Hello doctor, I am living with idiopathic RVOT NSVT for over ten years now. I had my RF ablation done a 20 days ago and my ectopic, NSVT episodes have come down by 90% and I am feeling healthy generally. I had my echo, ECG, Holter, cardiac MRI. Echo, cardiac MRI are normal. Cardiac MRI was done post RF ablation and also has come out to be normal. MRI was ordered to rule out any structural abnormalities and to rule to ARVD, and cardiomyopathy. I am feeling back ache, shoulder ache, and mild chest discomfort now continuously for a few days. It looks very much like muscle and back pain that I have always and is not related to exertion as some times I feel it even while sleeping. I have not been doing any physical exercise for a couple of months and have put on some weight too. With normal MRI, echo, ECG except for ectopic beats, can I conclude the pain is not cardiac related? Attaching here with my reports. Does the MRI report also talk about ischemic factors or should I under go any further cardiac tests to rule out cardiac factors? If not cardiac, which specialist should I consult now for my back pain?
Hello. I had gone through your all reports. (attachment removed to protect patient identity).  Your Holter monitoring suggestive of premature ventricular beats some time occasionally, sometime in bigeminy, other time in couplet or NSVT (nonsustained ventricular tachycardia) this could contribute to irregular pulse or palpitation. MRI (magnetic resonance imaging) not suggesting any ischemic areas, and your RVOT (right ventricular outflow tract) also not unduly dilated. There is a very mild defect in the mitral valve but that is not contributing to regurgitation or any symptom so nothing to worry and yes, you can exclude cardiac factor but only after some investigation like x-ray whole spine (cervical, thoracic and lumbosacral region). For your shoulder and back pain, I want to ask a few things. Since how long you are suffering from this? Is this pain radiate to arms also? Back pain is confined to which area? Lower back or upper back? Did you have an episode of palpitation along with chest discomfort? Until then, I will advise you to use the hard bed without a pillow, do some physical exercises. Take Neurobion once daily for seven days. Reduce wait. Avoid oily foods.