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Heart Disease  (Expert Forum)
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Ventricular Tachycardia
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MedHelp Member's Question

Ventricular Tachycardia

by WHMInc, Nov 15, 2006 12:00AM
After my primary care doctor noticed a small change in my EKG I went for a thalium stress test. 8 minutes in to the test I went into Ventricular Tachycardia for 38 seconds. I remained alert for the entire time and self converted.  Since then I have has cat-scan, cardiac MRI, and a EPS that was unable to recreate the problem.  All test have come back normal. I am currently on 50 mg of Atenolol twice a day.  I am frustrated that I have no diagnosis. I am a 43 year old male in average shape with high cholesteral (256).  I have changed my diet and workout 4 times a week. I have only passed out once before.  Currently I have a Reveal heart monitor in my chest and for the last 6 month have had no unusual cardiac events. It has been suggested by many friends that I should find a new doctor and have another complete work up (Clevend Clinic, Mayo, etc.). What are you thoughts?



I hate taking drugs and do not want to take Atenolol for the rest of my life.  One thought I had was to stop taking the Atenolol and retake the stress test to see if the event occorred again. Is this a good idea?



Is it possible that this was a one time fluke and will never happen again? In all the information I have read V-tach is serious. I know the internet is a dangerous place to find medical information. Is it providing me with information that is leading to undo concern?



Thank you
Doctor's Answer

by CCF-M.D.-MJM, Nov 15, 2006 12:00AM
Hello,



This is very interesting question.



I assume that you have a structurally normal heart or you have said otherwise.  If you have a structurally normal heart and normal cardiac work up, ventricular tachycardia is a much different event than if you have coronary artery disease and a reduced ejection fraction.  In fact, the treatment guidelines would suggest that a beta block is the appropriate therapy.



A reveal monitor is a good idea incase it comes on again. If you decide to come for a second opinion, bring the 12 lead EKG of the VT.  Exercise induced VT can be treated with an ablation, but I would only do the ablation if this was a common occurance.



It sounds like your doctors are doing the right things, but if you want a second opinion, we would be more than happy to evaluate you.  With the information given, I think the current work up sounds perfectly appropriate.



As far as a repeat stress test, that isn't a bad idea, especially if you really want to try to induce it again.  If you had a second episode, it would be more reasonable do consider an ablation.



Regarding the internet, I agree it is a powerful source of both information and misinformation.  I don't think you should worry about this that much, especially given the infrequent nature.



I hope this helps.  Good luck and thanks for posting.
Member Comments (20)

by wmac, Nov 15, 2006 12:00AM
To: WHMInc
Join the club!! I have had nonsustained vt for four years and I have had two ep studies and both times it could not be induced. I too had a monitor implanted I had it for 7months. Beings they could not induce the vt they tell me its not life threating. lol its easy for them to say not to worry. But I do worry every day of my life. I get the nsvt aleast once a month if not more it has always converted on its own. But I just wait for the day that it doesnt. I too have had all the test all normal my ef is normal and with that they say is why they dont worry. I do however have a bit of mvp. I do not take any meds. I tried the meds for three days and the third day into I had the worse run ever. So none for me. I seem to have my tachy when im sitting and doing nothing more so than if im doing things. Dont read too much because thats what I have done for four years and its almost put me into the ground. I have wore so many monitors and of couse when wearing them my heart behaves. But luckily I have lots of recordings to prove im not crazy. anyway good luck and if you find a cure let me know. lol



wmac

by anacyde, Nov 15, 2006 12:00AM
To: WHMInc
Haha, yes, the internet can be a dangerous place to find information.  I've scared myself to the brink of insanity a few times ;)



If it were me, I'd probably get a second opinion through a larger center.  But like wmac, you may not find definite answers even then.

by tdc03, Nov 15, 2006 12:00AM
Hey we could all have a little support group here!  I would stick with your cardiologist/ EP for medical information.  I've found some good information on www.hrsonline.org (this is the website my EP directed me to) or the american heart association.  I had a idiopathic VT and was on verapamil for a while and hated it, because it made me feel lousy and tired.  You should consult with your physician before getting off atenolol.

by tlcjuliet, Nov 15, 2006 12:00AM
I have runs on VT and have had so going on 12 years now.  I have been put on sotolol 160mg three times a day.  I havent had any bad runs of it lately, but since I have been on this drug, I have had a lot of pvc's and pac's, recordings show up to 15000 in a 24 hour period.  They are frustrating and annoying, but they are going to kill me so they say.  I feel everyone of them.  I did have a run of VT last night, but it settled after a short while.  My problem is I cant exercise much as I have Multiple Sclerosis, which is very restricting.  My heart specialist says my heart is structurally fine, except I do have high cholesterol, even tho I am vegetarian. The neurologist believes that the MS has cause lesions on nerves that control the heart.  I find when taking steroids the palps become worse.  I take calcium/B6/magnesium and a multivitamin everyday and eat dried apricots and bananas to keep potassium levels up.  Once after IV steroids, my potassium levels plummeted and my heart wouldnt beat correctly at all, which had me in the coronary care area of the hospital til they got them back to normal.  That was very scary.  I am wishing to come off the sotolol now, as I have been taking it for so long, but am scared my heart is not going to like it at all.  Is there another drug I can take that would work the same?

Anyway, I am babbling now and can never seem to get a question posted here, and I have been a member for 6 years of this site, but the board is always *closed* to questions.

Thanks for reading

Jules

by Carrie41, Nov 15, 2006 12:00AM
To: tlcjules
What?  It says in your post that the PAC's/PVC's are going to kill you?  Did you mean to write they aren't going to kill you?

by kitcurious, Nov 15, 2006 12:00AM
To: Carrie41 Everyone
I call those types of errors "Freudian typos" :-D

by Rachel's mom, Nov 15, 2006 12:00AM
Question for everyone who can relate.....I am on 25 mg atenenol during my menstral cycle only....works wonders on me....except for yesterday...i was on my period and atenenol and i had a day of skipped beats, extra beats all of the above happening about every 2 minutes...more than i have ever had in my life....went to the cardiologist today (coincidental that i had an appt for follow up today) he was not at all concerned of my heavy arrythmic activity said to double up my meds (which i won't) and no big deal....so has anyone else here have such activity while on a beta blocker and could the beta blocker made the activity worse...im so bummed cuz i thought i found my miracle pill.



Judianne

by tlcjuliet, Nov 15, 2006 12:00AM
yea that was a typo



meant to say *arent*

lol sorry....did I mention I am leagally blind?  thats another problem the ms has caused, it has destroyed my brain stem area

sorry again :)

by Carrie41, Nov 16, 2006 12:00AM
To: Jules
Oh my gosh!  Sorry about that Jules!  I was just a little concerned when I read so much that people say that the PVC's aren't going to kill you and then I read that they are going to kill you!  I am constantly on edge from my PVC's, PAC's and short non-sustained runs on v-tach.......



Does anyone out there get them when they first lay down at night?  I was terrified again last night because as soon as I went to bed it started skipping again.  I can seem to stop it when I go on my right had side but I can't stand the feeling.

by wmac, Nov 16, 2006 12:00AM
To: carrie41
How often do you get you runs of nsvt? How long do they last for and have you had them recorded, so you know for sure that that is what you have? Im just curious tell me what you can about yours. I have had my for four years now and some days I do ok mentally and others I dont.

wmac

by Carrie41, Nov 17, 2006 12:00AM
To: wmac
I never do okay mentally with the damn things.  I hate them.  I get the runs every couple of days.  I get thumps and skips every day though.  I get them sometimes twice a day and sometimes 10 times a day.  I know there are people that get a lot more than that but I don't know how the stand it.  I am going back to my doctor in 2 weeks to tell her I think about these things 24/7 and I just can't stand it anymore.  I am really at wits end.  I have had them for 20 years and you would think that I would get used to them but I just don't!  Do you get skips and thumps every day as well?  I also find when I lay down at night to go to bed it goes irregular for a little while and it freaks me out.

by ozzie2001, Nov 17, 2006 12:00AM
I too have had VT--a 12-beat run in May. I'm a healthy 28-year-old woman with slightly high cholesterol but a great ratio. Everything came back normal (MRI, echo, stress