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Heart Disease (Expert Forum)
PSVT and negative reaction to epidural anasthesia
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PSVT and negative reaction to epidural anasthesia
by Dana__0__0, May 27, 1999 12:00AM
Posted by Dana on May 27, 1999 at 11:11:50
I am about to deliver my third child in a few weeks and am having a lot of anxiety. After the birth of my son five years ago, I was diagnosed with PSVT and take 25 mg. of atenolol daily which controls it well. With the delivery of both my daughter (who is 8) and my son, epidural anasthesia had to be stopped due to my heart rate suddenly jumping up to over 180 bpm. After my son, I started having regular attacks which was when I was diagnosed. No one seems to know why the epidural has this effect on me. It always happens about 30 minutes after the first dose is given. Could it be epinephrine even though I was told that if it was, I would have reacted immediately (within 30 seconds). Should I avoid an epidural altogether this time? Could I possibly be pretreated with a medication that would counteract the tachycardia? We know it is not a drop in blood pressure, because both times my BP remained stable. Is there a certain type of anasthetic that could be used in the epidural that would not cause this to happen? Any input would be appreciated since I am getting a lot of mixed messages and I would like to to go into this birth feeling confident about my body's reactions.
Thank you.
Posted by CCF CARDIO MD - DLB on May 28, 1999 at 16:47:32
Dear Dana
Pregnancy is often a trigger for SVT - it is at this time that many women are diagnosed for the first time with SVT. Whether the SVT was related to the epidural itself is unclear to me. Potentially, epinephrine could be the cause, even though the time lag was a little longer than one would expect. I am not sure what the best path for you is, but I think there is a risk of SVT no matter what you do, but medicines like atenolol do decrease the risk.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
