Case: 71 year old male swimmer.
Reason for visit: Physical exam revealed premature heart contractions during an annual exam.
What is a premature contraction?
A premature contration is an early heart beat that disrupts the heart's rhythm. It is commonly described as a your heart "skipping a beat" but that doesn't actually happen. Instead, an extra beat comes sooner than normal with a delayed next beat that is stronger. There are two types of premature contractions. Premature atrial contractions (PACs) start in the upper chambers of the heart (atria) and premature ventricular contractions (PVCs) start in the lower chambers of the heart (ventricles).
What causes premature contractions?
Most of the time there is no identifiable cause. Rarely premature contractions can be caused by intense exercise or cardiomyopathy.
How are premature contractions diagnosed?
Premature contractions are difficult to diagnose because they occur sporadically and are unpredictable. Usually they will be found incidentally on an EKG during a routine exam.
What are the risks associated with premature contractions?
Most are benign. If the they are frequent they could potentially increase the risk of developing more serious cardiac arrhythmias. You should consult your doctor if you have heart disease and are experiencing frequent or prolonged premature contractions.
Should I stop exercising?
Premature contractions that mostly occur at times of rest and suppress with exercise are usually benign. Premature contractions that worsen with exercise may be indicative of a heart under stress, say from a partial blockage of an artery or something else. A heart doctor should evaluate arrhythmia that gets worse with exercise. Premature contractions in athletes could indicate that they are training too hard.
Treatment of premature contractions
People having premature contractions with no underlying heart disease and no other symptoms do not need treatment. Decreasing caffeine, tobacco, and alcohol will reduce the frequency of the premature contractions. Stress and anxiety play a role as well.
Patients with a history of heart failure or heart attack may be prescribed a beta blocker. Patients with heart disease and increased premature contractions during exercise, angioplasty or bypass surgery may be appropriate.
Do not hesitate to contact Scottsdale Sports Medicine Institute to schedule an appointment with Dr David Carfagno.
Dr. David Carfagno is a Board Certified Internist and Sports Physician, who trained at the Cleveland Clinic Foundation
American Heart Association. "Premature Contractions." Retrieved on March 1, 2011, from AHA website