sinus tach

Hello .My question is,when performing strenuous exercise such as lifting weights i get this feeling my heart speeds up.My last post you said you would like to capture this on a monitor,well i have and  the cardio said sinus tach with some pacs.I do not get these when using a treadmill or anytime other than strenuous activitys.Iaiso notice when i take a deep breath it goes back to normal?my last echo was normal when i went for stess test i had a panick attack and could not do it,Iwas very affraid of this when it first started happening thought it was going to kill me.I am going to a second cardio much closer to home, the first cardio has not contacted me but told me before this holter test no restrictions to work or exercise.I love to exercise and was wondering is it ok to with sinus tach and also what are treatments for this.Icant thank you enough for the service you provide on this site.I wish you and everyone on here a happy,healthy new year!!!!!!!rick

[CCF-M.D.-MJM]

Hi Rick,

Thank you for the kind words.

A fast heart rhythm that looks like a normal origin or sinus origin is usually just sinus tachycardia.  Other possible causes could be an atrial tachycardia triggered by the PACs (if the tachycardia was always preceded by the PAC), sinus node reentry (sudden onset and offset, sometimes initiated by PACs).   The most likely explanation is a normal sinus tachycardia responding to increased work load.  There is a variant of inappropriate sinus tachycardia that occurs only with exercise and not rest, however, this would occur with both aerobic and anaerobic exercise, making it an unlikely mechanism.  Atrial tachycardia and sinus node reentry tachcardia are diagnosed by a holter finding of sudden onset/offset and often initiated with a PAC or short burst of PACs.  I would need to see the holter to confirm this -- these are less likely diagnosis and your doctor probably would have commented on this to you.

If you have a normal heart (echo, EKG, and stress test), this does not represent any danger to you.  It would be treated conservatively with a beta blocker only if the symptoms were life  style limiting.

I hope this answers your questions.  Good luck and thanks for posting.