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Q. Why is my digestion triggering the symptoms of PVCs?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 05, 2021

Hello doctor,

For a month, I have had a very large increase in PVCs. Each day anywhere from an hour to several chunks of hours, I get runs of them. They happen every few beats during that time and come with no other symptoms. I had a Holter which I am awaiting results for, and I know it caught my symptoms as that day I had a ton. I had an ECG which they said was textbook normal, and a good listen by the Cardiologist who said everything sounds good. He was able to catch a couple as he listened for a while, and I am sure my nerves made them worse. He believes these are benign and should be ignored. Even so, he scheduled an echo for next month to cover everything. They seem to have gotten a bit better since then, but after eating especially a meal with more carbs, about an hour after I eat, I get an hour or less of them. So I know my digestion is definitely triggering them. What is happening? And does any of this sound concerning?

#

Hi,

Welcome to icliniq.com.

Thanks for the query.

PVCs without any cardiac disease are usually benign and cause no harm. Only symptoms are bothersome only when there are a lot of PVCs, such as 20000 per day, and then they may cause the heart to become weaker. Holter will count PVCs in 24 hours.

Echocardiography will see the structure of the heart. If the heart is of normal structure and function, PVCs are benign.

Electrolytes in blood should also be checked. Sometimes low blood potassium levels cause PVCs.

Often, PVCs occur only at rest when the heart rate is slow, and as soon as the rate rises, PVCs disappear.

Are you taking any medicine to control PVCs? Do you have diabetes, hypertension? Is there a family history of heart failure or cardiac arrest?

Also, send me your ECGs which have PVCs.


Investigations to be done:

Holter, echocardiography, Serum electrolytes (Na, K, Mg, Ca).

Treatment plan:

Tab Atenolol 50 mg daily, may increase dose to 100 mg daily if PVCs not decreased.

Regarding follow up:

When you have echocardiography and Holter done, send me reports so that I may guide you accordingly.

Hello doctor,

I had my metabolic panel done that includes potassium, and that is good. I am more curious to find out why is my digestion causing them mostly? The rest of the day, they are barely there.

#

Hi,

Welcome back to icliniq.com.

Good to know your electrolytes are normal. Atrial Fibrillation (AF) rather than PVCs sometimes occurs after high carbohydrate meals and during rest. This is called vagal atrial fibrillation. This is of benign nature. One possibility is that eating meals causes the parasympathetic nervous system to get activated, which causes the heart rate to slow down and increases the number of PVCs due to slow heart rate. PVCs will disappear on exertion when the heart rate rises. Since you have PVCs, structural heart disease should be ruled out as structural heart disease is the most common cause of PVCs. 24 hours Holter and echocardiography will clarify the situation. Avoid excessive caffeine, tea, and other stimulants.

Send me your ECGs that have PVCs.


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