PSVT questions

[LynnSB]

I've posted before about my palpitations.I'm on the last day of a month long even monitor which has revealed "inappropriate sinus tachycardia" (my heart shoots up to 120 after a minute or so of exercise or just walking across the room, sometimes),lots of PACs, a few PVCs, and non-sustained runs of PSVT.



20 years ago I had bouts of tachy(180 -200)that lasted for hours and was told it was "panic".I learned to break it with cold water on face. that stopped about 10yrs. ago.(I'm near 50, good wt.,good BP,excellent cholest.,thallium stress test last year fine.)I've learned that the scariest "palps",when I feel my heart acting weird and feel momentarily weak,are bursts of PSVT (150 or so). I have pacs and pvcs almost every single hour.



1 I've read PSVT is unpredictable.what does this mean?

2.Is ablation an option for non-sustained, frequent, PSVT?

3.Can the event monitor rule out WPW?

4.I was put on lopressor (25mg)1 wk. ago. I think I've had MORE skipped beats and a faster heart rate although today does seem better.It makes me tired at night. how long does it take it to work?

5.the monitor caught bursts of atrial tachy and lots of PACs during exercise (even just walking my dogs) and afterwards. Is this significant for my life expectency or for heart disease risk?

6.can the monitor distinguish between AV nodal reentrant tachy and accessory pathway  tachycardia?



Thank you!

[CCF-M.D.-RCJ]

LynnSB,



Thanks for the post.



(1) To say that PSVT is unpredicatable means that it can be very difficult to predict when the episodes will occur.  Some people have stereo-typed triggers, but most do not.



(2) Yes



(3) No.  WPW is the mechanism for a type of PSVT.  WPW can be apparent on an EKG, or hidden.  An electrophysiology study is the best way to look for WPW.



(4) Metoprolol (lopressor), as with all drugs, reaches steady state values in 5 half-lives, which would be approximately 2-3 days in most people.



(5) The PACs will not impact your life expectancy if you have an otherwise normal heart.  If the monitor caught the episodes, and you had no symptoms from them, then I would forget about them.



(6) Only, if it has gone to medical school.  Seriously though, most of the time the monitor cannot provide enough information to distinguish between these two types of SVT.  By the way, WPW = accessory pathway tachycardia.



Hope that helps.

[dande4]

Hi:



These palpitations are annoying!! Even knowing they are benign just does not seem like enough comfort. Especially after feeling well for a period of time and then they start back up, feel like you are back at square one, at least I do. Hope you are feeling better. I am heading out into the outside world now, in the heat, hoping nothing will start up while I am out!!!



Feel better!



Dande in NY

[tarczely]

hi my name is also Lynn.  I have also been dealing with the heart skips been thru all.......... the tests and still feel like there should be something else they can do, you just can't forget them as was suggested.  I too get them everyday all day and of course more noticed when i lay down to go to sleep.  I now take cardizem 180 mgs once a day.  But really does not seem to make a big difference.  I recently had to change heart dr's cause my other heart dr had me on so much meds it put me in the hospital 5 times in less the two years for 3 and 4 day stays, never mind the countless er visits.  So my regular dr. fianlly stepped in and the last time i went got me a new dr.  I was on toperal and nitro and the cardizem and I keep getting chest pains thought i was having a heart attack.  They thought it was anxiety (panic) which i do have anxiety, however have never had chest pain when i have had anxiety and i take .05 mg of the twice a day, but for some reason i have anxiety attacks when i drove (who knows)  but anyway the last time i was in the gastro guy came in and put me to sleep and ran the tube down and put me on protonix 40mg well its been since april and i have had no trips to the hospital no trips to the er. have been taken off the toperal and the nitro. (i think the toperal and the cardizem) was causing the chest pain but it was not heart pain.



Now here is still my problem he just upped my dose of cardizem to 240 once a day.  I still have all the same symptoms and I can hardley do anything. I had a garage sale yesterday with a friend and when it was time to clean up i was hot nearly 100 here yesterday i had to go in sit down and i was breathing so hard (no chest pain) but my heart must have been 160- 180 took over hour to calm down.  I had to have my husband come finish for me and then he took me home and even after resting all that time it finally came down to 116 then i took a cool bath and it came down to 88 took a nap and woke up and it was its normal 70 again.  



I feel iam very limited on my actvity, I want to do it but just cant and iam only 45 years old.



So iam to see my dr. again soon anyway and iam going to explain it to him. see what he says.



Now i have a new problem both the tops of my feet are numb i noticed this about a month ago (anyone?) iam going to call monday cause this is not going away.  



well lynn let me know what you plan to do! take care and i feel for you i know what it is like.

LynnT

[nikl]

MY HANDS AND FEET WOULD GO NUMB BEFORE I STARTED DEVELOPING FULL BLOWN ANXIETY ATTACKS.

[LUKE22]

Back when I was having my panic attacks my hands and feet would also tingle and feel numb. I dont have full blown panic attacks anymore but that uneasy feeling is still around. Im on Corgard 60mg,Xanax 25mg. I started Protonix 40mg a year ago for acid reflux and slight stricture and now my chest pains have disappeared. I guess all the panic/stress was causing the chest pain that I thought was my heart,though I still have to battle PVC's.

[tarczely]

thanks for the advise on the numbness, problem is i have the numbness but not the anxiety (so i have a feeling its not related) however i do think it could be a side effect of one of the meds i take.

LynnT

[Buckeye42]

A related discussion, PSVT was started.