How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Coachrobmd Your Own Question

Coachrobmd
Coachrobmd, Internal Medicine MD
Category: Medical
Satisfied Customers: 1785
Experience:  •Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.
66242556
Type Your Medical Question Here...
Coachrobmd is online now
A new question is answered every 9 seconds

I had a holter monitor done and results showed occasional pvcs

Resolved Question:

I had a holter monitor done and results showed occasional pvc's and pac's with a couplet. I am worried about these results as I have heard couplets are not good
Submitted: 2 years ago.
Category: Medical
Expert:  Coachrobmd replied 2 years ago.

Coachrobmd :

Hi, I'm Doctor Robert, a Medical Internist (MD) who deals with diseases of all organ systems. All my education has been completed in the US.

Coachrobmd :

No, couplets on occasion are not concerning.

Coachrobmd :

You need to know the total # XXXXX 24 hours to assess the severity. The trouble comes when you put three or move PVC's together.

Coachrobmd :

If you have REPEATED couplets, that's different. But if it's occasional, that is not especially concerning.

Customer:

I think there were around 20

Coachrobmd :

Avoid tobacco, caffeint, and alcohol.

Coachrobmd :

20 in an entire day?

Customer:

I am still getting them pretty regularly. My doc says I am okay but I am worried. Is this a normal holter

Coachrobmd :

Have you had a cardiologist review the Holter? What did he say?

Customer:

It was done by a heart specialty place and that was their interpretation is that good enough

Coachrobmd :

Yes, that's good enough. They looked at the shape of the EKG tracing PVC's and determined there is no risk.

Coachrobmd :

So, if they do this every day, and have examined it, then I would trust them.

Coachrobmd :

If an echocardiogram has not been done, that would be the next step if any.

Coachrobmd :

And continue the beta blockers.

Coachrobmd :

Any other questions I can answer for you today?

Coachrobmd :

Please realize this: I am limited to the information that I glean from your posts, as I can't see, talk to, or touch you. I can only give you my approach to the evaluation of your symptoms if you were in my office. That puts me at a disadvantage compared to your doctor who actually sees your body right there in the office. This is just the nature of advising across the internet. A specific diagnosis under these conditions is VERY difficult.

Coachrobmd :

If a heart specialist said it was okay, then why not trust them? They don't benefit from putting you at risk.

Customer:

I had one last july that was ok. what would it tell that holter did not

Coachrobmd :

If the echocardiogram was normal, then you don't have structural abnormalities that can cause PVC's. So, the work up is now complete. Congrats!

Coachrobmd :

Anything else?

Customer:

sorry I thought you said ekg

Coachrobmd :

No, echocardiogram. That is the only other thing that MAY be of value. And a holter is better than an EKG.

Customer:

are pvc's and pac's normal to have. Why is holter better than ekg

Coachrobmd :

Because t hey occur in many normal people. They occur occasionally during stress, eercise,etc.

Coachrobmd :

And a holter is a 24 hour CONTINUOUS EKG, versus an EKG that looks for just six seconds.

Coachrobmd :

Anxiety is a common cause of these by the way.

Coachrobmd :

Any other questions I can answer for you today?

Customer:

can it interpret the same thing as ekg and diagnose the same like ischemia

Coachrobmd :

Yes, it can do that, but is better for rhythm abnormalities. It's not desinged for ischemia; an Exercise Treadmill Test (ETT) is better for that.

Customer:

Is it normal to feel these as big skips

Coachrobmd :

Yes, it is.

Coachrobmd :

Are you crying???

Customer:

sometimes cause I am worried

Coachrobmd :

Well, worry less and listen more to the cardiologist who examined you and reviewed the holter. if you didn't trust them, you should not have had them do the test. Does this make sense?

Coachrobmd :

Beta blockers are very effective.

Coachrobmd :

Anything else?

Customer:

the cardiologist did not examine me only my gp. I am already on atenolol 12.5mg

Coachrobmd :

That's great. you're on the proper medications and the holter was not concerning.

Coachrobmd :

So, please don't worry.

Customer:

do you think I am ok with nothing to worry about even though they continue

Coachrobmd :

Yes, you're okay. That's what the Holter said.

Coachrobmd :

and the cardiologist.

Customer:

thanks I will try not to worry do you think it is just anxiey

Coachrobmd :

Sure.

Coachrobmd :

If you found this information useful, please click ACCEPT (and provide positive feedback which is FREE) in that case so that I may receive payment for assisting you today. Thanks!

Coachrobmd :

I do rely on your good faith. Yes, you can read my answer and love the advice without clicking ACCEPT and use the information to help you deal with your medical issue. But I'd appreciate an accept for my attention to your problem and the 14 years of training it took to be able to give you this advice. I have given you a list of ideas for discussion with your primary care physician. That's the best I can do without actually seeing you.

Coachrobmd, Internal Medicine MD
Category: Medical
Satisfied Customers: 1785
Experience: •Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.
Coachrobmd and 5 other Medical Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    14679
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2562
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11961
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/CO/commissure/2011-4-15_192514_REISD20080926JR1090.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    10667
    Experienced Physician trained in New York City. I'm ready to help.
 
 
 

Related Medical Questions

Chat Now With A Doctor
Coachrobmd
Coachrobmd
1720 Satisfied Customers
•Fmr. Dir. Hep. C Clinic. •Fmr. Dir. Head Trauma Rehab Ctr.