DEAR DR. ROACH: I went to a walk-in clinic because I had chest pain. They did an EKG and saw extra beats (PVCs). They recommended I go to a cardiologist, and he put me on a heart monitor, which showed that I had 5,000 extra beats within 24 hours. He had me come back in two weeks and did an echocardiogram (heart muscles are perfect) and heart monitor (still extra beats). He did a stress test, and it was normal. He has no idea why I have extra beats.
I have a feeling they have been going on for a long period of time, because when the nurse asked me if I could feel them while she was doing the echo, it felt like a flutter, and I had been feeling them for at least a year (I didn’t know what it was). He has me coming back to see him in three months. Can you give me some insight? — D.J.
ANSWER: Premature beats are very common, almost universal, and come in two types: premature atrial beats (PACs) and premature ventricular beats (PVCs). These can happen in people with perfectly normal hearts, but your cardiologist did exactly the recommended tests, including an EKG, echocardiogram and stress test. This is to be sure your heart function and blood flow are normal. Since they are, you don’t need to do anything about it unless the fluttering sensation is bothering you.
There are several mechanisms for PVCs. The electrical system of the heart can develop a kind of shortcircuit, called a re- entry loop, which is the most common cause. Individual heart muscle cells also can trigger a premature beat.
If you desire treatment, the usual treatment is a beta blocker, which can reduce symptoms. Other medications also are used. In cases where medications don’t work, radio waves can be used to stop the areas of the heart where the extra beats arise.
The booklet on abnormal heart rhythms explains atrial fibrillation and the more common heart-rhythm disturbances in greater detail. Readers can obtain a copy by writing: Dr. Roach — No. 107W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: About two years ago, I had terrible pain on the top part of the left side of my head. It also felt very warm. I went to my doctor, who diagnosed it as shingles and treated me with gabapentin. I can’t recall how long I took the pills, but eventually he told me to wean myself off of them.
My question is: Did I really have shingles? I had the pain, but no sores or blisters. — T.K.
ANSWER: There is a condition called zoster sine herpete, which means “zoster without the blisters.” I have seen cases where the pain precedes the blisters by months — once by 18 months — but I haven’t personally seen a case where the blisters never show. Still, given your history, I think there’s a very good chance that your doctor was right.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med. cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475.
©2015 North America Synd.