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What are the possible causes of my PACs and PVCs?

I am 35 yr old female with recent heart palpitations. I have never had any heart issues, went to the ER and was told having a lot of PAC's and PVC's. [Premature Atrial Contractions, Premature Ventricular Contractions] Heart rate varies from 35-190 resting.  They gave me Lopressor and told to f/u with EP MD. I have appointment coming up in a few weeks but I have been wearing a monitor for a few weeks. My question is what could be the possibilities that are causing this? My HR increases greater than 30 beats upon standing, I have dizziness, chest discomfort, SOB, I get very shaky, some nausea, GI upset, and extreme fatigue. I appreciate any input. Thanks!  

submitted by Dawn from Charleston, West Virginia on 3/14/2012


Mohammad Saeed, MDby Texas Heart Institute cardiologist, Mohammad Saeed, MD    

There are many possibilities. Some of them include:
A) Diseases of heart have to be ruled out, e.g. problems with heart muscle or heart valves are a common cause of both PAC's and PVC's.
B) Systemic causes (not related to heart) have to be considered also, e.g. anemia, thyroid overactivity.
C) Autonomic and neuro-cardiogenic causes can also have same manifestation, e.g. increase in heart rate with standing because of drop in BP.
D) Isolated electrical problem of the heart can sometimes present similarly. Usually a diagnosis of exclusion.

If heart disease is ruled out then most of the other causes are usually benign and carry an excellent prognosis. Treatment will obviously vary depending upon the exact etiology.     

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Updated March 2012
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