PVCs: Managing Dizziness, Rapid Heartbeat, and Numbness

Early contractions accompanied by dizziness, rapid heartbeat, and hand numbness?

Hello, doctor.
Thank you for providing this platform.
I would like to elaborate on my medical history, and I appreciate your help!
Over a year ago, after experiencing a severe cold, I began to have symptoms of premature ventricular contractions (PVCs).
At that time, I underwent a 24-hour Holter monitor test, which recorded over ten thousand PVCs.
An echocardiogram showed normal results.
In the following months, the frequency of PVCs gradually decreased, and a subsequent 24-hour Holter monitor test showed a reduction to 1-200 PVCs.
A few months later, I hardly felt the PVCs anymore.
However, after about 8 to 9 months, the PVCs reappeared, and their frequency fluctuated but persisted.
About a month after the PVCs became more frequent again, I experienced a sudden onset of symptoms while sitting at my computer.
I felt a momentary dizziness (not the spinning type of vertigo), just a sudden feeling of lightheadedness, as if my vision was about to fade to black but did not completely do so.
My awareness was clear, but standing up made the sensation more pronounced.
At the same time, I felt my heart racing, and my hands and feet began to feel cold and tremble.
When the symptoms were more severe, I had a sensation of almost fainting.
These episodes occurred suddenly, lasting anywhere from 10 to 30 minutes, and would gradually resolve after resting.
Initially, these episodes occurred about once every month or two, but they have become much more frequent this month.
However, not every episode leads to numbness in my limbs or a feeling of darkness in my vision.
During shorter episodes, I mainly experience dizziness and a rapid heartbeat (around 90-95 beats per minute), but I still worry about fainting.
I was prescribed antiarrhythmic medication and took it once because I was concerned about my heart rate during a long flight.
After taking it, I felt better.
These symptoms have caused me significant anxiety, and I am unsure how they relate to my PVCs or my heart health.
Additionally, for the past week, I have felt dizzy every day, with a sensation of heaviness in my head and lightness in my legs.
There have been a few days when I woke up with a headache, which gradually subsides after activity, but the dizziness and heaviness often persist throughout the day.
Even slight exercise or climbing stairs makes me feel dizzy and lightheaded.
I do not have a history of headaches except during my menstrual period.
Currently, I am alone abroad and have registered with a cardiologist, but the wait time is long.
I am very concerned about potentially dangerous heart issues or the risk of a stroke and would like to seek your preliminary opinion.
Thank you very much!

Ding Ding, 30~39 year old female. Ask Date: 2017/01/16

Dr. He Dongjin reply Cardiology

Hello, PVCs may be related to difficulty in expressing emotions.
I don't believe it's likely that recent stress has caused autonomic nervous system dysregulation leading to symptoms.
Let's first focus on stress management.
Changhua Hospital cares about you.

Reply Date: 2017/01/16

More Info

Understanding premature ventricular contractions (PVCs) and their associated symptoms can be quite concerning, especially when they manifest alongside dizziness, rapid heartbeat, and numbness. Your detailed account of your medical history provides valuable context for understanding your current situation.

PVCs are common and often benign heart rhythm abnormalities that occur when the ventricles contract prematurely, disrupting the normal heart rhythm. Many people experience PVCs without any significant underlying heart disease, especially if they have normal echocardiograms and other cardiac evaluations, as you have described. The fact that your echocardiogram was normal is reassuring, as it suggests that your heart's structure and function are intact.

The symptoms you are experiencing—dizziness, rapid heartbeat, and numbness—can be distressing and may be related to the PVCs or other factors. Dizziness and a sensation of lightheadedness can occur during episodes of PVCs, especially if they are frequent or if they lead to a temporary decrease in cardiac output. The feeling of your vision darkening and the coldness in your extremities may indicate a transient drop in blood flow or blood pressure, which can happen during episodes of significant PVCs or other arrhythmias.

The fact that you have experienced a recurrence of PVCs after a period of relative stability is not uncommon. Stress, fatigue, caffeine intake, and other lifestyle factors can contribute to the frequency of PVCs. It’s important to monitor your symptoms and identify any potential triggers. The increase in frequency of your PVCs, along with the associated symptoms, warrants further evaluation, especially since you mentioned that these episodes have become more frequent and intense.

Your experience of feeling faint or on the verge of fainting during these episodes is particularly concerning. While PVCs are often benign, the combination of symptoms you describe—especially the dizziness and the feeling of impending faintness—could suggest that your heart is not effectively pumping blood during these episodes. This could be due to a variety of reasons, including the frequency of PVCs leading to a decrease in effective heart function, or it could be related to other underlying issues such as anxiety or orthostatic hypotension (a drop in blood pressure when standing up).

Given your symptoms of persistent dizziness and headaches, along with the recent increase in PVC frequency, it is crucial to seek medical attention as soon as possible. While waiting for your cardiology appointment, consider the following steps:
1. Keep a Symptom Diary: Document the frequency of your PVCs, the circumstances surrounding each episode, and any associated symptoms. This information can be helpful for your healthcare provider.

2. Monitor Your Blood Pressure: If possible, check your blood pressure regularly, especially during episodes of dizziness or lightheadedness. This can help determine if there are significant fluctuations that need to be addressed.

3. Lifestyle Modifications: Reduce caffeine and alcohol intake, manage stress through relaxation techniques, and ensure you are well-hydrated. These changes can sometimes help reduce the frequency of PVCs.

4. Avoid Triggers: If you notice that certain activities or situations trigger your symptoms, try to avoid them until you can discuss them with your doctor.

5. Emergency Care: If you experience severe symptoms, such as prolonged dizziness, chest pain, or fainting, seek emergency medical care immediately.

In summary, while PVCs are often benign, the symptoms you are experiencing warrant further evaluation to rule out any serious underlying conditions. It is essential to communicate your concerns with your healthcare provider, who may recommend additional testing, such as a Holter monitor or an electrophysiological study, to better understand your heart's rhythm and function. Your health and safety are paramount, and timely medical advice is crucial in managing your symptoms effectively.

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