r/askCardiology

How do I know that I won’t die from them? I’m having them constant I’m scared and it feels like my heart is stopping then restarting with a flutter and I just had one where my heart rate went rapid for a few seconds and stopped I’m so scared

My 7 day ZioPatch report came back with

> Isolated PAC burden was 7.4%, atrial couplet burden was 4.4% and atrial triplet burden was 2.8%.

So is my total pac burden 7.4 + 2x4.4 + 3x2.8 = 24.6%?

I recently started tirzepatide and have noticed that my Oura cardiovascular age has gradually moved in the wrong direction over a relatively short period. My estimated PWV has gone from roughly the low 6s to 6.5 m/s, and my cardiovascular age has shifted from around 5-ish years younger than my actual age to 3.5 years younger.

I’ve also noticed that I’m eating significantly less since starting tirzepatide, and lately I haven’t felt like I’m recovering from exercise as well. Yesterday I did a late workout with running and weights after not eating very much during the day, and my heart felt like it was pounding more than usual. My resting HR also seems a little higher than my normal baseline.

I’m going to discuss this with my doctor, so I’m not looking for a diagnosis. I’m mainly curious about other people’s experiences:
Has anyone who tracks Oura PWV/CVA noticed it change after starting tirzepatide?
Did your resting HR change?
Did increasing calories, carbs, fluids/electrolytes, or adjusting exercise intensity make a difference?
If your PWV/CVA changed initially, did it eventually return toward baseline as your body adjusted?
I’m particularly interested in people who have Oura data from before and after starting tirzepatide.

i got some ekgs in the er and this showed up in both. i had one a week before at urgent care and it didn't say it on it, which is why its worrying me because of the sudden change. also because i've had shortness of breath, lightheadedness, etc. for like 3 weeks now and feel awful every day and no one wants to run any tests outside of the er or seem concerned at all. they didn't mention it to me there and i've just seen it now in my chart. my doctor doesn't seem to want to do a echo (she saw it before i did, i never got the chance to discuss it with her) and my parents are fed up with heart tests so now i'm too scared to work out or do anything athletic. should i ask to redo the ekg to see if its a fluke? i'd feel better with an echo but i don't know where to go from here

Background:

Im 32 female and athletic (can run a, 8:30mile, can do 2 pull ups, 20 pushups etc). But I dont have great diet and my life is pretty stressful. I have never smoked and I drink 1-3x a year.

Over the past 3ish years, I have began experiencing chest pain that has increased in frequency. At first it would happen 2-3x a year, and now it happens 2-3x month. Its slowly increased over the past 3 years.

I took all the steps - bloodwork normal, labs normal, treadmill stress test normal, and i just got an echocardiogram done which came back normal!

The doc doing my echocardiogram said "stress can cause chest pain" and I was like "i know I know"

-

Here is my dumb question:

When doctors say "stress can cause chest pain" does that mean:

"Its a symptom of anxiety and your heart is perfectly healthy. When you feel pain, its imaginary and you could theoretically ignore this pain for decades straight with no real problems since its imaginary pain. Just ignore the pain since its meaningless"

OR does it mean:

"your stressful lifestyle is actually damaging your heart, and eventually your heart will have physical damage from your stress. If you let this go on and ignore it, you will create lasting damage to your heart muscle. Every time you feel the pain, your heart is being damaged in a tiny way and it will add up"

Requesting more social than medical advice. I'm a new patient (36F) and wondering if there is a certain culture amongst cardiologists I should accept or if I should seek a new doctor.

I came in without symptoms to get checked out due to extensive family history of heart issues. The front desk workers were pretty nasty (more or less expected), but the cardiologist I saw was almost worse. He was really short with me and seemed annoyed when I asked basic questions or for explanations about what he was saying (for example, when he said he's ordering an echocardiogram and a calcium scoring test, I asked what those were and he said, "they're just tests to see what's going on with your heart" and stood up to leave the room). Since the initial visit, I got both tests with almost no information unless I begged for it and have gotten individual communications from multiple other medical staff members about putting me on medication and a holter and getting blood panels. I've heard nothing from my doctor and received no further information or explanation of my test results (calcium score of 3 in LAD and I guess maybe something weird in the echo?).

Is this normal treatment for preventative care (if it's even considered that with the results)? I understand I'm not coming in with something complicated or life-threatening, but I'm pretty uncomfortable, feeling like I'm being shuffled around like a piece of medical meat while workers check off boxes, paying through the nose to see a specialist and yet getting all my information from Cleveland and Mayo Clinic websites. Is this just how cardiology offices behave with what I assume is overload/burnout?

For context, the office is part of a large, highly-reputable university medical system. I consider myself to be overly polite to medical professionals and am particularly averse to questioning a professional's authority.

Thanks in advance for any insight

hi, i’m new to this sub. i’m 27f, i’ve had isolated pvcs at a very low burden for about 4-5 years (maybe longer but only became aware of them around 21y).

however, in the last year they have gotten much worse. two years ago i had a mini stroke caused by a spontaneous artery dissection in my neck. this led to genetic testing, where i found out i have (unrelated to the dissection) a VUS on my RYR2 gene. i’ve ultimately had extensive cardiac work up and they think i don’t have CPVT but i still worry a lot about my pvcs.

about a year ago, i started getting ventricular bigeminy and couplets. i’ve also had several episodes of SVT that were started by pvcs and bigeminy. i went from having 1-2 pvcs every week or so to having almost 100 every day. this started after i got sick with some sort of virus (not covid) in october of last year.

i’ve been on a beta blocker since 2024. first metoprolol and i am now on propranolol 60mg ER which has helped to eliminate my SVT episodes and greatly reduce my PVCs but im still getting them.

i can always feel my pvcs. they feel like my heart is doing flips, it always makes me cough involuntarily and i can feel it jump into my throat.

i’m worried i had vtach the other day and i didn’t capture the episode so i know there’s no way to say but im just so anxious about it.

also, id say about 90% of my pvcs are triggered by positional changes (bending over, squatting, turning over, sitting down etc) or like laughing, eating, things like that.

i was at work the other day (im a barista). i’m standing at the register talking to a customer when all of a sudden i feel a pvc. i expected it to go away but then i felt a very hollow feeling in chest almost like sinking feeling. i felt a few more pvcs back to back, maybe bigeminy but i’m worried it was vtach. i felt extremely faint and i looked pale. i excused myself to the bathroom and by the time i got there the episode was over. my ekg on my watch by that time was normal rhythm and HR of 57.

has anyone experienced this before? i’m just scared. i messaged my cardiologist and he just said to hydrate and avoid caffeine. i only ever have like half a matcha at work but i will cut that out for now.

i’m just scared that im on the verge of SCA or something and idk how to cope.

I have visible pulsations all over my body, and people can even notice them when they’re standing or talking close to me.

I’ve seen a cardiologist and had both an echocardiogram and a stress echocardiogram, and everything came back normal.

I also had a comprehensive medical check-up, and all the results were normal.

The only other symptom I have is persistent shortness of breath.

Has anyone experienced something similar? If so, were you able to find the cause or a solution?

Looking for insight: unexplained heart scarring after sudden cardiac arrest
I’m hoping someone in this community may have experienced something similar or can point us in the right direction.
My husband is in his early 40s and recently suffered a sudden cardiac arrest while exercising at the gym. He was active, energetic, not overweight, and had no idea that he had a serious heart problem before this happened.
Thankfully, he survived and now has an ICD/pacemaker for protection.
One finding from the day of his cardiac arrest that has always stood out to me is that when he arrived at the ER, his potassium was extremely low at 2.6 mmol/L. It was later corrected. We still don’t fully understand what role, if any, that severe hypokalemia may have played in triggering the cardiac arrest, especially in combination with the heart scar that was later discovered.
His cardiac workup showed no significant coronary blockage, so his doctors do not believe this was a typical heart attack.
His heart function was initially reduced after the arrest, with an ejection fraction around 35–40%, and it subsequently improved to approximately 45%.
The finding that concerns me most is his cardiac MRI, which showed scarring/fibrosis involving the lower portion of his heart with what was described to us as a ring-like pattern. We were told that this scar could have created the electrical instability that led to his cardiac arrest.
The big question we still have is: Why does a relatively young, active person have this type of heart scar in the first place?
Genetic cardiomyopathy was considered, but his genetic testing came back negative. At this point, we still do not have a clear explanation for how the scar developed.
We have essentially been told to continue his heart medications, allow the ICD to monitor/protect him, repeat imaging over time, and see whether the scarring progresses.
I completely understand the importance of monitoring, but after surviving a sudden cardiac arrest, I’m not comfortable simply waiting without trying harder to understand the underlying cause.
I would love to hear from anyone who has dealt with a similar combination:
Sudden cardiac arrest during exercise
Potassium of 2.6 mmol/L at presentation
No significant coronary blockage
Cardiac MRI showing a ring-like/circumferential pattern of myocardial scarring
Reduced EF that subsequently improved
Negative genetic cardiomyopathy testing
No definite explanation for the myocardial fibrosis/scarring
Were you eventually given a diagnosis?
Did your doctors investigate previous myocarditis, cardiac sarcoidosis or another inflammatory condition, arrhythmogenic cardiomyopathy, autoimmune disease, previous viral infection, or other causes of nonischemic myocardial scarring? At first they thought it may have been covid vaccine, an internal virus.

I’m particularly interested in whether anyone was evaluated with additional testing such as a cardiac FDG-PET scan, repeat cardiac MRI, inflammatory/autoimmune testing, more extensive genetic testing, or evaluation by a cardiomyopathy specialist/electrophysiologist.
And for anyone knowledgeable about this area: Could potassium as low as 2.6 have been an important trigger for the cardiac arrest in someone who already had myocardial scarring, even if the low potassium itself didn’t cause the scar?
We are pursuing another medical opinion. I’m not looking for an internet diagnosis—I’m trying to educate myself so we can advocate for a thorough evaluation and make sure we’re not overlooking something important.
If you’ve experienced anything similar, or you’re a medical professional familiar with this type of cardiac MRI/scar pattern, I would be extremely grateful for any insight about what questions we should be asking and what type of specialist we should consider seeing next.

Thank you!!!

Hi!
So this happened to me today. I was outside working out and my heartrate goes pretty high during workouts like 180+. I had to drop everything and run back in because my baby woke up and I grabbed him out of bed and jumped around with him. I then sat him back down and was out of breath checking my watch and it showed pretty high so I tried to just relax. It went down to 130 but stayed around there and started getting really anxious (I’m getting evaluated for SVT and was thinking I was having an episode) So I tried bearing down etc but didn’t change my puls. I layed down and it was justb staying arund 130. So I went to take a shower and it spiked it to 170. That’s when I packed up and had my husband drive me to the ER. I was in the car and it went back down to around 90 and when I got out of the car and walked inside it went back up to 165. Their ekg that was taken around 5 minutes after that was at 111 showing steady “normal” rythm. It kept going betwen 90 and 130 during triage and blood pressure was fine too. They ran all kind of labs and all labs look good too. So they don’t really have an explanation.
What do you think?
F 29, 9 months postpartum, 170cm and 65kg, struggling either anxiety especially heart related things.
The first episode I had that brought up svt was that I was at the park, I went to the bathroom, came back, drank water and had an extremely painful swollow sensation, stood up and held my 23 pound baby, then I felt some weird heart stumbling and then my heartrate went up to 180/200. I then layed down and it came back down into the 100 to 140 range for 30 minutes but stayed around 100 to 120 for a couple of hours. I also was extremely anxious during that time. I have ecg (apple watch) from both episodes.

Wanna add that my heartrate has always been very sensite but even worse after having a baby. I pick him up from floor and set him down again and stand up straigt: 149, I push stroller up a slight hill:170.

Also had a clean echo a week ago and had a clean sport test in 2024 that just showed that my heartrate goes high.

Hi all, going to do my best to keep this brief. I was wondering if anybody could help me understand my SVT/atrial tachychardia history... trying to avoid a Dr. Google moment, lol.

For context - healthy 28F, some minor health conditions but none life-threatening. Since I was a teenager I've had heart palpitations and a generally elevated heart rate - sent me to the ER a few times. When I was in my early 20s that my primary care recommended I wear a monitor for a few days, and finally, the palpitations were caught. At the time, my cardiologist explained them as "extra beats primarily coming from the atrial chamber, with a few coming from the ventricular chamber". And she said I had something called atrial tachycardia. I was put on metoprolol 25MG ER and have been taking it daily for a year, with decent results at keeping my heartrate lower and minimizing the palpitations. I still have some - maybe a couple skipped beats a week, and 5-10 minute "runs" once every 6 weeks or so.

A few weeks back I went to get cardio clearance for a shoulder surgery, and since my cardio is out of office for a bit, I saw a colleague who was filling in. He read my chart and had no concerns, but said we should do the heart monitor + stress test to be safe (I do these annually at my cardiologist's recommendation). He told me to tell my surgeon that he should expect the clearance to come thru.

I saw a different cardio the following week for my stress test + monitor results, and he said everything came back clear (a few palpitations on the monitor but no SVT). However, he looked thru my chart and said that he saw a history of SVT in other monitors we've done, and that because of this, we need to move my surgery out of the surgical center and to a hospital with telemetry and access to the ICU, if something goes wrong. Unfortunately we had to cancel my surgery (a week before, a little frustrating) and its being rescheduled so it can be done in a hospital.

My question - why didn't the first cardiologist I see, who had access to my chart, make this same recommendation? I had no idea I had a history of SVT - is this something that requires specialized treatment? Was this recent cardiologist I saw just being overly cautious?

Thank you guys, any advice would be appreciated!

Hey everyone,
I was hoping someone could possibly put my mind at ease. I have been struggling with PACs and PVCs for close to a decade now. I will have really good stretches where i have very few, and then I’ll have a horrible flare where i get them every few beats for hours.

Recently I have been noticing more sensations of ectopics that run together. Last night I laid down and felt a strong THUD, THUD, THUD, THUD, THUD. And then back to normal. It doesn’t exactly feel faster, but feels much more forceful and worrisome. I worry about NSVT although I’ve never been diagnosed with that. I have rare episodes when on a monitor which is very frustrating, so my issues never fully get caught when I’m in a flare.

I have had 3 echos, and at least 5 monitors, probably closer to 6. And all is “normal”. I was a college athlete for hockey and track and never had these issues until after I graduated. I’m assuming the stress of adult life.

I worry daily that I’m just going to drop dead (but I had two friends die at early ages from heart attacks due to underlying conditions).

I am going to therapy, but I just want reassurance that the likelihood of something being terminally wrong with me is small.

I feel like my cardio dismisses me a bit.

32F, active, technically overweight. 11m Postpartum. On lexapro to help (initially helped SO much, not as much now). My dad has Afib and has been in a fib for years. He’s obese and an alcoholic so I don’t think that’s a good family history indicator. I have never been diagnosed with a fib.

Is it really likely that I’m okay? Why do they come and go so suddenly? Are these strings of ectopics harmful?

Hi. Just ranting.

I’ve been waiting WEEKS for this appointment. It was supposed to be tomorrow, but I just got a call saying state insurance denied my stress echo so they have to cancel my appointment, but they’re going to continue working with the doctor who ordered it so we can hopefully reschedule. I’m so angry and sad. I really needed this, especially for peace of mind.

Has anyone ever had something like this denied? Did your doctor do something different to get it approved? How long did it take?

I have other symptoms such as shortness of breath and get feet/ ankles/ and sometimex whole leg swelling.