27 yr old female with SVT in NYC, physical or stress?

[misschang]

For yrs, I have gotten hot easily,would sweat a little walking a few blocks, also headaches daily. I'm fit and thin. Bloodwork run 2yrs ago-was normal and was told this was just how my body was.

I started having chest pains in Dec 03.  After feeling light headed, chest pains, and short of breath for 3 days,I went to the ER, where my BP was 145/105.  After a dose of valium to eliminate stress related high BP, my BP had come down marginally. Normal BP is 110/60. Clots ruled out, EKG normal  I followed up with a cardiologist and have had EKG's, Echo, bloodwork, all were normal except my CO2, which was 25 on arterial bloodgas.  Flying recently, I fainted on the airplane.  EKG in ER was normal. After wearing a holter monitor under care of my cardiologist, diagnosed with SVT.  My monitor showed that I had many episodes of SVT to max of 153 beats/min, that would last for several hrs.  During test: 2 glasses of wine,no exercise

Questions:
1)Is the constant getting "hot" and sweating related to arrhythmia?
2)Was I born with arrhythmia? Does it run in families? (my aunt and mother have it)
3)Is SVT entirely related to/triggered by stress given my Echo is normal?  Will it go away w/ lifestyle changes?
4)If its stress related, why don't Dr's prescribe Xanax, why beta blockers?
5)I am taking beta blockers and is this something I need to take given I'm 27? Or can I seek lifestyle changes?
6)What is the follow-up my cardiologist should take?  Should he examine the root of the SVT?  Should I see an electrophysiologist?
7)What is occurrence in young, otherwise healthy people?

[Cleveland Clinic]

miss chang, thanks for the post.

1) If your heart function is normal and If you were not having the arrythmia at that time, probably not. An event monitor would be a better mechanism to determine what your rhythm is at the time of your symptoms.  You should also have thyroid function test performed.

2) There is probably some genetic component to arrythmias. It is impossible right now to tell if you were 'born' with it. You were probably born with a predisposition though and some other factors may have brough it out.

3) There are a multitude of triggers people experience. Only time will tell, but that modification should attempt to eliminate the triggers you are familiar with.

4) Xanax is a short term anti anxiety medication. Not one I commonly prescribe. Most likely the anxiety is a side effect of experiencing the arrythmia and not the predisposition. I would use that route before prescribing benzodiazepines.  If the arrythmia is recurrent, ablation may be effective in a cure.

5) Again, I'm not sure of the details of your arryhtmia. Ablation may be able to cure your arrythmia, eliminating the need for long term medication.

6) You should work on the route you take. Discuss the possibilities of medication versus ablation with your doc.

7) Do you mean recurrence. It's variable, and depends on the therapeutic modality taken to eliminate the arryhtmia.

hope this is a start.

[misschang]

Thanks for your quick response.

I have had thyroid tests and just about everything run on my blood, its all normal.  What I'm trying to sort out is, do I have arrhythmia and SVT because I live a stressful life, and stress is the trigger,  or are there physical reasons behind this and I would have SVT regardless of stress?   What is the physical defect or disease behind SVT?

Thanks

[LynnSB]

Hi,

There is a difference because the CAUSE of an arrhythmia, such as PSVT , and a TRIGGER for such an arrhythmia ( although some arrhythmias hapen with no known or discernable trigger).

If you have PSVT, you have some extra cells capable of sort of going off on their own and firing, setting up the fast rhythm. That's why ablation ( which "zaps" the troublesome cells so they can no longer trigger an arrhythmia) is a cure in the vast number of folks with PSVT who opt for an electrophysiology study ( which locates via "mapping" the heart's electrical system) and ablation.

Here is some info you might find helpful:

Causes of PSVT:
http://www.adenocard.com/psvt_causes.html

an article on ablation: http://www.pslgroup.com/dg/fcb6e.htm

good luck!

Lynn

[Linda123]

Lynn - how are you doing?  I'm really interested in your progress.  Please keep us updated.
Hope all is well.
Best Wishes, Linda

[LynnSB]

My progress? Well, I wish I could say I was palp-free. I wish I could say I don't have them every single day.. but I do. I wish I could say they don't scare me any more.. not true, however.

I don't have the runs of very fast beats I had pre-ablation. I do have loads of uncomfortable skips, flutters, fast ( not really fast.. sort of double time, not triple time) runs of maybe 5 to 10 beats ... the ones that make me feel like I am going to die for just a second, leaving me weak.

My internist talked to my cardiologist and she is convinced that HE is convinced that I am in no danger and I just need to live with these " background" PACs ( if that's what they are.. they are assumed to be because that's mostly what I had on the 2 month long event monitors pre-ablation). No one wants to put me back on an event monitor, in fact, because noone ( except moi) is concerned.

I still get scared.. especially if, for example, I'm out walking my dogs at night and I get a run of skipped beats or it feels like my heart " stops".. I get panicky. I am so disappointed in the amount of arrhythmias I still have.

I'm going back to the cardiologist at the end of the month for a check-up. I really don't tnink there's any other help for me. I'm trying very hard to accept that.

Lynn

[LynnSB]

Gosh, Hank! Glad you went to the ER and had the chest pain checked out and glad you are ok.

It is hard to answer your question about whether the palps are better that pre-ablation because I have had periods over the years when they were better and worse. And right before the ablation , when I went on and then off of the beta blockers, they were THE WORST ever.. just horrible 24/7.

I would not say they are much better, if at all, although a specific kind of "burst" or "spurt" of fast beats.. no doubt the SVRN tachycardia that was ablated seem to be gone.

I've tried going totally off caffeine, yadda yadda.. been on magnesium for 20 years, fish oil for 10, etc.  I have found that meditation will reduce my resting heart rate from the 80s to around 60, even after I'm up and moving about for a while after meditation. I'm doing a form of Tibetan Buddhist meditation.. I need to do it every day, obviously! But the holidays have been enormously stressful for me and there was a death in my family.. none of this is helping the palps.
re: the event monitor.. my internist was for it but after talking to my cardiologist she agrees with him that it is a waste of time and money. They are SOOOOOOOOO convinced I am fine and, after all, heaven knows I've had more tests over the years that most people and , besides, one thinks the chairman of the dept of medicine who has also been a cardiologist for 30 years knows what he's doing! I hope ..... I think I've reached the end of my rope for getting medical  help for these things. I have been to an acupuncturist before and I think I 'm going to try that route again on a regular basis.

Lynn

[tlcjuliet]

*hugs* Hank
Hope you are feeling better now.

[Dr. Erik]

I'm sorry you had to go through that last night Hank. I know it is very scary. I have been through it many times myself going to the ER with chest pains thinking I was dying. Thank God you are alright. Just want you to know I'm thinking of you. Hope you feel better! Take it easy.

Erik

[chrisr]

Hello Hank,
Sorry to hear of your recent chest pains and also wish you a speedy recovery since you are such a great source of info on this site. Could you kindly explain Costochondritis from AS? I ask because after bypass surgery 3 yrs ago I also get sudden chest pains particularly after any strenuous work such as lifting. After repeated tests I am always told everything is OK but the pains are worrisome and they occur regardless of palps or ectopic beats. Could this be costochondritis and if so what is the best approach to control it?
Thanks in advance for your comments and wish you all the best for the new year.
Chris R

[pandora9048]

Hey Hank,
So sorry to hear your not feeling well.  I know that "panic" feeling well, and its awful.  I hope u feel better soon.  I dont know what we'd do without u here!!:)
Take care,
Pan

[jobob52 ford]

Its good to hear from all of you but am sorry to hear that all is still not well. I'm not out of the woods yet either, spent New Years Eve in ER for a-fib. They didn't cardiovert me but put me back on atenolol, fleckainide and coumadine. I converted 16 hours later. I'm bummed but thankful that I still haven't had any episodes of the tachy (250 bpm stuff).
Strange how we've never met but all of you are such special people to me.
Wishing you the best in the new year.

[Ianna]

Hello Hank,

Sorry to hear of your pain and anxiety.
Must have been horrible.
Really wish you well!
-
Love -*Ianna*

[mbimom]

I noticed that you are from NYC.  You should go to Dr. Lerman. He is out of NY hospital.  He is one of the first doctors is this area to do ablations. I really liked him.  I would get an opinion from him if possible.

[Momto3]

So sorry to hear about your trip to the ER. I hope you are feeling better!

I also have costochondritis and it can be miserable. Mine seems to linger most of the time, but it's the flare ups that really hurt..I remember the doctor pressing on my ribs and asking if it hurt.  Um, yep...it hurts!! I've tried some prescription meds, but Advil seems to do the trick. Do you suppose there is any connection between MVP, palps, heart stuff...and costo?

Take care of yourself Hank!

connie

[LynnSB]

FYI:I have talked to several MVP syndrome experts over the years who said, yes, costochondritis is very, very common in those with MVP syndrome and/or dysautonomia. Of course, it is pretty common anyway in the population but those docs noticed it to be part of the array of MVP syndrome symptoms ( theses were MVP doc researchers).

Also, of course you should always get chest pain checked out, but cardiologists usually point out that if your chest hurts when you touch or  rub it -- if it hurts from the OUTSIDE -- it is highly unlikely it is  your heart causing the pain. Instead, it is muscle soreness or cstochondritis.

Lynn

[Momto3]

Thanks for filling me in!! I've always felt that the whole "syndrome" thing had a lot of merit....just too many coincidences.  

I was reading your posts about your post ablation "stuff" and I'm kinda surprised that your doctor does not want you to wear a monitor, even if it's just for your peace of mind. About a month after my first ablation, I told my doctor about the returning palpitations and she ordered an event monitor to "check it out". After she could see that I was still have scads of pvcs, she ordered another holter. Turns out, the pvcs were kicking up a storm from a different foci...No surprise there since I knew that could happen. Anyway, ended up with a second ablation and whoala...So far, I am MUCH improved in the pvc department. I get an occasional (compared to thousands) palp, but I've only had one "storm" since the 2nd ablation.

I understand that you may be medically "fine" but what about peace of mind and your quality of life? Would medicine or a second procedure be helpful? Hope you are feeling better. Just curious, where (city or state) did you have your ablation? connie

[Linda123]

Hank - so sorry to hear of your ER ordeal and very relieved to hear that all was OK.  You simply cannot get sick as too many people on this forum enjoy reading your wise and sympathetic words!  
Lynn - I'm really sorry to hear of all the palpitations you are still getting and like everyone else I too think you should have a monitor afterall you have had an invasive procedure.  I think it might be an idea to stamp your feet a little about this and get it checked out.  However, to cheer you, a lot of these palpitations could still be down to inflammation from the ablation, I do know of a lady that had an ablation for a-fib and it took a good 8 months before things started to settle down.  It's maybe still early days for you.  I do hope so.
Keep us all posted.
Best wishes to all,
Linda

[LynnSB]

thanks for your kind thoughts and concern. I really don't think i can get another event monitor any time soon. I'll bring it up when I see the cardiologist at the end of the month. but i'm pretty assertive, believe me, and i do think i have run up against a brick wall on this one... it's annoying but I can't change docs ( don't really want to) and there's the insurance thing to worry about so i'm pretty much stuck.

Lynn

[misschang]

Thanks for the info on Dr. Lerman, do you have his full name, or perhaps his phone number? I googled the name, and came up with a few Lermans' is it Bruce Lerman? Thanks!

[suzy345]

Hi,

I have a question for anyone who has experienced non-sustained ventricular tachycardia.

I get occasional PVCs, about one a day, not too bad.  I've had an ecg, an exercise stress test and an echo, all showed nothing.  But three times over about three years I've had many PVCs in the space of about 30 seconds, and I want to know, is this v-tach?

I'll try to describe what it felt like in more detail.  It felt like a PVC, a normal heartbeat, a PVC, a couple of normal beats, another PVC, etc, about six times over about 30 seconds.  The PVCs were not all clumped together and my heart wasn't beating fast - that's what makes me think it wasn't v-tach, but I'd like to know from someone who knows what v-tach is.  

It happened twice when walking, and once just after diving into a swimming pool.  What scares me is that this happened so unexpectedly and it didn't feel like it would stop.

Can anyone tell me what this is, and what I should do about it?  I feel like my cardiologist was impatient with me when I went to see him and I don't want to bother him.  

By the way, I have had hyperthyroidism, but I didn't have it any of the times when these runs of PVCs came.  

If anyone can help me I will be very grateful.  I may try to post this as a question for the doctor if I can.

[mbimom]

Yes it is Bruce Lerman.  It has been a while since I have seen him.  My husband had his ablation with him in 1996 and I think that it was a pretty new procedure back then I had mine done in 2001. Yes my husband and I both had SVT I was in denial about my symptons for a long time because I thought how could i have the same thing as him.
  There was also a doctor Steve Marchovich (sp?) in the practice who I liked alot. He was a good listener.  Good luck and if you need more info let me know I can go in my files and pull up the numbers for you.

[mbimom]

Yes it is Dr. Bruce Lerman. There was also a Dr. Steve Marchovich(sp?) in the practice that I liked alot. It had been awhile since I have seen them but if you need their number let me know and I will look it up in my files. Good luck.

[Momto3]

Hi Suzy!  When you have a PVC every other beat, it is referred to as "bigeminy". A PVC every third beat is "trigeminy", and a PVC every fourth beat is called "quadrigeminy".  It sounds like you were experiencing pvcs, but not necessarily in one specific pattern (some bigeminy, some trigeminy, etc). Two pvcs in a row, with no normal beats in between are referred to as "couplets"; three in a row, as "triplets".  Sometimes 3 or more in a row are referred to as "runs" or "salvos". While some physicians refer to runs as non-sustained v-tach, others do not classify them as VT so quickly. For example, even though I had many occasions of "runs", my doctor says I did not "technically" have VT.

Have you had a holter monitor or an event monitor to record your heartbeat? Recording what you feel as it occurs can be especially reassuring.  Good luck!

[suzy345]

thanks for your help, Momtobe.  I have had a holter monitor but it only got the single pvcs.  The times when I get groups of them are so rare that I don't know how I could catch them.  I would have to be on the monitor for more than a couple of months at a time.  I found your comments interesting and helpful, and reassuring.

[denimill]

Hi everyone.  I am new to this site and have a question.  I am 53, slightly overweight and under a lot of stress (two seriously ill children).  During a well-woman exam my OB heard a heart murmur and suggested I see a cardiologist.  In the past I have had several episodes which I thought were anxiety attacks in which my chest felt thick, and it felt like there was a lump in the base of my throat.  Also, I felt slight pain up the left side of my shoulder and neck.  It lasted about 10 minutes and went away except that I still have a heavy feeling in my chest, my heart beats about 80-90 beats instead of its normal 70 and I feel like that little bone in between my ribs is pushing in.  Strange as these are they are my symptoms.  Does anyone have any idea what this could be?  Or where I could go to get more information?   The cardiologist can't see me until mid February.  Thanks for any information you can offer.

[parunuweap]

This sounds like a panic attack to me.  I experienced some symptoms similair to these soon after I had my ablation.  I had some palpitations that were nothing like I was used to and it put me in a very concerned state which caused the panic attack.

[KarenSA]

Hi, I am considering having an ablation for AVNRT and am interested to know more about your ablation experience.  What were you ablated for?  Are you much better now?  How long did it take to improve your symptoms after the ablation?  I also have ventricular ectopy and have had an EP study done to confirm my arrythmia diagnosis.  
Thanks!  Karen

[parunuweap]

Karen,

I had an SVT that would race up to 160 bpm at rest and 280 bpm with exercise.  I had it ablated in May 2002 at UCSF and was very well cared for. When I woke up after the ablation it felt like a truck had hit me.  Some people get the ablation and hardly any effects afterwards, but I ended up staying overnight in the hospital.  Maybe it had something to do with the blood thinners that they used since my problem was in the left side of the heart.  After a few days I felt fine except had a lot of pressure and pain where they made the incisions for the procedure.  After a few weeks I started noticing a handful of strange palpitations a day.  Sometimes a hard flutter, sometimes a dozen slow and very hard beats in a row, and just a lot of other oddities.  These alternated between lessening and worsening over the next six months and then they pretty much went away.  I still get quite a few PVCs now and then but they're the same ones I used to occasionally get before the ablation.

[Chrissy27]

Hi everyone- I am new to this forum but I can relate to each and everyone of your stories.  I am a 27 year old female from Philadelphia with severe SVT.  I take toprol and have had every test done and have been told by 3 cardiologists that there is nothing wrong with my heart muscle- just an SVT arythmia disorder.  I have been clocked over 250bpm and have developed severe anxiety and panic attacks from this.  I am scared to travel or drive far distances.  I have to take ativan every day to relax myself and experience palpiations everyday as well.  I know my triggers- heat, anxiety, caffeine, nicotine, alcohol etc... and avoid them all.  I was shocked to find out that even one alcoholic beverage will put me into an SVT later that night and increase my heart rate.  Does anyone have this as a trigger as well??