Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum.  ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Heart Disease  (Expert Forum)
 | 
New PSVT diagnosis
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Post a Question Back to Forum
MedHelp Member's Question

New PSVT diagnosis

by Montanan, Apr 18, 2001 12:00AM
Hello!  I'm a 42-year-old male.  I recently completed 24 hours with a Holter monitor after experiencing several weeks of mild, intermittant chest pain, pounding heartbeats, and shortness of breath.  (A stress test was also performed, which was normal.)  My family physician called with the news that the Holter had recorded "several brief episodes" of PSVT.  He said that the condition was "entirely benign," but that I could choose to start taking Toprol if the symptoms were bothersome.  So, here are my questions ... sorry if it's a fairly long list!



1.  Is the Holter recording sufficient diagnosis for PSVT?

2.  The tests were done by my family doctor.  Should I find a cardiologist to look at this?

3.  Should I consider additional testing to rule out the possibility of other conditions, such as ARVD or W-P-W?

4.  Would there be disadvantages to starting on a beta blocker?

5.  Would I need to continue the Toprol indefinitely?  Is this the med to choose?

6.  What about ablation for something like this?  (I live in a rural area ... I assume I'd need to visit a major medical facility for this procedure?)

7.  And finally, is there anything else I should consider (or worry about!)?



Thanks for your assistance ... I've already learned quite a lot reading the forum!
Doctor's Answer

by CCF-M.D.-CRC, Apr 18, 2001 12:00AM
Dear montanan,



1. Is the Holter recording sufficient diagnosis for PSVT?

A: Usually the Holter is a good first step for the diagnosis of paroxysmal supraventricular tachycardia (PSVT) but often an EP test is needed for final diagnosis.



     2. The tests were done by my family doctor. Should I find a cardiologist to look at this?

A: Yes, I would probably make sure that a cardiologist has at least seen the Holter test.





     3. Should I consider additional testing to rule out the possibility of other conditions, such as ARVD or W-P-W?

A: ARVD is not a type of SVT but is instead a VT so it would be less likely. WPW could be a possibility.





     4. Would there be disadvantages to starting on a beta blocker?

A: There are benefits and risks to all medications and this would have to be weighed by you and your doctor.



     5. Would I need to continue the Toprol indefinitely? Is this the med to choose?

A: A bit premature to answer.  It would depend of what type of PSVT you had and what symptoms you were having.



     6. What about ablation for something like this? (I live in a rural area ... I assume I'd need to visit a major medical  facility for this procedure?)

A: Many PSVTs can be cured with ablation and no additional medication is needed.  It is a consideration at some point.

    

     7. And finally, is there anything else I should consider (or worry about!)?

A: Most PSVTs are treatable but I would recommend seeing someone with some special knowledge in this area.
Member Comments (19)

by Deborah, Apr 18, 2001 12:00AM
I was diagnosed with PSVT 1 1/2 years ago.  An ablation was attempted but was too close to the AV node and I would have had to have a pacemaker.  I chose not to at that time, so the physician placed me on Rythmol.  It is wonderful and I have very little problems with my PSVT.  You have to take it 3 times a day, so it gets bothersome, but not as bothersome as a pacemaker and its rare that I have problems with the PSVT.  I also have cardiac microvascular spasms (cardiac Syndrome X), but the cardiologist stated that the PSVT did not cause these spasms to occur.  It is something separate.  I find only basic information on this subject and was wondering if anyone else that has PSVT also has Cardiac Syndrome X?  Please talk to your physician about Rythmol. I was miserable until I received this med.

by Montanan, Apr 19, 2001 12:00AM
To: Deborah
Hi, Deborah ...



Thanks for the suggestion about the Rythmol -- I'll mention it when I go in for my next follow-up (in a few days).  It sounds like a fairly "hard-core" medication, though, and I'd hope to avoid something like that if at all possible.



I'm building up a huge list of questions for my doc ... hopefully I won't drive him _too_ crazy!   There's so much research to do when something like this comes into your life -- with our medical system the physicians just don't have unlimited time for you, and you need to do a lot of your own homework.  The internet has been a real help in this regard, but sometimes you still can't find the specific answers you need.  And sometimes the net tells you just a little _too_ much ... it's way too easy to wander around a bunch of medical sites and find a couple of dozen horrible, amazingly-rare syndromes that match your symptoms, and that you just KNOW you've got! (It's sometimes hard enough to keep yourself from freaking out as it is ...)



The best of luck to you --



Mark



by Xtian, Apr 19, 2001 12:00AM
To: To Deborah Re: "Syndrome X"
I also Have been diagnosed with "Syndrome x" and have PSVT. This has been going on for 5 yrs and I have not been able to capture my mysterious chest pain spasms on a 30 day monitor (I always get my spasms when I'm not wearing the monitor!). My chest pain is crushing but only lasts for a few seconds and is beneath the sternum. It's very scary and has happened both at rest and with exercise (I run 3miles a day 5x a week), though only occasionally with exercise. Doctors have done all tests including PET scan of heart, Cardiolite stress test, Stress echocardiogram, numerous holters, all negative except for mild mitral regurgitation (1+) and the PSVT diagnoses. I can cope with the PSVT as I often get strange rhythms (doctor suggested Rhythmol since my low dose beta-blocker is not doing much, but I don't like the side effect profile of rhythmol) but the chest pain spasms really freak me out! I am a healthy 34yr old male and have considered an angiogram, but the Dr's don't really want to do it because my chest pain only lasts seconds (not typical of even a cardiac spasm) and has gone on for five years without getting worse.There is no pattern to my spasms. I can get a few one week and then go a month without any pain. I noticed that they seem to happen if I go a long time without eating and also seem to happen early in the morning when I'm driving and had not had enough sleep. I also have a history of panic attacks (sweaty hands, dizzyness, nausea, tachycardia) but often the attacks happen after I get chest pain or out of the blue, and since I also get the pain sometimes while running I can't atttribute it soley to anxiety. Please keep in touch deborah, as it sounds like we have simlar problems. My e-mail is ***@****. Hope you are well.

by Deborah, Apr 19, 2001 12:00AM
To: Xtian
Thanks for the comment.  I have been on Norvasc (calcium channel blocker) that really seems to help the microvascular spasms.  My spasms feel like an elephant on my chest instead of a spasm feeling.  The only thing that relieves it is Nitro under my tongue.  I am also on Isosorbide (long acting Nitro) and Atenolol.  All of these combined have made my life almost back to normal.  I can now run up and down stairs (I'm in respiratory therapy)and to codes without losing my breath as much.  Sometimes out of the blue I will have a day in clinic where I'm on the run and have no problems.  Other times it can be a light day, but when I stop and simply walk up a flight of stairs, I'm out of breath.  It's a lot better, but I hate being on all the meds.  My spasms were diagnosed when a heart cath was performed and was seen again when another cardiologist tried to perform an ablation on my PSVT.  Ablation did not take because the site was too close to the AV node and with the spasms, he was afraid he would knock out the AV node.  A friend of mine has panic attacks, but is finding a way to control hers without medication.  She finds that if she does deep breathing exercises in the morning and then again in the afternoon, she almost never has an attack.  Maybe this could help you.  When she feels one coming on, she simply sits back, takes a couple of deep breaths and breathes out slowly.  It helps them to pass fast.  Maybe it could work for you.  Good luck!

by LaurieD, Apr 20, 2001 12:00AM
I have just had a holter monitor on, and it showed 1,127 Narrow Beats within a 24 hour period. My cardio says I am imagining the beats, and that the computer errored. I know I felt them, and I think he's a quack. Does anyone know what "narrow beats" are and why I might be having so many? I also suffer bouts of paroxymal Atrial Fibrillation and PSVT according to a recent holter. Yet my stress test came out fine! Any feedback would be appreciated. My email addy is ***@****

by Deborah, Apr 22, 2001 12:00AM
To: Laurie D.
According to The Merck Manual (excellent medical reference and can be bought in any bookstore) what your cardiologist may call "narrow beats" is: (word for word from Merck Manual) "The term narrow QRS is preferred to supraventricular because these arrythmias may involve ventricular tissue.  One of the most common narrow QRS tachycardias is the reciprocating tachycardia of the WPW syndrome which involves supraventricular structures (atria, atrioventicular node, accessory pathway) and the ventricles.  The 3 forms of regular narrow QRS tachycardia are atrioventricular nodal reentry tachycardia, reciprocating tachycardia associated with accessory pathways, and true atrial tachycardia.  These first 2 forms constitute >90% of all regular narrow QRS tachycardias."  Laurie, hope this information helps.  If you are looking for it in the Merck Manual, it's on pages 1724-1725.

by LaurieD, Apr 22, 2001 12:00AM
To: Debra
Thanks for the info, yes it does help. My problem is also, I have bouts of Atrial