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Treatment of bad anxiety attacks and PVC'S.

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I am 42 year old female and started having bad anxiety attacks starting two years ago stemming from getting pvc’s. I am on 50 mg. zoloft and 3.25 mg bisoprolol. Under stress, i get pvc’s and short of breath all the time. When i feel a pvc, sometimes it is very bad and i get very dizzy and short of breath. My cardiologist told me not to worry and that they were benign but i can’t stop worrying. I am afraid that stressing over these is making my heart worse and will eventually make me have heart disease. I try to excercise but am afraid i will get pvc’s. I try not to stress but i can’t help it. I am at the end of my rope and don’t know how to get better. Help.

Category: Cardiologist

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Category: Cardiologist
 18 Doctors Online

Hello. Thank you for your query at
I understand that you have anxiety on account of multiple ectopics. Your cardiologist has labelled them as benign, which is a good thing.

I wish to ask you whether you have undergone a 24 Holter examination, a 2D ECHO test and a Stress test. If yes, what were the results?

This information will help me understand the problem better. Kindly provide me with the same.
Regards, Dr Vivek Mahajan, DM Cardiology.

Patient replied :

I have had a couple holter monitors and an event monitor. They all showed pvc's and pac's and nothing else to worry about. I have had a few echocardiograms that showed slight mitral valve prolapse but that was it, otherwise good. I have had blood work (thyroid, cbc, anemia,minerals, etc.)-all ok. I had a stress test three years ago- that was ok. The palpitations ate different now sometimes. I will get a PVC, then my heart will beat pretty fast for a minute (130 beats per min.)or so.

If your echo and stress test were previously normal then the pvcs and pacs carry benign prognosis. If you feel that it is a new problem which wasn't there previously when you underwent those tests then you could get another echo and holter examination and if echo is normal and holter again shows only pvcs then we can be relaxed about it. It is probably more of anxiety and you could seek medical help for it
Dr Vivek Mahajan

Patient replied :

I am on Zoloft for anxiety but maybe its not working anymore. Do you think its worth me trying another beta blocker? Also, will all of this harm my heart or increase my chances of having heart disease when I am older? Is being on beta blockers for a prolonged period of time bad for me? Thanks.

Maybe your anti-anxiety drugs are not sufficient and you need more. As far as beta blockers are concerned, whether they are working can be ascertained from your heart rate. If your heart rate during rest is around 60 to 70 per min then they are doing well. If that heart rate is not achieved, you need to increase the dose.
Beta blockers in the long run do not harm the heart. They are good for patients with coronary artery disease and heart failure.
For a person without these diseases, like you, they are unlikely to cause any harm and may be beneficial.

Regards, Dr Vivek Mahajan, MD Medicine, DM Cardiology.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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