Heart Issues: PVCs, AFib, and Related Symptoms Explained

Cardiac problem consultation?

Dear Dr.
He,
I have some heart-related issues I would like to consult you about:
1.
Could you please explain the difference between "premature ventricular contractions" (PVCs) and "atrial fibrillation" (AFib), and how can one distinguish between the two?
2.
I have symptoms of gastroesophageal reflux disease (GERD).
Can GERD trigger arrhythmias, such as tachycardia or irregular heartbeats?
3.
Recently, I have been experiencing feelings of palpitations, as if my heart is racing or beating irregularly.
Occasionally, I feel a slight tremor in the center of my chest, but I am unsure whether it is my heart, esophagus, or muscles that are shaking.
The tremor seems to be localized in the central chest area, but I do not feel particularly uncomfortable.
In your opinion, what condition is most likely causing my palpitations and the tremor?
4.
Additionally, I currently experience palpitations and tremors, and I also feel my heartbeat continuously while sleeping.
Based on the symptoms described, do you think I need to see a cardiologist for an electrocardiogram (ECG) and echocardiogram?
Thank you, Dr.
He.

Axiang, 30~39 year old female. Ask Date: 2021/05/10

Dr. He Dongjin reply Cardiology

Hello, ventricular premature contractions and atrial fibrillation can be identified through an electrocardiogram (ECG).
Generally, without testing, it is difficult for the average person to distinguish gastroesophageal reflux, which may trigger arrhythmias, palpitations, and tremors.
The most likely cause is autonomic nervous system imbalance.
Based on your description, it is advisable to visit a cardiologist for an ECG to ensure peace of mind.
Changhua Hospital cares about your well-being.

Reply Date: 2021/05/10

More Info

Understanding heart issues, particularly conditions like premature ventricular contractions (PVCs) and atrial fibrillation (AFib), is crucial for managing symptoms and overall cardiovascular health. Let’s break down your questions one by one.

1. Difference Between PVCs and AFib:
- Premature Ventricular Contractions (PVCs) are early heartbeats originating in the ventricles. They can feel like a skipped heartbeat or a fluttering sensation in the chest. PVCs are generally benign, especially in individuals without underlying heart disease, and can be triggered by stress, caffeine, or fatigue.

- Atrial Fibrillation (AFib), on the other hand, is a more serious condition characterized by rapid and irregular beating of the atria. This can lead to blood pooling in the heart, increasing the risk of stroke. Symptoms of AFib may include palpitations, shortness of breath, and fatigue. The key difference lies in the rhythm: PVCs are isolated early beats, while AFib involves a chaotic rhythm with no discernible pattern.

2. Gastroesophageal Reflux Disease (GERD) and Arrhythmias:
- GERD can indeed contribute to heart rhythm disturbances. The esophagus and heart are closely located, and irritation from acid reflux can stimulate the vagus nerve, which may lead to sensations of palpitations or irregular heartbeats. While GERD itself does not directly cause arrhythmias like tachycardia, the discomfort and anxiety associated with reflux can exacerbate existing heart rhythm issues.

3. Symptoms of Palpitations and Chest Tremors:
- The sensation of your heart racing or feeling like it’s “jumping” can be attributed to PVCs or anxiety. The occasional tremor in the chest could be related to muscle spasms, esophageal contractions, or even anxiety-related symptoms. Given that you do not experience significant discomfort, it’s likely benign, but it’s essential to monitor these symptoms.

4. Need for Cardiac Evaluation:
- Given your symptoms of palpitations, the sensation of tremors, and the awareness of your heartbeat during sleep, it would be prudent to consult a cardiologist. An electrocardiogram (ECG) can help identify any arrhythmias, while an echocardiogram can assess the structural function of your heart. These tests are non-invasive and can provide valuable insights into your heart health.

In summary, while PVCs are generally benign and often require no treatment, AFib is a more serious condition that necessitates medical intervention. GERD can contribute to palpitations, and your symptoms warrant further evaluation to rule out any underlying heart conditions. It’s always better to err on the side of caution when it comes to heart health, so scheduling an appointment with a cardiologist for a thorough evaluation is advisable. Additionally, lifestyle modifications such as stress management, dietary changes to address GERD, and regular exercise can also help improve your overall cardiovascular health.

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