Skipped heartbeats are very common
Dear Dr. Donohue: I am writing in hopes that you can give me some information on skipped heartbeats. I have been bothered by them for some years. The doctor gave me an ECG and said they are premature heartbeats. They make me very anxious. What causes skipped heartbeats? — Anon.
Answer: I could paper every story of the Empire State Building with letters asking about skipped heartbeats, so common are they.
Premature beats are extra beats sandwiched between two normal heartbeats. They are of two varieties: atrial or ventricular. Atrial premature beats arise in the upper heart chambers and are as close to being insignificant as anything can come. Ventricular premature beats arise in the lower heart chambers, and people often feel a thud in their chests with a PVC — premature ventricular beat. The early beat causes a heart contraction when it is not completely filled with blood. The next normal beat is delayed a bit, and the heart is overfilled. On that contraction people feel the thud.
Close to 60 percent of normal adults have PVCs. If the heart is otherwise healthy, if the PVCs are not all that frequent and if they don’t trigger a sustained, irregular heart rhythm, then often the best treatment is to ignore them. What causes them? Caffeine, nicotine, carbonated beverages and anxiety might bring on some PVCs, but for most people, a cause is never found.
More serious heartbeat abnormalities, like atrial fibrillation, are discussed in the booklet on that topic. Readers can order a copy by writing: Dr. Donohue — No. 107W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
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Dear Dr. Donohue: My next-door neighbor and best friend was treated for pneumonia for two months with different antibiotics. Then she was put in the hospital, and I am told she has BOOP. When I first heard it, I thought it was a joke. It is not. What is it, and how is it treated? — M.A.
Answer: “BOOP” stands for bronchiolitis obliterans with organizing pneumonia. It’s a condition affecting small airways (bronchioles) and air sacs (alveoli). Its cause is unknown. The name sounds strange because it was coined quite recently — in 1985. Most people have never heard of it.
Your neighbor’s story is typical. It often takes two months of symptoms before the true diagnosis is made. People have a dry cough, are fatigued and might lose weight during the initial months. Frequently they are believed to have pneumonia and are put on antibiotics.
The diagnosis is made with a lung biopsy that displays the typical microscopic pattern of this condition. Steroids — cortisone drugs — are its treatment.