Re: PSVT or Panic Attack

Posted By CCF CARDIO MD - CRC on November 24, 1998 at 10:55:29:

In Reply to: Re: PSVT or Panic Attack posted by Denise on November 22, 1998 at 15:30:00:






I am a 52 year old female and have recently been diagnosed with PSVT after a visit to the ER with a heart rate of 210bpm. Since the age of 28 I have experienced what I thought were panic attacks and have been on meds for anxiety since 1993. When I was diagnosed with PSVT I found out that this condition was commonly misdiagnosed as panic disorder. The symptoms for both seem to be the same. For example: palpations, rapid pulse, anxiety(feeling of impending doom), shortness of breath and chest tightness.
Now I am left wondering just how much of what I have experienced in the past years as panic attacks have actually been the PSVT.
My question is: can you experience any one single symptom alone such as shortness of breath or even a rapid pulse that is lower in range(110-120bpm) than the typical 150bpm and up, and still be the result of the PSVT.
I am taking toprol for the tachycardia but It makes me sleepy and sluggish and I still have an occasional daily flutter. I have seen a EP specialist and am considering RV ablation. I admit that I am terrified of the prospects of a 2-6 hour procedure. I am open to any suggestions or recommendations. In recent years what I believed to be, the panic/anxiety disorder, has become more disrupted. If I thought that even 25% of the so-called panic attacks were actually a PSVT episode I would have the ablation done tomorrow.

Hi,
I am a doctor by no means, but will give my personal experience.
I started having PSVT last September.  I went into the E.R. and with a heart rate of 180 and when they hooked me up to the EKG, my rate was 130 because the nurse showed me a maneuver to get out of the arrhythmia before the EKG.  They diagnosed it as SVT.  They just didn't have the location of the SVT.
Well, needless to say, my electrophysioligst suggested I see a Neurologist because of the numbness in my head I would experience before some of my attacks.  One of the first things the Neurologist said "It is common for women your age to have panic attacks".  Well, I knew from the very beginning I would just let her do whatever testing she wanted to make sure nothing neurologically was wrong, but other than that, nothing else.
I am not a stressed person and hate being told stress this and stress that.  What stresses you is the fact you are having these things and people are telling you it is stress, but you know differently.  You saved a lot of time by having the E.R. tell you about the PSVT (as have I).
I don't know you, so I have no idea on your history of stress.  What would happen to me during these attacks is:
Lightheaded
chest pain (sometimes)
numbness or tingling in face (sometimes)
abrupt increase in heart rate (usually 180)
tremors afterward
I had the ablation done on October 12 so I could be medication free.  The procedure lasted 2 1/2 hours for me.  Before that, I had not been sedated since I was 8 years old (33 now), so I can relate to not wanting to go through this procedure.  Only your electrophysiologist can tell you whether you are a good candidate for this procedure.  It is all over before you know it.  Does the electrophysiologist think you are having anxiety/panic attacks or do s/he think this is all related to the PSVT?
I've never experienced an anxiety/panic attack (that I know of), only these PSVTs and can tell you, they are scary and NO FUN!  Go on what your electrophysiologist suggests because s/he knows your history.  I went for it because there was no way I wanted to have to deal with that problem all my life!  With the advances in medicine/technology the way it is nowadays, the risks are very low for a "normal" person.  As I stated before, I'm not a doctor and you should decide with your electrophysiologist your best approach to dealing with this. If s/he thinks ablation would be the best for you, GO FOR IT, you are young yet!  I have an excellent electrophysiologist with a high success rate.  I'm sure the ablation was successful for me.  I have other things beside the PSVT, (i.e. adrenalin problem) so... My cardiologist referred me to the electrophysiologist, so I knew I was in good hands.  Don't be afraid to do research on the electrophysiologist doing your ablation. You definitely want one who has performed a lot of ablations with a high success rate.  If you are near the CCF, go there!  Do some homework, it never hurts!
I'm sure you will get an excellent answer from the CCF.  You are not alone out there!  It is hard for the doctor if they can't get the arrhythmia recorded because the PSVT is so close to anxiety/panic attacks.
Good luck,
Denise
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Dear Denise,
Thank you for sharing your experience.  Have you had any additional symptoms since your ablation?
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.