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Old 11-12-2005, 12:37 AM   #1
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Post How to distinguish between SVT, PAC, and PVC

Yet another tachy thread

It seems that alot of people get rapid heartbeats, fluttering in the chest, skipped beats, ect. My question is, how do you distinguish between SVT, PACs, and PVCs?

My thoery is that PACs and PVCs are smaller, extra beats that do not occur during every second of an episode (I.E. you will get an extrea beat every few seconds, or no?), while with SVT (and VT), you get a sudden onset of a rapid heartbeat that is consistant until it goes away; however, I am not sure about the symtoms of these. Also, as far as I know, its hard to distinguish SVT from VT (until you begin to faint), and likewise with PACs and PVCs.

Can some knowledgeable individual please explain in detail the exact symtoms of PACs, PVCs, SVT, and VT? I.E. how hard does the heart beat during an episode of X, how rapidly does it beat, do you have a pulse, ect.
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Old 11-12-2005, 03:19 AM   #2
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Re: How to distinguish between SVT, PAC, and PVC

I don't know about PAC's and SVT, but where PVC's are concerned... It differs. Some people get the skipped beats every single heart beat, some just every few heart beats. As for the heart rate: with some it stays the same, with others it speeds up.

I'll give you my example. I usually get my PVC's in runs: extrasystolic beat - normal beat - extrasystolic beat - normal beat etc. My normal heart rate slows down, but I get the extrasystolic ones in between. Instead of having a heart rate of around 80 per minute, I'll have normal beats less than 1 per second, and extrasystolic ones in between. When taking my pulse I feel the normal beats, but I only feel the extrasystolic beats in my chest. So my pulse feels slower than usual.

But I'm sure this is different to others...

 
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Old 11-12-2005, 04:00 PM   #3
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Re: How to distinguish between SVT, PAC, and PVC

PVCs are among the most common ventricular dysrhythmias. They can be found in young healthy persons or in diseased hearts. It is a premature beat (in the ventricle) that occurs earlier than the next expected beat. Worrisome PVCs include the following: 1) more than 6 per minute. 2) PVCs that occur in bigeminy (every second beat), trigeminy (every third beat), or quadrigeminy (every fouth beat). 3) 2 PVCs in a row (couplets) 4) 3 (or more) PVCs in a row (ventricular tachycardia). 5) Multifocal PVCs (on an ECG, these are PVCs that look different from each other, which means that they originate from different places in the ventricles).
Causes of PVCs include: exercise, stress, caffeine, hypoxia (lack of O2), anxiety, alcohol, tobacco, electrolyte imbalance, certain drugs, heart attack, and congestive heart failure.

A PAC is a premature beat (in the atria) that also occurs earlier than the next expected beat. Causes include: caffeine, alcohol, stress, hypoxia, pulmonary disease, and heart disease. They can also occur in healthy individuals (like myself ).

Now, SVT on the other hand is a completely different story. Supraventricular tachycardia broken down - supraventricular (above the ventricles, in the atria), tachycardia (elevated heart rate). Heart rate associated with SVT can be anywhere from 150-250 beats per minute. Because the heart is beating so fast, it does not have adequate time to fill and empty completely. This causes a decrease in the amount of circulating blood in the body which can cause lightheadedness, dizziness, nausea, sweating, fainting, chest pain, low blood pressure, shortness of breath, etc.

VT (ventricular tachycardia) originates from the venticles. The heart rate for VT is 101-250 beats per minute. V-tach occurs when there is a run of three or more PVCs in a row and a rate of more than 101 beats per minute. V-tach may be short, lasting less than 30 seconds or it may be sustained, lasting up to several hours. It may or may not occur with a pulse, the person may or may not be conscious, or the person may be stable with normal vital signs or unstable with low blood pressure or no vital signs. It is usually caused by myocardial (heart) irritability, electrolyte imbalance, coronary artery disease, mitral valve prolapse, rheumatic heart disease, and pulmonary embolism.

From a medical standpoint, PACs (usually) don't concern me and PVCs only concern me in patients known to have heart disease or if there are many. The heart rate in patients having PACs and PVCs is normal unless there is an underlying problem with the heart. SVT and V-tach are always concerning to me. To tell the difference , you only need to check your pulse. If your heart is beating so quickly that it's difficult or impossible to count, then that's a problem. If you're feeling lightheaded, dizzy, or nauseous, then that's also a problem.

 
Old 11-12-2005, 10:27 PM   #4
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Re: How to distinguish between SVT, PAC, and PVC

Thanks for your reply. But I would like to further elaborate on this, if its not too much to ask, because I am always hearing of PACs, PVCs, and SVT and I still do not know which one I have, dispite my attempt to carfully evaluate things written on this board.

Timber, in a previus post, wrote
Quote:
Originally Posted by timber
Do a search on this board for PVCs (which is the name for the fluttering/skipping feeling you are having)
By definition, "flutter" is to "move along rapidly and lightly". This exactly what I feel (the heartbeats are lighter than normal, but extreamly rapid). This rapid heartbeat has occured for over an hour with me, so according to what you wrote

Quote:
Originally Posted by Sassafrass627
V-tach occurs when there is a run of three or more PVCs in a row and a rate of more than 101 beats per minute
Then I must have V-tach, as I must have had thousands of PVCs, or heart "flutters" in a row... However, this must not be true because I have never died (...lol), nor have I ever felt light-headed, even in episodes lasting over an hour.

I really do not know what to think. So, lets say that all of the sudden, my heart starts beating lightly and rapidly (must have been atleast 200 bpm), and this lasts for about an hour. My heartrate (by feeling my chest) was so fast that I couldn't count them. I did NOT bother to check my pulse (ill do that next time). I did NOT feel lightheaded. Several other episodes happend, and stoped once I stopped drinking coffee (except for a 2 second episode...), soon thereafter I started taking hawthorn. An episode in my case would be defined as comming and going quickly, lasting for anywhere from a few seconds to an hour, and occuring every other month. Would that most likely be SVT, VT, PACs, and / or PVC?

Edit :: Whatever it is, it evidently takes place in the Atrium, or else I would be dead. hmn, it sounds like I have atrial fibrillation right?...If so, I heard that atrial fibrillation can cause strokes.

Thanks in advanced
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Last edited by eNathan; 11-13-2005 at 01:01 AM. Reason: spelling

 
Old 11-12-2005, 11:20 PM   #5
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Re: How to distinguish between SVT, PAC, and PVC

i have pvc's which my cardio and 2 docs told me not to worry bout, Tho i do have around 10-15k aday which sometimes come every other, second third beat and even every 20-30 beats sometimes, still they say, no worries. Now bout that lack of h2o i have nasal problems, im ALWAYS stuffy, one nosteral or the other, could that be the cause of my increase of pvc's? cause iv had them for about 3-4 years now. but back to the subject, if you had "thousands" of pvc's in a row, id think you would not be posting in the forums.

Last edited by yugokid; 11-12-2005 at 11:22 PM.

 
Old 11-13-2005, 03:54 AM   #6
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Re: How to distinguish between SVT, PAC, and PVC

Quote:
Originally Posted by Sassafrass627
Worrisome PVCs include the following: 1) more than 6 per minute. 2) PVCs that occur in bigeminy (every second beat), trigeminy (every third beat), or quadrigeminy (every fouth beat). 3) 2 PVCs in a row (couplets) 4) 3 (or more) PVCs in a row (ventricular tachycardia). 5) Multifocal PVCs (on an ECG, these are PVCs that look different from each other, which means that they originate from different places in the ventricles).
Why are these worrysome? (except for 4), that I can understand)
When I get PVC's, I get them like: normal beat - extrasystolic beat - normal - beat - extrasystolic beat - normal beat - ... Is this bigeminy or couplets?
Also, when I have them, it's usually more than 6 per minute.
How could this be worrysome?

 
Old 11-13-2005, 01:39 PM   #7
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Re: How to distinguish between SVT, PAC, and PVC

its not in a normal heart besides the pvc's, tho if you have around 20k pvc's in a day, of a long period of years it could cause a weak heart, thats why you need surgery

 
Old 11-13-2005, 02:18 PM   #8
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Re: How to distinguish between SVT, PAC, and PVC

In simple terms, PACs and PVCs are extra or skipped beats whereas SVT is a sustained, extremely fast heartrate.

PACs and PVCs feel nothing like SVT, to me. When I have a PVC or a PAC, they feel like one or two messed up heartbeats, like either a hard pounding feeling or a quick flutter, and they're over quickly, but when I'm in SVT my heart is completely out of control for long periods of time.

I think EKGs probably are the best (and certain) way to distinguish between PACs/PVCs and SVT/VT.

 
Old 11-13-2005, 02:39 PM   #9
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Re: How to distinguish between SVT, PAC, and PVC

Quote:
Originally Posted by Timber
In simple terms, PACs and PVCs are extra or skipped beats whereas SVT is a sustained, extremely fast heartrate.

PACs and PVCs feel nothing like SVT, to me. When I have a PVC or a PAC, they feel like one or two messed up heartbeats, like either a hard pounding feeling or a quick flutter, and they're over quickly, but when I'm in SVT my heart is completely out of control for long periods of time.

I think EKGs probably are the best (and certain) way to distinguish between PACs/PVCs and SVT/VT.
Thanks for the clarificatoin. What about distinguishgin SVT/VT from Atrial Flutter? Atrial flutter, as far as I know, is 4 (or so..) extra, small, premature beats which take place in the atrium, and come in long episodes as with SVT. hmn...perhaps with SVT, you have rapid "regular" beats, but with Atrial Flutter, you have rapid "light" beats?

Any enlightenment
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Old 11-13-2005, 03:31 PM   #10
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Re: How to distinguish between SVT, PAC, and PVC

Quote:
Originally Posted by eNathan
Thanks for the clarificatoin. What about distinguishgin SVT/VT from Atrial Flutter? Atrial flutter, as far as I know, is 4 (or so..) extra, small, premature beats which take place in the atrium, and come in long episodes as with SVT. hmn...perhaps with SVT, you have rapid "regular" beats, but with Atrial Flutter, you have rapid "light" beats?

Any enlightenment
First of all, SVT and V-tach are 2 completely different dysrhythmias. SVT originates in the upper (atria) portion of the heart while V-tach occurs in the lower (ventricle) portion. Throw in A-fib and A-flutter and you're going to drive yourself crazy trying to "distinguish" between the 4 when it's impossible to do so WITHOUT AN EKG.

You cannot differentiate between any of these based simply on what the "flutter" or missed beat feels like. A missed heartbeat feels like a missed heartbeat whether it's a PVC or a PAC. Heck, there's even a PJC. But they all feel the same. The only way to tell any of these apart is through an EKG.

Your Cardiologist is the best person to answer these questions and alleviate your fears. This board appears great in that it allows people to share personal experiences and provide support, but it is not a substitute for your doctor. Good luck to you!

 
Old 11-13-2005, 03:45 PM   #11
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Re: How to distinguish between SVT, PAC, and PVC

hehe well I guess I am just going to go without knowing whats wrong with me, as I cannot see a Cardiologist or a Doctor. By the way, I still do believe its posible to distinguish different dysrhythmias based upon evidence, but thats just a theory.

Thanks for the help.
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Old 11-14-2005, 12:41 AM   #12
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Re: How to distinguish between SVT, PAC, and PVC

Hi, I'm new to this board. I don't know do I've PAC or PVC but I've Atrial Tachy, A-Fib and it increases my Ventricle rate. Dr also has given me a "WPW sydrome" as a present when I was 15!!!

Talk in the post or thread is free. When you talk to a cardio or Dr, it was timed and has to pay $$$$. If you're saying one word wrong, it can be end up: small is a test; big one could be on the operating table.

I wish I can help you. Honoursly, I wish to know how PAC and PVC beat like? I think I've it but no Dr mentions to me.

Pika.

Last edited by Pika; 11-14-2005 at 12:47 AM.

 
Old 11-16-2005, 12:11 AM   #13
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Re: How to distinguish between SVT, PAC, and PVC

Quote:
Originally Posted by Pika
Hi, I'm new to this board. I don't know do I've PAC or PVC but I've Atrial Tachy, A-Fib and it increases my Ventricle rate. Dr also has given me a "WPW sydrome" as a present when I was 15!!!

Talk in the post or thread is free. When you talk to a cardio or Dr, it was timed and has to pay $$$$. If you're saying one word wrong, it can be end up: small is a test; big one could be on the operating table.

I wish I can help you. Honoursly, I wish to know how PAC and PVC beat like? I think I've it but no Dr mentions to me.

Pika.
If I were you, I would ask your doctor every question you could imagine. Imagination is the key..the only dumb question is the one you dont ask
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Last edited by eNathan; 11-16-2005 at 12:13 AM.

 
Old 11-16-2005, 08:29 PM   #14
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Re: How to distinguish between SVT, PAC, and PVC

This interests me since during my "episodes" if that's what you want to call them , my heart skips every third beat and it can last up to several hours. My fingertips and toes get tingly, I get short of breath and dizzy and I have a pressure/pulling feeling on my left chest into my armpit. At times I'll skip every other beat but that's not as usual. I get flutter feelings at times also.

I've found that lying on my side increases them...anyone know a good reason why that would be? I started avoiding cough/cold meds (took them as sleep aids), caffeine and sugar since I noticed it makes them worse. They improve with exercise but are worse the day after strenuous activity.

I'm still awaiting the results of my Holter monitoring. EKG looked good and an ECHO I had done last year was normal (had it done due to a neurological condition that predisposed me to having congenital heart disease).

I do not feel anxious when I get them although they're annoying and have prevented me from getting to sleep.

Sassafrass, you stated the following:
Quote:
Worrisome PVCs include the following: 1) more than 6 per minute. 2) PVCs that occur in bigeminy (every second beat), trigeminy (every third beat), or quadrigeminy (every fouth beat).
What is it exactly about these that are "worrisome"?

I don't mean to hijack the thread but I didn't want to start another thread mentioning the same thing . Thanks for letting me step in a little!

Love and Prayers, Kelly

 
Old 11-16-2005, 10:43 PM   #15
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Re: How to distinguish between SVT, PAC, and PVC

Worrisome PVCs include the following: 1) more than 6 per minute. 2) PVCs that occur in bigeminy (every second beat), trigeminy (every third beat), or quadrigeminy (every fouth beat).

What is it exactly about these that are "worrisome"?

I hope I explain this right and if anybody reading this has anything to add or corrections to make, have at it!

A random PVC or PAC is no cause for concern as a lot of people have them and the cause is usually associated with stress, caffeine, alcohol, nicotine, etc. When someone begins to experience a more "regular" irregular heartbeat (i.e. every second, third, or fourth beat) then that tells me that the focal point in the heart that's causing these extra beats is becoming more irritated than usual or that there's a specific irritant causing it. I should have clarified that it's only worrisome or concerning to me when I see this in older patients or ones that have a relatively serious history of heart disease. It can be a precursor to other problems for these people. A lot of times, simply placing these patients on oxygen drastically reduces the number of PVCs. I have ECG strips of mine that show me throwing bigeminal and trigeminal PACs, but I'm young and healthy so it's of no concern to me (mainly just really annoying! lol). Anyway, I hope this helps explain what I meant by worrisome. If not, just let me know and I'll dig out my books and do some more research for ya!

 
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