Those PVCs cannot have anything to do with coronary artery disease

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Q:

Are you telling me that PACs and PVCs are heart failure? I had a stress echo of my heart in April 2007, and an echo done September 2008 and was told everything was excellent; I had the stress test where I was injected with radio isotopes; my BMI is roughy 28% (using calipers and BMI measurements) as I am a large framed man (prior athlete).  I seen my cardiologist in September and again he said no reason to worry.  With this information do you still hold the same opinion that it is unsafe to exercise.  Had a short run of SVT last night for about 5 seconds as well, which is new, what does that mean? What do I do, should I make another appointment with my cardiologist?

A:

I agree with you that in 2-3 years it is unlikely damage to your heart would have occurred w/o a heart attack.
What I am concerned about however, is that these are new arrhythmias that have started to increase (according to you) with exercise. (Early) heart failure is a big word, that applies to all conditions where it can no longer “do its duty”. Since the most common cause for heart failure is coronary artery disease, the only way I would be able to judge whether this increase in PVCs is due to a (relatively) insufficient blood supply at exercise, is with a stress ECHO.
As far as your BMI is concerned, I can only use the regular formulas for calculating and there are always exceptions such as your situation. A BMI=28 is still too high however, in addition you are being treated for hypertension, another risk factor for CAD.
Your situation is similar to that of other patients:
http://www.cardiac-risk-assessment.com/ca-blog/i-dont-think-those-new-pvcs-have-
http://www.cardiac-risk-assessment.com/ca-blog/my-irregular-heart-beats-are-gett
As a result, if I had seen you in my office I would likely have recommended a stress ECHO.
Whether or not you have CAD, you need to be evaluated for this change in rhythm,
Hope this helps,
Dr T
http://www.cardiac-risk-assessment.com

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