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PVC's PAC's and Supraventricular tachycardia
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MedHelp Member's Question

PVC's PAC's and Supraventricular tachycardia

by dmbe70, Apr 24, 2006 12:00AM
I am a 35 year old, 145 lb. woman with two small children.  No known health issues, generally pretty healthy. B/P usually 120/70.

Ever since I had my first daughter, I have had episodes of what they tell me are pvc's and pac's.  I will be standing making dinner, or sitting with my children and it will feel like this heavy sinking feeling in my chest (almost throat) area.  For the most part, it is quick, and if I brace for literally a few seconds, it's over.  Since this past August, I have had 5 different episodes where it feels as though it is fluttering and my rythym does not reset immediately; the longest one lasting close to 6 minutes.  It is a very strange feeling which starts like the sinking feeling I get from the premature beats but doesn't stop. It is difficult to catch my breath during the episode and it is very frightening.  I am not an anxious person, and am generally able to stand and ride it out, but there are times where it feels like it will not reset and it can make me a little nervous.  Only once, it made me very dizzy and short of breath, but that lasted less than 30 seconds.

I wore an event monitor for 30 days, where they were able to record the PVC, PAC activity.  I was also told that I was having a supraventricular tachycardia.

I am told by my cardiologist that she is "very confident" that it is nothing to worry about.  I had an echo/stress test and blood work and was thankfully told my heart is just fine, but these episodes are quite scary.  

What is a svt and can this really all be nothing to worry about? Should I get a second opinion?

Thank you!

Doctor's Answer

by CCF-M.D.-MJM, Apr 24, 2006 12:00AM
Hello,



It is common for women to have more PVC/PACs during and after pregnancy. It is also common for SVTs to manifest during or after pregnancy.  SVTs are almost never life threatening and most cardiologist will not miss the life threatening cases becauase they are straight forward (WPW with atrial fibrillation).  The key for you is capturing the arrhythmia -- the one that makes you very symptomatic -- while you are wearing a monitor.  Many of SVTs are treated successfully with medications.  If the medications do not work, they are often successfully treated with abaltions.  It depends on the type of SVT you have.  If  you trust your doctor and the symptoms are too dibilitating, I don't think you need a second opinion.  If the symptoms really bother, it wouldn't hurt to see an electrophysiologist for a second opinion.



I hope this helps.  Good luck and thanks for posting.
Member Comments (27)

by andie3330, Apr 24, 2006 12:00AM
In a healthy, structurally normal heart, svt is usually more of an annoyance and not dangerous. I'm sure your doctor has ruled out wpw syndrome by looking at your resting ekg. WPW is one type of svt that can be more worrisome due to an abnormal electic pathway in your heart, but wpw shows up as "pre-excitation" of the ventricals on a resting EKG, so you would know if you had it. Has your doctor recommended vagal manuvers to convert a svt episode back to normal sinus rhythem? Sometimes splashing cold water on your face or bearing down, as if having a BM, can convert your heart out of svt. I don't think any treatment is necessary for svt unless the symptoms are very bothersome and frequent for you, in which case there are meds that can reduce your symptoms (not because svt is dangerous but just to help you feel better). Also, svt can often be "cured" with an ablation procedure - but, of course the procedure has its own set of risks which must be weighed against how much the svt is bothering you.



This is only my best understanding of svt - I'll wait to see what the doc says for more info.

by andie3330, Apr 24, 2006 12:00AM
Looking back over your question and my comment, I'm not sure I really addressed your basic question. SVT (not to be confused with NSVT which is something different) is just a faster than normal heart rhythm which originates from a signal in the atria other than the SA node.  It usually comes on suddenly and can last a few seconds or up to a few hours or more. Your heart then converts back to the normal rhythm just as suddenly. So, just for example, your pulse could be 70 beats per minute then suddenly be 200 beats per minute then back to 70. Vagal manuvers may help convert your rhythm back to normal sooner than it would spontaneously. I think it is a relatively common condition, in fact, I think the majority of the general population may experience at some point in their lives. I could be wrong about this point, but that's what I've heard. Hope that helps a little. Best wishes, Andie

by dmbe70, Apr 24, 2006 12:00AM
Do you know what an SVT feels like, exactly?  I have never heard anyone explain it in the way that I feel it.  I would love it if someone can describe what it feels like to them.  It is so hard to describe, I know, but I would be thrilled if someone could try!  Do my symptoms sound like it could be something different?

Thanks!

by talylor, Apr 24, 2006 12:00AM
To: dmbe 70
I have been having a problem for the past 4 months. I have gone thru testing for cardio (ekg's, stress, echo) and lungs (chest xray, chest ct scan, pft test) and even gastro (barium swallow). You can read my post in the gastroenterology forum for more detail. Your post caught my eye because of your description. I havent been able to describe what I am feeling in my chest and throat (which sometimes radiates to the stomach). I have said butterly type feeling, hollow type feeling, sometimes, pressure, sometimes tight, I can go on and on. I even said it feels like a "pit" type feeling, like when going down a rollercoaster or a hill. I guess, your description of "sinking" feeling fits as well.  At rest or while active (walking, or simply doing chores around the house). Bending can bring them on, deep breathes as well. I get them literally for a few seconds and they are gone.But for those few seconds, I get very nervous and scared. I will stop in my tracks and do my rest to stay calm and let them pass. My docs have prescribed me antianxiety meds recently cause they are simply getting the best of me. I feel FINE all day. No other symptoms such as headaches or fever or nausea, other than constant soreness on my left side.



My docs said he is pretty sure based on all my tests he can rule out heart and lungs and sent me to a gastroenterologist but I am not completely convinced. He decideded to put me on a heart monitor (which I get on Wed). He thinks this should rule out heart once and for all.

by momto3girls, Apr 24, 2006 12:00AM
Hi dmbe 70,



I too am suffering from SVT.  Mine is hereditary (my dad has really bad SVT which goes up to 250 and stays) and mine has gone up to 180 for no apparent reason.  I literally would just be sitting down and my heart would take off.  The best way to describe the svt is that for me, I feel very jittery like I've had too much caffeine and jumped on treadmill at the same time.  Other times my heart flutters, skips and pauses.  I have had a pretty decent cardio work-up with ekg, echo, stress test, stress echo and this Thursday I have a nuclear stress test.  From everything I've read and been told by my cardio doctors, SVT, Pac's and Pvc's are totally benign if your heart is structurally normal.  Now, that is so nice to hear but when these little buggers hit, sometimes that explanation goes right out the window!  If I start to get anxious when I feel them coming on (whether svt, pac or pvs) they get 10 times worse and last longer.  When I try to calmly ride them out and take deep breaths reassuring myself that it's nothing, they really do go away.  Weird, huh?  Just know that you are in good company, there are so many others out there who are experiencing the same symptoms and are just as worried about it.  Try to relax and tell yourself that in light of the good cardio work-up you've had, there just a nuisance, not life-threatening.  To make you feel better, my dad has had svt for over 20 years and it didn't damage his heart at all!  He just this past christmas opted for an ablation because his svt would go so high and stay high for hours and that meant he needed to go the ER to be converted.  Even then, he was fine, just annoyed!  He could even tell the ER doctors how fast his heart was going.  They got a kick out of that!  Take care and don't let this consume you (easier said than done, I know!)

by andie3330, Apr 24, 2006 12:00AM
To: talylor
What you describe sounds to me like PVCs - which are totally benign - almost everyone has them occasionally. However, most people don't notice them much.  I never noticed PVCs till I was pregnant, but then I started having a lot of them and they felt like you describe - like the sinking feeling you get after going over a hill on a country road and the feeling radiates up to your neck. To confirm that you are having PVCs (non-technical, at home confirmation) feel your pulse when you think you are having them. If you just have one, isolated PVC then by the time you feel your pulse you won't feel anything abnormal - but my PVCs tend to cluster together - so if you are feeling your pulse before and during when you have a PVC, there will be a definite pause between beats and sometimes the next beat feels stronger than usual. Like: beat..beat..beat......BEAT..beat..beat..etc.

That's how I figured out that my symptoms were due to PVCs. Unless you are monitored with an ekg or holter when the PVCs actually occur, a standard cardiac workup won't show that you are experiencing them.  Again, PVCs are benign, but its hard to believe that fact when you can feel them so intensely.

Anyway, I may be way off base and your symptoms may have absolutely nothing to do with your heart - but your description struck a chord with me.

by Pickyrose, Apr 24, 2006 12:00AM
I am 44 and have been dealing with this since 1997.  I too am post surgical menopausal and began having symptoms after having the flu. I noticed that I could not walk as far as some of the other people I was with, while in Boston, without being out of breath.  I then started having episodes wheere I could feel my heart racing at rest which would cause shortness of breath and for no appar