Holter and Echo Results

Hi,

Thanks again for taking the question.  I wrote back in late 2004 about problems with palps and tachycardia/chest pain I had experienced since the birth of my daughter in May 2004.  I am 32 and live in London, UK.  I have just received the results of my echo and holter and I quote:  "I am pleased to report that her heart was structurally normal, with a blameless echo.  Her 7 day event recorder was similarly unremarkable.  There were a dozen manual recordings consistent with momentary palpitations as described by the patient, although not as severe as in the past.  Looking at these episodes more closely, one or two occur during sinus tachycardia, however no significant dysrrhythmia was detected".  A recent lipid profile was excellent and my EF was 66%.

My questions:

1) Can I assume that the chest pain I have is muscular and not heart related?
2) I did not have an 'episode' whilst I had the monitor, as they only occur every few months.  What should I do the next time I have one? (racing heart, sweating, feeling of doom etc).
3)The only thing that bothers me now is the constant awareness of my heart beat, especially at night.  My chest will be moving and elsewhere in my body I can feel my pulse and it is very loud in my head.  Should I just ignore this, is it normal and probably a result of the heightened awareness?
Finally, during labour, my heart rate was 120 and the hospital wanted to keep me in because of this and the fact that I had a slight temperature following delivery.  Surely a heart rate of 120 is not exceptional, even normal, during labour?

[Cleveland Clinic]

Rochelle,

An echo and holter look at the structure and rhythm of the heart. Chest pain can be caused by other things in the chest includeing blockages in the arteries, asthma, muscles of the chest, and reflux disease to name a few.  At 32, your overall risk of having blockages is low unless there are extenuating circumstances. I would expect a good history and physical examination would help point in a direction to help elucidate the cause of your symtpoms.

2) If you didnt have an episode, then its impossible to tell 100% if the episodes may be rhythm related. There are monitoring procedures that you can use for extended period of time.  Otherwise, if your symptoms persist long enough to get an ECG in a local emergency facility, that would accomplish the same thing.

3) This is a common problem. Your holter showed no relation to rhythm. Hopefully that is some assurance.

4) Labor can certainly elevate your heart rate due to the discomfort. Also, an infection, perhaps the cause of your fever can also cause heart rate elevation.

good luck

[Rochelle73]

Just wanted to say thanks again for this.  It is not possible to see the actual results of my tests in this country without a lot of hassle, I just got a letter from the hospital saying the above and this service has helped me so much.

[Jeff67]

I would say a heart rate of 120 during labor is excellent when you consider the lack of sleep and stress, but more than anything I am surprised the doctor did not mention the actual physical exertion of labor!