PSVT

[Julie__0__0]

      I am a 28 year old female and I recently read an article on PSVT in Prevention magazine.  The symptoms sounded so much like the things I have been going through that I wanted to find out exactly what my next step should be.  
      About 2 years ago while at a party, I suddenly began having tremendous palpitations in my chest.  My heart felt like it was going to burst its way through.  It was extremely unnerving and I truly thought I was going to die.  The attack lasted for about 45 minutes to an hour.  The following day, after taking some Excedrin (which contains caffeine) I experienced another bout of plapitations.  Again I was scared and thought something was seriously wrong.  However, since I was having no heart attack symptoms I assumed it was akin to a panic attack, although I had never had one before.  I felt dizzy, nauseous, and had shortness of breath.  I could not figure out what was wrong.  Finally I went to a family friend who is a doctor and she had me wear a Holter monitor for 24 hours.  Nothing irregular showed up.  In the meantime, bloodwork showed that I had Premature Ovarian Failure (POF).  This, the doctor said, was what was causing my heart palpitations.  She suggested hormone therapy and said that the shock to my system was what exacerbated the palpitations and told me to visit a psychologist to deal with it.
      Needless to say, the palpitations, although lessened, continued.  Even after hormone therapy, I had several "attacks."  Once I was sitting in a movie theatre enjoying a movie with my friends when suddenly I felt fidgety and my heart began to race.  I got up an ran outside thinking I was going to die.  These attacks come from nowhere and I can find no "trigger" that might spark what psychologists would call a panic attack.  My questions are: Could this be PSVT?  Could POF be the cause of these sudden palpitations?  Would the Holter monitor have picked up PSVT?  Would an EKG pick up PSVT? And, ultimately, what should me next step be?  I am tired of living in fear of the next attack.  I don't know when or where it will happen.  Any help you could give me on this matter would be most appreciated.
  Thanks,
  Jami

[Cleveland Clinic, MD]

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Dear Jami,
Q: Could this be PSVT?
A: Yes, it could be PSVT or it could be one of a variety of different things.
Q: Could POF be the cause of these sudden palpitations?
A: I think that is unlikely.
Q: Would the Holter monitor have picked up PSVT? Would an EKG pick up PSVT?
A: Only if you had an episode while you were wearing the Holter or EKG.
Q: And, ultimately, what should me next step be?
A: I would seek the advice of an internist or cardiologist.  You may need to wear an event monitor which is like a Holter monitor but is worn for a longer period of time to try to "catch" the rhythm.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
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.