Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Featured premature ventricular contractions patient discussions on symptoms experienced
"I have had PVCs for about 15 years. (I am now 48.) They go away with exercise and return on resting phases. Emotional stress and coffee seem to increase the frequency. I suffer from migraines as well. Wine and stress seem to be triggers too. I can go long periods without any PVCs if coffee and stress aren’t there. I have had echocardiograms, EKGs, cholesterol tests, advanced cardiac disease screens, and they all say the heart is healthy. The cardiologist says many healthy people have them. Getting them checked out can rule out any PVCs that are risky. "
"I am a 28-year-old female that is healthy and found out about my heart condition when I was 17. This past year my condition has worsened. I have had every test done out there, so I know what that is like. I had the Holter Monitor done about a month ago and they found out that I had 8,690 PVCs within a 24-hour period. That is beyond severe. I am always tired, always sick, feel like I can't breathe very well and my chest feels like it's going to explode sometimes. Very scary! I haven't been to a cardiologist in a long time, but my doctor is finally making me go again to get this checked out."
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What are premature ventricular contractions?
Premature ventricular contractions (PVCs) are premature heartbeats
originating from the ventricles of the heart.
Premature ventricular contractions are premature because they
occur before the regular heartbeat.
Normal function of the heart
The heart has four chambers. The upper two chambers are the atria, and the lower
two chambers are the ventricles.
The atria deliver blood to the ventricles, and
the ventricles deliver blood to the lungs and to the rest of the
body.
The right ventricle delivers blood to the lungs while the left ventricle delivers
blood to the rest of the body.
The heartbeat (pulse) that we feel is
caused by the contraction of the ventricles.
The heartbeat is normally
controlled by the electrical system of the heart. The electrical system of the
heart consists of the SA node (sino-atrial
node), the AV node (atrio-ventricular
node) and special tissues in the ventricles that conduct electricity.
The SA
node is the heart's electrical pacemaker. It is a small patch of cells located
in the wall of the right atrium; the
frequency with which the SA node discharges electricity determines the rate at
which the heart normally beats. The SA node keeps the heart beating in a regular
manner. At rest, the frequency of the electrical discharges originating from the
SA node is low, and the heart beats at the lower range of normal (60-80 beats/minute). During exercise or
excitement, the frequency of discharges from the SA node increases, increasing
the rate at which the heart beats. In people who exercise regularly, the resting
heart rate may be below 50-60 and is not of concern.
The electrical discharges pass from the SA
node, through the special tissues of the atria into the AV node, and through the
AV node to the special conduction tissues of the ventricles and causing the
ventricles to contract.
What happens during a premature ventricular contraction?
During a premature ventricular contraction, the
ventricle
electrically discharges (and contracts) prematurely before the normal electrical
discharges arrive from the SA node. These premature discharges are due to
electrical "irritability" of the heart muscle of the ventricles and can be
caused by heart attacks, electrolyte imbalances, lack of oxygen, or medications.
Immediately after a premature ventricular contraction, the electrical system of the heart resets. This
resetting causes a brief pause in heartbeat, and some patients report feeling the
heart briefly stopping after a premature ventricular contraction.
How common are premature ventricular contractions?
Premature ventricular contractions are common. Many people have premature ventricular contractions without any symptoms. Premature ventricular contractions may be more common among older patients, patients with high blood pressure, and patients with
heart disease. Premature ventricular contractions can also occur in young healthy individuals without heart disease or high blood pressure.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
Palpitations are unpleasant sensations of irregular and/or forceful beating of the heart. Palpitations can be relieved in many patients by stress reduction, stopping cigarettes, and reduction of caffeine and alcohol.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Mitral valve prolapse (MVP) is also also known as "click murmur syndrome" and "Barlow's syndrome." Mitral valve prolapse is the most common heart valve abnormality. Signs and symptoms of mitral valve prolapse include: fatigue, palpitations, chest pain, anxiety, and migraine headaches. Echocardiography is the most useful test for mitral valve prolapse. Most patients do not need any treatment, however, patients with severe prolapse may need treatment.
Potassium is an essential electrolyte necessary for cell function. Low potassium (hypokalemia) may be caused by diarrhea, vomiting, ileostomy, colon polyps, laxative use, diuretics, elevated corticosteroid levels, renal artery stenosis, and renal tubular acidosis, or other medications. Symptoms of low potassium include weakness, aches, and cramps of the muscles. Treatment is dependant upon the cause of the low potassium (hypokalemia).
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Heart valve disease occurs when the heart valves do not work the way they should. Symptoms of valve disease include shortness of breath, weakness or dizziness, discomfort in your chest, palpitations, swelling of your ankles, feet or abdomen, and rapid weight gain.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, and heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
Your heart is an amazing organ. It continuously pumps oxygen and nutrient-rich blood throughout your body to sustain life. This fist-sized powerhouse beats (expands and contracts) 100,000 times per day, pumping five or six quarts of blood each minute, or about 2,000 gallons per day.
How Does Blood Travel Through the Heart?
As the heart beats, it pumps blood through a system of blood vessels, called the circulatory system. The vessels are elastic, muscular tubes that carry blood to every part of the body.
Blood is essential. In addition to carrying fresh oxygen from the lungs and nutrients to your body's tissues, it also takes the body's waste products, including carbon dioxide, away from the tissues. This is necessary to sustain life and promote the health of all the body's tissues.
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