paroxysmal tachyarrhythmia

Posted By Linda Ann on November 23, 1998 at 16:11:31:







49 y.o. woman with hyperlipidemia for 20+ years (low HDL, Increased triglycerides and total cholesterol), positive family history of coronary artery disease and diabetes.  I have labile hypertension with average BP 140/85 but at times it is as low as 106/60 and at times of stress as high as 200/100.  I also have documented calcification of the aorta in the area ?slightly above the renal artery.   The question I have is that I have episodes of tachycardia usually in the range of 120-140 bpm.  I recently got an event monitor when it seems particularly disconterting, the rate was between 140-148.   However, since the tracing was only a lead two and not on an EKG - it was read as either sinus tachycardia or aflutter with 2:1 block.   The pattern was not the usual sawtooth so it was difficult to read - and it came at a period of extreme stress so I am certain that my BP was high.  My T4 was normal.  TSH is pending, but I expect that will be normal as well.   The only other factor of note is that I had tried tenormin for two weeks (25 mg qd) and was tapering off because I was feeling too many ectopic beats as an adverse reaction.  My questions are how can I find out if this was really flutter vs sinus tach?  What is the best, least invasive approach to work this up?  I have these episodes about 4 times a year, but they seem to be getting more frequent.  The other ringer is that I am allergic (anaphylactoid) to contrast dye.  I would appreciate any thoughts that you might have.