress test but it was 2 years ago. It showed "interferolateral Q waves and minor non-specific ST-T abnormalities. At peak exercise there was up to 2.4mm of mildly uploping S_T depression when compared to the resting ECG". I went to cardiologist then and he wasn't concerned. I just don't have insurance now so a stress test is kind of out of reach at the moment.
Expert:  Dr. Chip replied 2 years ago.
OK. I think in the end there's no reason for worry for now. The ST changes on the Holter now are probably as nonspecific as they were before and with a previous stress test and clearance from a cardiologist, I really don't think we're dealing with an ischemia problem. As I said, I see no need to treat the PVC's right now--only if they get to the point of six or more per minute might I consider putting you on medication. I think for now you just need a repeat EKG in a few months and it's a possibility that the PVC's will have resolved by then.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22777
Experience: Over 20 yrs of Family Practice
Dr. Chip and 2 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you so much. You've really eased my mind. I'm hoping that the PVC's are just stemming from my anxiety disorder and hopefully will resolve soon. I did a holter 2 years ago and didn't have any PVC's at all so I'm hoping its just anxiety this time around. I will do a follow up EKG in a few months as you suggested. Again I can't thank you enough!
Expert:  Dr. Chip replied 2 years ago.
You're very welcome and you may very well be right about the anxiety part--it would be a little unusual for these to suddenly crop up at your age from a true cardiac problem.

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