DEAR DR. DONOHUE: I am a 43-year-old female who has had PVCs on a daily basis for 15 years. They come when I eat or have a glass of water, and they last 30 minutes or longer. I get very short of breath, dizzy and have chest pain. I feel like I’m having a heart attack.

My ankles swell, and I have pitting edema. I have never done drugs or alcohol. I have been 100 pounds overweight for about 10 years. I have had nuclear stress tests, which are normal. All lab work is normal. I was born with a heart murmur and have had three echocardiograms, which show mild regurgitation. I don’t take any prescription drugs. I don’t understand why this is happening to me. – A.

ANSWER:
You’ve got to get the heart matter settled to your satisfaction, or it will drive you up a tree. Forty-three is young for a woman to have heart disease.

Your heart murmurs are not the cause of your symptoms, since three echocardiograms have shown only slight regurgitation. That’s a leak, and it’s not a significant leak.

PVCs – premature ventricular contractions – are extra heartbeats that almost never indicate serious heart disease. If you haven’t worn a Holter monitor – a device that records all heartbeats for one, two or three days – you should. It will tell how many PVCs you’re having and what’s going on with your heart when you eat food or drink water.

A nuclear stress test is the ultimate in stress tests. Not only does a person exercise on a treadmill while a continuous EGK runs but, at the end of the test, a radioisotope is injected that delineates any part of the heart not getting a sufficient blood supply.

The anxiety and frustration you experience from not knowing the exact cause of your symptoms is taking a greater physical toll on you than the condition itself, if there is a condition. If you haven’t seen a cardiologist, do so. If you have, get the opinion of a second cardiologist.

I can’t explain the ankle swelling and leg edema (swelling). It needs an explanation.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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