Brief Answer:
Serial answers
Detailed Answer:
Dear XXXXXXX
Thanks for your query. In my experience, when young, smart, inquisitive patients like yourself "dive" into the Internet to explore symptoms and relate to a diagnosis, it leads to more
stress,
anxiety and confusion than is necessary most of the time.
Let me address the specific questions:
1) Most of the fluttering sensations that patients experience are related to PAC's or PVCs which in a young person like yourself should be totally benign. Rarely, they are related to
atrial flutter, since this is a persistent
arrhythmia.
2) Stress certainly increases the number of PAC's and PVC's through stimulation by the sympathetic nervous system
3) PVC's can be more XXXXXXX than PAC's in very sick heart patients, since they can trigger
ventricular fibrillation or
tachycardia, but again, if we line up 100 people to get Holters, more than 95 of them will have PAC's and PVC's that are inconsequential.
4) If a Holter monitoring was inconclusive in terms of the origin of the fluttering sensations, or if there is question about an arrhythmia that was not "catched", then an event monitor is the next step, it can be worn for up to 4 weeks.
Hope this was helpful, best regards.
Dr Brenes-Salazar MD
Mayo Clinic MN
Cardiology
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