Question Title: sinus tachycardia w/ sinus arrhythmia

Forum: The Heart Forum
Topic: Arrhythmia

Posted by CCF Cardio MD on August 15, 1997 at 15:56:02:

In Reply to: sinus tachycardia w/ sinus arrhythmia posted by Cyndi W on August 10, 1997 at 02:52:10:

: In the last several months, I have ended up in the ER with chest pain or pressure and a very fast heart rate with increased blood pressure several times. Last month, they even did a heart cath but it was ok. Last weekend, the ER only showed "Sinus Tachycardia with Sinus Arrhythmia, otherwise normal". What does this mean. I'm on methotrexate, Relafin & prednisone for psoriatic arthritis and am on HCTZ, prilosec, levsin & potassium was on tenormin (50mg) for high blood pressure. I went off tenormin a few weeks ago and put on ISMO until the last episode and now tenormin was added again. My internist says my heart is fine so why do I continue to have these episodes of rapid heart rate etc. Can you shed some light on this one for me. I get where I feel guilty about going to the ER when they happen. I try to wait them out to see it they will go away and sometimes they do. If they last more than 1 1/2 hrs, I go to the ER. My doctor said I need to go to the ER if they don't stop bo I'm confused. If there is no problem, then why do I have to go to the ER. Is it something that can become a problem? I have had quite a few irregular beats captured on my EKG's but things always return to normal after awhile. Why is this? Can you explain to me what is happening and whether I need to worry or not. Thank you for your assistance. Cyndi

Dear Cyndi W,

There are essentially two functioning parts of the heart
1. The muscular part or pumping chambers
and
2. The electrical part, an intricate wiring system found throughout the heart
that is very organized in that it starts at the top and showers down upon all
the chambers of the heart in such a way that all chambers beat together. The
natural pace that this system works at is 60-100 beats per minute, unless of
course you are exercising in which case the electrical system will speed
the heart up, usually more than 100 beats per minute.

Now in direct answer to your question Cyndi, there are many influences both in and out
of the body that can affect your heart rate, and everyone has a few "skipped beats" and
"extra beats" so to speak; as well, sinus arrythmia is a normal variation of the heart's
electrical system. Now "very fast" rhythms tend to be due to a faulty switches of the
electrical system, or structural abnormalities of the heart itself and these are the
abnormalities we look for in patients with "very fast" rhythms. Another important
part of defining the rhythm is to actually see it on the monitor (via leads attached to
the chest) or continuously monitor the rhythm for 24-48 hours by a device called a
Holter Monitor.

The reason why fast rhythms come and go is not easy to define however,
the tenormin you were given is known to decrease the frequency.

There are quite a few influences that make very fast rhythms more likely to occur
such as stress, caffeine, and certain drugs, however it really depends on what kind
of very fast rhythm you are experiencing.

Lastly, any "very fast rhythm" is a potential threat to your life if it lasts long
enough that the heart just tires out and gives up, i.e. stops beating. Without
knowing your particular rhythm I can not be more specific about hazards and or influences.

Do not ever feel guilty about going to an E.R.

The heart doctor that specializes in heart rhythms is called an electrophysiologist,
if you would like to see such a cardiologist in consultation at the Cleveland Clinic
Foundation just call 1-800-CCF-CARE.

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