Significance/prognosis of paroxsymal atrial tachycardia..

Dear Doctors:

Firstly, Happy Holidays and hope this find you all in good health!

I am a 38yr F w/3 children. Dx.w/MVPS in 91. Echo and echo/stress tests since have been shows prolapse in apical view but does not meet strict criteria for MVP. Trace/trivial regurgitation. Structurally normal heart. Have yearly checks echos and routine ekg every 3mths with Dr. One episode during last pregnancy 3yrs ago a bout of tachy was recorded on monitor. It slowed down over period of 45min. One opinion was pat other was sinus tachy.rate 140 All quite since then. Recently was at a party and had not eaten until then. Had a hotdog and within 1/2 hour felt a tight/anxious feeling in my stomach. Pulse was quick.I drank water, waited but felt it again and it was a bit quicker. It did not jump to rapid, seemed to get quicker gradully. No watch to time the rate. During the course of 45min. it slowed down bit by bit. No other symptoms.Appt. with dr. next day, ekg 92, wore holter was fine, had stress/echo all same. Felt it was poss. due to eating and triggered adrenaline to rush.claims for years I am hyperadregenic.Have had pa/anxiety low b/p, pac etc time to time. On 12.5 atenolol with o.k. to increase during times of increased symptoms. Told it was probably a pat episode brought on by eating, not to worry, benign,increase med for period of time.Tight knot in stomach since
Questions: What is prognosis for PAT. Does it tend to recur with age or decrease or is it dependent on each individual?
Can triggers be stress/anxiety, food etc?
Can PAT go dormant again
Looking for reassurance.
Thank

[CCF-M.D.-MJM]

Hello,

I think I can provide your reassurance.

You symptoms sound more like anxiety than PAT.  PAT tends to start and end abruptly (eg. Heart rate jumps from 92 to 120, maintains 120 and then just drops to back to 92.).  Any time heart rates increase grandually of minutes, that suggests anxiety or exercise.  I have seen quite a few patients that have food and social situations as triggers for panic attacks and their stories are very similar to yours.

What is prognosis for PAT. Does it tend to recur with age or decrease or is it dependent on each individual?
The prognosis for PAT is no different than the normal population.  In patients with documented PAT, it does tend to recur, but it does vary on a case by case basis.

Can triggers be stress/anxiety, food etc?
I do not know of any triggers for PAT.  That does not mean they don

[Christie2004]

I did have PAT 20 some years ago--it began just as the doctor described--abrupt "ping" in my chest and severe tachycardia to 200 making me unable to even stand and had to go by ambulance to the ER where they were unable to chemically cardiovert me.  Stayed in CCU 2 days- eventually spontaneously cardioverted.

Was put on Digoxin for a few years after that.  Stopped eventually and really never had another episode like that, though I do run on the tachy side and have PAC/PVCs from time to time that don't bother me at all.

[arthur]

It's "hyperadrenergic"  and can be found all over the web...basically related to over-sensitivity to a variety of stimuli which kick up adrenaline in one's system.  -Arthur

[mom4cem]

Do you still take the Digoxin?

Thanks Arthur for the correction!!!

Now if I could only get all this adrenaline under control! Just felt anxious again and my pulse started to quicken except this time I had to use bathroom(sorry),,it seems to pick and choose what area it is going to effect..

Thanks for the repsones all!

[uptowngirl]

Hi.  Just a quick question?  You mentioned something in your post about MVPS.  What exactly is this?  I have been diagnosed with MVP, moderate; but wasn't sure what you meant about MVPS.
Any clarification(by anyone)would be appreciated.
Thanks,
Uptown

[jkf]

Hi,
I was diagnosed with PAT about 10 years ago.  Just like the doctor said, I feel a pause and my heart jumps to 220.  It usually lasts around 5 minutes then just as abruptly returns to normal.  I get this about twice a year (thank god).  I take 1/4 of a 25mg tenormin every night.  When this PAT happens, I take 1/2 of the tenormin and I guess that is why it quiets down quickly.  The last episode lasted for about 20 minutes.  It woke me up from sleep.  (very scary).  I am told it is a benign condition but it sure doesn't feel like it.  I also get pvc's along with the fast rate, so I really don't have a regular heart beat during that time.  I also know what you mean when you talk about your heart slowly starting to race.  Mine does this too but I really think it is anxiety related.  However, mine does choose to raise after eating sometimes as well.  I get an anxious feeling in my stomach. almost like a knot, and I know if I feel my pulse that it will be around 100.  Nothing really makes sense because it seems to have a mind of its own.  I can eat chocolate all day and not have any problems.  Then out of the blue on another day after a normal lunch..bam, it decides to jump around and race.  It can really ruin your day.

[pms_barbie]

MVPS is an older term that has been supplanted by POTS (postural orthostatic tachycardia syndrome). This is a syndrome of fast heart rates, fainting and normal or near normal blood pressures. It is more common in young women and may be confused with a variety of other diagnoses including panic attacks

This definition was found in the archives here on the forum.

[pbanders]

You might want to try ending your PAT episodes by using the "Valsalva maneuver". Look it up on Google for more information. Basically, you close your glottis and "bear down". When I had PAT (finally went away) for years, I could generally stop an episode quickly using this technique, avoiding the need for drugs to treat it.

[Momto3]

MVPS stands for mitral valve prolapse syndrome.  MVP generally involve the valve only, whereas MVPS is representative of a myriad of symptoms.  Thus, it is termed a "syndrome."  I have a really good link, but can't put my hand on it right now.  In the meantime, maybe these links will help:

http://www.advocatehealth.com/system/info/library/articles/heartcare/common/mvpsynd.html

http://www.medicinenet.com/mitral_valve_prolapse/article.htm

[jkf]

Thanks. I will try it if or when it happens again.  I'll tell you though, my head already feels light enough when the rate is that fast.  The thought of bearing down would only add to that feeling. But..if it makes it stop faster, then I'm all for it. Did your heart get up to 220?

[mom4cem]

What everyone said is right. It's mitral valve prolapse syndrome. The syndrome being panic/anxiety, low b/p, tachy, pvc pac, cold extremities, ibs,,plus a whole bunch of other symptoms. An imbalance in the nervous system. I take 12.5 tenormin 2x since the last episode. Of course I know I am making myself crazy waiting for the next episode. Lifestyle threatning just like MVPS can be.

Try www.mitralvalveprolapse.com and www.mvprolapse.com The last is from the mvp center in Alabama.

[uptowngirl]

Hi. Thanks for all the info. You all are great.
Uptown

[kellebelle]

Hello Mom4 wow, you have a lot sympotms I do. Almost identical.
How low is your blood pressure?? Mine is 90/60 or some where in that range. My cardio still has me taking a beta blocker for pvc's I get pac's as well. Anyway all of this is very interesting. I have had all the routine tests and my doc says all is okay. I have a cousin with mvp but my echo showed no mvp , I have all the symptoms so it confuses me. This all begin with Panic attacks and my body seems to take a different course every so often can be tachy, but over the last year lots of pvc's.

I am 43 and agree that around my cycle the darn things bother me more. Also I have Hashimoto's thyroid syndrome, not on meds for that since my thyroid levels seem to be in the normal range.Of course the holiday season has brought along an extra amount of stress and my body seems to love the adrenaline, I don't!!!

Happy Holidays to all and to all a pvc free day, Kelly

[mom4cem]

Hi Kelly,

Min has gottn that low also. Mostly 110/70..during the summer, if I am outside and am doing gardening, or anything that has me bend over, when I get up I gray out a bit, my b/p really drops.  You don't have to show MVP on a echo to have symptoms of dysautonomia, it just seems that many people who have MVP have dysautonomia also.

Check out some of this sites posted and try some of the self help suggestions, like keeping hydrated, cutting sugar/caffiene etc. Some good info is out there!

Enjoy the holidays!

[pbanders]

Yes, my hr used to get up to 200+. Look up "valsalva maneuver" on Google for more info on it, it worked for me.