"Healthy Heart" Murmur?

My Cardiologist has diagnosed me with having a murmur, which he calls a
"healthy heart" murmur. He said it is normal in some people and nothing
to be concerned about. I went to see him regarding skipped beats, forceful beats,
and sometimes a racing heart rate. I’ve had a echo, which was normal, a stress
treadmill, also normal, and wore a King of Hearts monitor for 4 weeks. I recorded
numerous episodes of skipped beats for the Cardiologist to look over.
My final diagnosis was a "healthy heart" murmur, skipped and premature beats, and
occasional PSVT, paroxymal superventicular tachycardia.
All of which my cardiologist said there is nothing to be concerned about, just
cut out caffeine and keep exercising, both of which I’ve done several weeks before
the last office visit.

Basically I’m alittle concerned over this murmur, because I can find no reference
to a "healthy heart" murmur. The only thing I could find is an innocent murmur, which
is common among infants. All the info I’ve read about murmurs is that they are not good.
So do I have reason for concern?

As far as my other conditions are concerned, the skipped or premature beats, occur
about 2-5 times a week, lasting no more than 1-5 seconds. The PSVT has occurred 4 times
since February, lasting about 5-30 minutes with a usual heart rate of between 140-190BPM,
depending on the level of anxiety that occurs with it. I also have episodes of normal
and steady, but very forceful heart beats that radiates into the neck, lasting about 30 minutes.
My cardiologist made no comment to this, but the info I’ve gathered calls this a
"bounding(not pounding)heart beat, which is usually caused by excess fluids in the bloodstream.
Can drinking 5-8 glasses of water a day cause this?

Any feedback to the above would be greatly appreciated.

8 Responses to “"Healthy Heart" Murmur?”

  1. admin says:

    On 15 Aug 1996 20:16:56 -0700, ticker wrote:

    >Basically I’m alittle concerned over this murmur, because I can find no reference
    >to a "healthy heart" murmur. The only thing I could find is an innocent murmur, which
    >is common among infants. All the info I’ve read about murmurs is that they are not good.
    >So do I have reason for concern?

    Heart murmurs as a rule are not good, as you say.  However, there is
    something called a "flow murmur" which is probably what your doctor is
    referring to in your case.  This is not a true murmur in that it isn’t
    caused by structural heart disease — valvular problems or holes in
    the heart, for instance.  Basically, it is the same sound as is heard
    in aortic sclerosis (or mild aortic stenosis) — a diamond-shaped or
    decrescendo systolic murmur in the aortic listening area.  On echo,
    there is no evidence of either aortic stenosis or sclerosis.  The
    source of the murmur is thought to be the turbulence created by the
    forceful ejection of blood through the aortic valve into the aortic
    root.  Since it is not associated with any cardiac pathology, it is
    not cause for concern.

    >As far as my other conditions are concerned, the skipped or premature beats, occur
    >about 2-5 times a week, lasting no more than 1-5 seconds. The PSVT has occurred 4 times
    >since February, lasting about 5-30 minutes with a usual heart rate of between 140-190BPM,
    >depending on the level of anxiety that occurs with it. I also have episodes of normal
    >and steady, but very forceful heart beats that radiates into the neck, lasting about 30 minutes.

    The initial approach to PSVT is indeed laying off stimulants such as
    caffeine and nicotine.  Beta blockers are often used if the PSVT
    continues to be bothersome.  If the PSVT is extremely frequent or
    symptomatic, radio-frequency catheter ablation (a cath lab procedure)
    is sometimes used to eliminate the source of the SVT.

    >My cardiologist made no comment to this, but the info I’ve gathered calls this a
    >"bounding(not pounding)heart beat, which is usually caused by excess fluids in the bloodstream.
    >Can drinking 5-8 glasses of water a day cause this?

    Nope.  Your kidneys will get rid of any excess water quite quickly.
    The sensation of a pounding heart beat is usually either due to
    bigeminy (PVCs alternating with normal heart beats) or nothing that
    can be seen on Holter monitoring.  Since bigeminy (or trigeminy or
    whatever) isn’t ominous, it’s usually best to try to ignore it.  :-)

    – Chris

    >Any feedback to the above would be greatly appreciated.

    ____________________________________________________________

     Chris Klugewicz
     Fellow, Div. of Cardiology
     University of Maryland               email: c…@chesbay.com
    ____________________________________________________________

  2. admin says:

    ticker wrote:
    >My Cardiologist has diagnosed me with having a murmur, which he calls a
    >"healthy heart" murmur. He said it is normal in some people and nothing
    >to be concerned about. I went to see him regarding skipped beats, forceful beats,
    >and sometimes a racing heart rate. I’ve had a echo, which was normal, a stress
    >treadmill, also normal, and wore a King of Hearts monitor for 4 weeks. I recorded
    >numerous episodes of skipped beats for the Cardiologist to look over.
    >My final diagnosis was a "healthy heart" murmur, skipped and premature beats, and
    >occasional PSVT, paroxymal superventicular tachycardia.
    >All of which my cardiologist said there is nothing to be concerned about, just
    >cut out caffeine and keep exercising, both of which I’ve done several weeks before
    >the last office visit.

    ++++++++++++++++
    From what I gether from your message there should be no problem for
    your health. Just one doubt about the opportunity of drug medication
    for your PSVT…. has your cardiologist prescribed any drug?
    As far as the sensation of "forcefull heart beat" is concerned, this
    is part of the symptoms due to your arithmia.

  3. admin says:

    In article <4v4t2q$…@dns2.IT.net>, paul…@pn.itnet.it says…

    >From what I gether from your message there should be no problem for
    >your health. Just one doubt about the opportunity of drug medication
    >for your PSVT…. has your cardiologist prescribed any drug?

    No medication has been prescribed. The PSVT has only occurred 4 times,
    the first in February, which was the worst. The other three being within
    the last 6 weeks. I’m not too concerned over the PSVT since it occurs
    very infrequently, lasts only a short time, 5-30 minutes, and is only
    uncomfortable if the anxiety that accompanies it gets the best of me,
    otherwise I just sit back, relax and wait for the tachy to return to normal.

  4. admin says:

    In article <4vavce$…@vixen.cso.uiuc.edu>, a-…@staff.uiuc.edu says…

    >From your description, during PSVT, you don’t appear to suffer symptoms
    >other than the palpitation and slight anxiety (i.e., no shortness of
    >breath or dizziness), which is a good sign.

    Actually I failed to mention that two of the four PSVT episodes I’ve had,
    shortness of breath, lightheadedness, and tightness of the chest were present.

    >Presumably you’ve had ECGs recorded and examined for possible
    >manifestation of Wolff-Parkinson-White (WPW; an accessory pathway,
    >which helps sustain the PSVT).  It’s possible that the WPW will not
    >show itself in every ECG.  You probably don’t have an ECG of your
    >PSVT; that would also be of diagnostic value.

    Well the first PSVT episode put me in the ER back in Feb., I was a
    panic case at the time. Anyway, I had a 12 lead EKG done just as the
    PSVT was going away.
    The diagnosis was minor sinus tachycardia. A few months later I wore
    a King of Hearts monitor for 4 weeks. Numerous episodes, skipped beats
    and such, but no PSVT, were recorded and diagnosed as premature and
    skipped beats. Actually one Cardiologist said I had a Quaduplet, while the
    head Cardiologist said it wasn’t.

    >(I have WPW.  My first ECG was normal.  The ECG that recorded my PSVT
    >had some nonspecific ST-T wave changes, but otherwise looked normal.
    >It was 2 years later that an ECG during sinus rhythm showed the
    >telltale "delta wave" of WPW.)

    This is interesting. I wonder what an ECG of mine would look like now.

    >The PSVT episodes could be triggered by your irregular beats, and it’s
    >possible that they could also be induced by exercise.

    It’s triggered by irregular beats. I would be okay one minute, then
    I start feeling an odd sensation deep in the chest like tapping, then
    little by little the heart rate will rise until it reaches it’s climax
    of about 160-180BPM, then slowly drop back down to normal. The whole
    episode usually lasts no more than 5-10 minutes.

    >When you experience your next PSVT, you might try the following
    >"vagal stimulations" in an attempt to terminate the rhythm:

    >  [from, "Understanding Electrocardiography" (Conover), p322]

    >  Both carotid sinus massage and gagging are strong vagal
    >  maneuvers.  Others are squatting, leg elevation, blowing against
    >  a closed glottis, and cold water to the face.)  This maneuver
    >  should be performaed as soon as the tachycardia is recorded.
    >  The longer the wait, the more difficult it is to convert with a
    >  vagal maneuver because of the increasing dominance of the
    >  sympathetic nervous system.

    Right, I’ve used a wash cloth soaked in cold water many times, PSVT or not.
    Holding my breath helped some also.

    >Albert

    Thanks for the reply.

  5. admin says:

    From your description, during PSVT, you don’t appear to suffer symptoms
    other than the palpitation and slight anxiety (i.e., no shortness of
    breath or dizziness), which is a good sign.

    Presumably you’ve had ECGs recorded and examined for possible
    manifestation of Wolff-Parkinson-White (WPW; an accessory pathway,
    which helps sustain the PSVT).  It’s possible that the WPW will not
    show itself in every ECG.  You probably don’t have an ECG of your
    PSVT; that would also be of diagnostic value.

    (I have WPW.  My first ECG was normal.  The ECG that recorded my PSVT
    had some nonspecific ST-T wave changes, but otherwise looked normal.
    It was 2 years later that an ECG during sinus rhythm showed the
    telltale "delta wave" of WPW.)

    The PSVT episodes could be triggered by your irregular beats, and it’s
    possible that they could also be induced by exercise.

    When you experience your next PSVT, you might try the following
    "vagal stimulations" in an attempt to terminate the rhythm:

      [from, "Understanding Electrocardiography" (Conover), p322]

      Both carotid sinus massage and gagging are strong vagal
      maneuvers.  Others are squatting, leg elevation, blowing against
      a closed glottis, and cold water to the face.)  This maneuver
      should be performaed as soon as the tachycardia is recorded.
      The longer the wait, the more difficult it is to convert with a
      vagal maneuver because of the increasing dominance of the
      sympathetic nervous system.

    Albert

    - Hide quoted text — Show quoted text -

    Ticker writes:
    >No medication has been prescribed. The PSVT has only occurred 4 times,
    >the first in February, which was the worst. The other three being within
    >the last 6 weeks. I’m not too concerned over the PSVT since it occurs
    >very infrequently, lasts only a short time, 5-30 minutes, and is only
    >uncomfortable if the anxiety that accompanies it gets the best of me,
    >otherwise I just sit back, relax and wait for the tachy to return to normal.

  6. admin says:

    a-…@staff.uiuc.edu (Albert Liu) writes:
    >The PSVT episodes could be triggered by your irregular beats, and it’s
    >possible that they could also be induced by exercise.
    >When you experience your next PSVT, you might try the following
    >"vagal stimulations" in an attempt to terminate the rhythm:
    >  [from, "Understanding Electrocardiography" (Conover), p322]
    >  Both carotid sinus massage and gagging are strong vagal
    >  maneuvers.  Others are squatting, leg elevation, blowing against
    >  a closed glottis, and cold water to the face.)  This maneuver
    >  should be performaed as soon as the tachycardia is recorded.
    >  The longer the wait, the more difficult it is to convert with a
    >  vagal maneuver because of the increasing dominance of the
    >  sympathetic nervous system.

    Something that has worked for me a couple of times is doing a shoulder
    stand for 10-15 seconds.  That shortens the attacks sometimes.

    I would avoid medication if you can help it and are feeling good
    otherwise.  I’ve been on calcium channel blockers, beta blockers, every
    possible combination of the two and now I’m on Tambacor and I *still*
    get breakthrough attacks.  The side effects are no fun, though slightly
    better than several attacks a week.

    <sigh>  Time to get cracking on a second R-F ablation since my first one
    failed…anyone had one done at the Health Sciences Center in Oklahoma
    City?


    [X] Molly Bowling

    The day that this country ceases to be free for irreligion, it will
    cease to be free for religion.            -Robert Houghwout Jackson

  7. admin says:

    I should preface this by stating that I’m not a doctor, just a patient
    with WPW who has done some research.

    Ticker writes:
    >In article <4vavce$…@vixen.cso.uiuc.edu>, a-…@staff.uiuc.edu says…
    >>The PSVT episodes could be triggered by your irregular beats, and it’s
    >>possible that they could also be induced by exercise.
    >It’s triggered by irregular beats. I would be okay one minute, then
    >I start feeling an odd sensation deep in the chest like tapping, then
    >little by little the heart rate will rise until it reaches it’s climax
    >of about 160-180BPM, then slowly drop back down to normal. The whole
    >episode usually lasts no more than 5-10 minutes.

    If your heart rate rises and drops slowly, then it’s probably not
    PSVT since, by definition, paroxysmal SVT start and stop suddenly.

    In case you missed it, read the following warning from Rod Venger
    <ven…@earth.usa.net>:

    - Hide quoted text — Show quoted text -

    >Word to the wise: Don’t use carotid massage without talking to your
    >doctor first and whatever method you use to induce a vagal response,
    >NEVER do it while standing. A precipitous drop in heart rate of 100+ BPM
    >can have predictable results. -Rod-

  8. admin says:

    >If your heart rate rises and drops slowly, then it’s probably not
    >PSVT since, by definition, paroxysmal SVT start and stop suddenly.

    You might be right, the PSVT has not been offically diagnosed
    as such. It is something my Doctor mentioned that may occur and
    has matched the usual symptoms of PSVT, at least what I’ve read.
    It certainly isn’t anxiety, the first episode was worsened by it, but
    the other episodes I was calm and relaxed. However if you say that
    PSVT must start and stop suddenly, then maybe I have something else.
    All I can say is that one minute it’s normal and within 30 seconds or
    so it would be at least 160BPM, then it would drop a little, then disappear.
    Chest tightness, shortness of breath, and lightheadedness were present
    two of the four episodes. Also, FWIW, extreme fatigue occurred after all
    four.

    >In case you missed it, read the following warning from Rod Venger
    ><ven…@earth.usa.net>:

    >>Word to the wise: Don’t use carotid massage without talking to your
    >>doctor first and whatever method you use to induce a vagal response,
    >>NEVER do it while standing. A precipitous drop in heart rate of 100+ BPM
    >>can have predictable results. -Rod-

    Right, I read such warning on the web page http://www.familyinternet.com, which,BTW,
    has some good reading material on cardio and other medical information.
    I tend to use cold water on the face and neck when I encounter any uncomfortable
    heart conditions. Holding my breath for a few seconds here and there would help
    some, but the cold water feels best.

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