Pulse too fast to count- are doctors missing something?

[adviceseeker777]

I am 39 years old and have been diagnosed with 'panic disorder'. However, my heart has really been going out of control, far beyond what I had experienced in the past with an attack.  Over the past few months I have been to the ER and have had a number of EKG's-- my heart rate was always elevated at the time I went (which of course had me in a panic).  The EKG's were fine, but my bpm was anywhere from 113 to 130.
I went to a cardiologist who had done another EKG, stress test, and sonogram...he said I was normal and didn't think i needed a heart monitor.

Last night was horrible for me.  I came back from dinner where I had had one glass of wine, and before I knew it my heart was pounding out of my chest.  The rate was so fast it was impossible to count and I can guess it was probably close to 200.  I could hear it in my ears and it was impossible to focus on anything else.  My psychiatrist had given me Inderal and xanax to take.  I took 10mg of Inderal and .5 of xanax but in 30 minutes it still had not slown down.  This terrified me even more.  I called my doctor and got permission to take another 10mg of Inderal and they wanted me to take 1mg more of xanax.  It took well over an hour for my heart to slow down to 100bpm which I don't consider very slow!!!  About 90minutes afterward, it finally went down to about 80 and i seemed to calm down. But it felt for the longest time as if it wouldn't stop and just keep going until it finally gave out.  I'm sure you can imagine how horrifying this is.  I had spoken to the cardiologist and he didn't seem to think much of it. But I am afraid I'm being dismissed as someone who has 'panic attacks'  and they are overlooking other things...
What else can I do?  What kind of tests should I be getting?   Last night in no way felt like a normal panic attack. It felt as if there were something seriously wrong with my heart.
Please advise.  I am so terrified of it happening again.  I wanted to go to ER but my cardiologist last night said it wouldn't be necessary.  
I also recently had a Chest CT scan because I've been feeling it difficult to breathe. That came back completely normal if that means anything.  
thank you for your time,
k

[adviceseeker777]

thank you so much for your thoughts and advice...
I have to say, since I have been suffering from panic disorder and the attacks have been especially bad this year, I have been to a number of doctors.  The cardiologist never mentioned  SVT to me...he told me he thought my heart was normal and that it was coming from my brain (i.e. the panic attacks).  I never heard of SVT until I started reading these boards.  The doctor on another board explained to me though that an SVT usually goes from 200+ back to a more normal range within a matter of a few beats and that a heart racing at that speed and slowing down gradually is more indicative of 'sinus tachycardia' which is consistent with a panic attack.
I am going to insist on having the heart monitor for a few weeks.  But you have all been a tremendous comfort in letting me know that while it feels like I'm going to die, either of these diagnosis would not be life-threatening.
thank you so much.
wishing you all the very best,
k

[mabebesc]

I have just read all the posts and having SVT for 36 years I agree that a rate too fast to count (200) most likely wouldn't be a panic attack. I'm guessing it  most likely is SVT.  I agree that wearing a monitor to record when this happens would be the next step.  The  monitor will show whether it is anxiety or SVT  Regardless of the cause, it is frightening when your heart is beating out of control.  But please know that both are not life threatening. Whatever is the cause, it can be treated. I always tried to not get myself too upset when it happened.  I would hold my breath and squat down and this would break the SVT. For anxiety, deep slow breathing will slow the rate down. You are not alone-we all understand and are here to help.

[andie3330]

I agree, it seems that an event monitor would be useful because, based on advice seekers original post, it is not clear whether s/he is experiencing just a panic attack or an episode of SVT. They are, of course, two different things, although anxiety can make SVT episodes more likely. While both are generally benign findings, SVT episodes can often be converted back to normal sinus rhythm with vagal manuvers (Try holding your breath and bearing down as if having a bowel movement). Myself, I have had anxiety induced sinus tachycardia well above 150BPM and I have had days on end where it seemed my heart rate didn't go below 120. However, a heart rate above 200 that lasts for more than a few minutes seems to me to be more likely to be SVT. Either way, both conditions are very manageable and NOT life threatening - but an event monitor would give you peace of mind to know exactly what is going on.

[lagoya]

hey
great advise by greendave above i have svt and suffered like that also when the fast rate would start i would panic and that would make the whole thing worst.but i am not sure if u have been diagnosed with svt.a panic attack can be a frightful experience and certainely produce dramatic effects on the body as well as the heart.if u are over producing addrenaline which is kinda what happens to most in a panic atttack this is going to effect the heart.the breathing exercise as described above is worth trying.

now if u are not happy with the tests u have had ask or demand from your doctor an event monitor which is a portable device u can wear for a few weeks and when an eposide like this happens u can record it {heartrate} and also note what u were doing at the time and get an ep to look at it ,,then u  will know if this is svt or an arrhythmia or not and it may just take the worry off a little.i had an ablation for mine but i still get a lot of pvcs which make me anxious depending on where i am or what i am doing but in time u will get used or have more confidence with these.
inderal is a good beata blocker i am not sure how long u are on it but it will work.

take care

[greendave]

I don't have to 'imagine how horrifying this is' as I have lived with this for 27 years and am still here to tell the tale and better than that I can hopefully pass on to you how i have learned to keep the SVT incidents to a minimum.by learning what triggers these attacks for my body and you can do the same.
So firstly you have found someone who knows first hand what you are going through and lots of people in this community also know and will be able to help you but firstly you have done the right thing by having all those tests and now you need to accept as a fact that your heart is not going to 'give out'. My first big surprise after I came out of hospital and had my first stress test was how pleased they were with my extremely fast heart rate while exercising - what i thought was terrible they thought was really good that my heart could go that fast.
Secondly keep a diary and look for triggers that seem to correlate with your SVT incidents and in my case I have an extreme sensitivity to alcohol particularly wine so that glass of wine would do it for me so i don't do it.
Next the 'panic attacks' are often triggered by over breathing so you need to be conscious of your breathing and change to 'abdominal breathing' which simply means your abdomen will rise and fall as you breathe not your upper chest. Sit relaxed and open in a chair and place your hand on your abdomen and breathe slowly and gently with your hand rising up and down showing that you are breathing correctly.
I know how terrifying this is and the loneliness of those early morning hours womdrting if you're going to see the dawn but you are and you will so know that and start fighting back.
Others will give you there advice but I will be there for you to bounce your experiences off and hopefully help.
dave