whats happening to me

[JR]

this morning, after a shower, i sneezed very hard and immediately got the feeling that something wasnt right. i started to get light headed and sat down. tried to take my pulse but my heart was beating so fast that i coulnt count it! i basically crawled to bed and lied down and was about to call 911 when all the sudden everything was ok. this has happened to me once before when i bent over suddenly to pick something up once and i coughed. i am a 23yo female non-smoker non-drinker with no known heart problems in the past. what is going on with me, and should i see a doctor about this? if so should i go to a cardiologist? what kind of tests will they do?
thank you...
p.s. both of these "attacks" lasted about 5 min and the first time i almost blacked out.

[Cleveland Clinic, MD]

Dear restless,

The medical term for what you are describing is tachycardia. There are many causes of tachycardia  (fast heart beat) and they can be divided roughly into sinus (originating from the sinus node or heart's natural pacemaker) and non-sinus tachycardias.  

Nonsinus tachycardias are either  supraventricular (coming from the upper chambers of the heart) or ventricular (coming from the lower chambers of the heart).  Supraventricular tachycardias are also know as SVT's (supraventricular tachycardia) and include:  paroxysmal supraventricular tachycardia (PSVT), atrial flutter, atrial fibrillation and AV nodal tachycardia.

The treatment of SVT depends on what type of SVT it is.  PSVT is often treated with a catheter ablation but may be treated medically as well.  Atrial flutter is almost always treated with ablation now days.  Atrial fibrillation is usually treated with medications but may sometimes be treated with certain surgical and interventional methods.  AV nodal tachycardia can also be treated with ablation.  It may not be possible to tell which type of SVT on has from surface ECG recordings and if that is the case a special type of study called an electrophysiology study is performed.

Sinus tachycardia is defined as a heart rate of greater than 100 beats per minute originating from the sinus node.  Sinus tachycardia is classified as either appropriate or inappropriate.  There are many causes of appropriate sinus tachycardia such as exercise, anxiety, panic attacks, dehydration, deconditioning, volume loss due to bleeding or other loss of body fluids, hyperthyroidism, electrolyte abnormalities and many other conditions.

Inappropriate sinus tachycardia can only be diagnosed when all causes of appropriate sinus tachycardia have been ruled out.  It is not clear what causes inappropriate sinus tachycardia but possible etiologies are an increase in the rate at which the sinus node depolarizes and an increased sensitivity to adrenaline.  Once the diagnosis has been made by ruling out all of the potential causes of appropriate sinus tachycardia  there are several treatment options.  If the symptoms are not overly concerning no treatment needs to be done.  There is no increase in morbidity or mortality in persons with this condition and they can expect to have a normal life-span.  For persons in whom the symptoms are unbearable medications such as beta blockers or calcium channel blockers can be used, usually with good results.  In the rare person unable to tolerate medical treatment catheter ablation (burning) of the sinus node with insertion of a pacemaker or surgical removal of the sinus node have been used in the past.  Newer techniques are being developed using catheter ablation to modify and not destroy the sinus node thus avoiding the need for a pacemaker.

As you can see the diagnosis and treatment of tachycardia is not straight forward and oftentimes a specialist is needed.  The type of cardiologist who treats these type of problems is called an electrophysiologist.  Your doctor can refer you to one if needed or you can probably find one at the nearest major medical center.

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.

[stevebu]

I am not a doctor, but what your discribing sounds like SVT.  This happened to me for years when I would bend over fast, jerk suddenly, or sometimes for no reason at all.  My heart would start racing.  Sometimes it would last a few minutes, sometimes a couple hours.  I had RF ablation done last month and they think it is cured.  Only time will tell.  You can have your heart monitor put on, and if it is caught on tape they will know what it is. Good luck!

[Ben, Ohio]

Restless on Monday,
I am not a doctor either but I would go see my cardiologist. If you do not have one, go to your GP and ask him who he would see if he needed a cardiologist.
I could be nothing or it could be anything. Have it checked out.

Ben

[CLM]

Again, I am not a doctor but I am a healthy 34 year old woman diagnosed with PSVT and I also have the fun of lots of pvcs (they are like "skipped beats").  What I want to let you know is that even though all of this that you are going through seems really scary you will be just fine.  You will go and get thoroughly checked out and get through the tests and then your dr. and/or cardiologist will let you know what your situation is and what you can do about it.  What they might forget to do is let you know how many folks have some kind of arrhythmia!  And they may not understand how very scared you are because to them:  you are young and healthy and probably not at much risk!  It is not nearly so uncommon as it seems to you right now and as the years pass (yep,more than likely you'll be living a long lifetime and tellin' your grandchildren about these "spells" you had in the year 2000 before they were growin' hearts from toenails... ha ha)  you will find that more and more people you encounter have some experience with it.  But when you are young and just starting to feel the nasty feeling of an episode like that and don't know much about it and don't know anyone else with it... it is awful.  So hang in there and learn all you can and take all the tests but don't freak out:  it is indeed a bummer but it can be dealt with.  You are not alone!

[MoPalese]

As I sit here, I'm experiencing pvc's on top of one another.  They went "away" for about 7 years and have come back just last Tuesday.  The mind games begin again.  Sometimes I feel like I'm gonna go crazy with these things.  Amazingly enough, what I've found is that the more I ignore them, the less I notice them, so I try to keep my mind and body busy.  I've been through all the tests just like everyone else and have gotten the same advice, ignore them.

I'd like to know from anyone out there if they have had problems during sleep.  Sometimes I wake up out of a sound sleep with a frozen feeling in my chest right where I normally feel the pvc's.  I'm wondering if they are related.  E-mail me at ***@**** if you can help.