Hello. I am 33 years old, non-smoker, healthy weight. I exercise 3-5 times a week with cardio and weights. I have had palpitations for years off and on. I did a Holter in 2001, which I remember them saying was fine, and everyone has palpitations. In 2002 in my first trimester in pregnancy they found MVP when I mentioned to my OB that I couldn't fall asleep unless propped up on a few pillows. I was told it was "because" of the pregnancy and I never got it followed up.
So this past summer I was really trying to push myself at the gym. I have lost 60 pounds and as a challeneg I decided to train for a 1/2 marathon. However, I would feel palpitations and hard "thumping" in my chest, get light headed and SOB, when my HR would get up to the 150-160's. And it was frustrating to see overweight people running at the gym, too. I would have to stop and I felt really mad like my heart wouldn't cooperate with me. So I gave it up and stopped trying to run fast/far. I just went back to cardio and weights. And the occas palps here and there as usual.
Then about 5 weeks ago at the gym, I felt a big palpitation as I began a jog. I stopped for a second caught my breath and thought "geez, I hate this!" and started jogging again and WHAM! my HR went up to 230. It lasted about 3 or so minutes. and stopped.
So I saw an EP Cardio-- he wanted to ablate me after a 5 minute conversation. I asked for a little more conservative approach and I am currently wearing a 30-day event monitor. Here are my recent concerns that I will ask you guys, since calling the office hasn't gotten me answers: I have sent downloads in of me exercising and feeling the "episodes" of thumping and SOB, and the event office says it shows nothing? Since the SVT, I have had a dull pain/ache/heaviness in my chest. I keep waiting for it to subside, and it will come back off and on. I have especially noticed it at night. I climb stairs and crawl into bed and my heart will pound and I feel pressure and I feel SOB for a few minutes. I called the Cardio office today and asked what about the MVP they found all those eyars ago? Would he want an ECHO to be re-done? He didn't even auscultate my chest in the exam so how does he know I dont' have a murmur. The nurse said MVP doesn't cause SVT. True? I don't know--- it makes my head spin to think I lost this weight, want to be an athlete and now I am currently thinking I might have something wrong with my heart?
May I also add that the Cardio's nurse told me to keep my HR under 150 because "why take the risk". When I do cardio, especially run/jog, I easily can be 160 and feel "symptoms". So she told me to stop getting that high. But I don't see the fairness in that? That's why I called a cardiologist. i want to be able to do my cardio. After 3 years of working out, shouldn't my heart respond better to cardio? I have heard the term "Inappropriate Sinus Tachy". Is that something I should ask about?
what about getting a 2nd opinion? that's what I did for my own peace of mind
I went to an EP and he agreed with my cardiologist and took about 5 min likes yours = told me I could die from my pvc's if I didn't have an ablation...I got 2 other opinions and they both agreed with the others, that I needed surgery but it wasn't that big a deal (I have NSVT & VT episodes, MVP/Tricuspid reg; and some other things)
I made a major mistake in the 2nd opinion - I decided to go with EP #2 to do my ablation since she was head of cardiology at a major teaching university here in FL.
She told me she wanted me to try Toprol first, "a conservative approach" ; that it was a wonder drug etc etc...I ended up in the ER because she didn't know I had a major problem with my ANS and wasn't going to do a tilt table test first (said it wasn't needed as my first EP said) During that test, I found out I have NCS/OI and my heart stops when I pass out.
After that episode I decided to get another opinion, but ended going with my first EP. Sometimes you just have to go with your gut feeling and find a dr you trust and can put your faith in. Luckily I did, because during my ablation I had major complications and from the nurses in the hospital, they said my EP was the best at handling complications.
I would err on the side of caution for now until they do a full cardio workup if they haven't, you don't want to end up in emergency surgery or find out after what you were feeling is something else entirely. I know how hard it is to let go for even one day with routines, I had to do that and was put on a no exertion order the first time I saw my cardiologist.
He seemed like sush a nice guy, and I was happy he wasn't blowing me off and saying it was "just SVT" and go live with it. However, I didn't like the idea of not knowing if anything else was going on. Which is why I am a little puzzled that I suggested the event monitor, and I am trying to call the office to ask for an ECHO, and why he didn't even bother to listen to my heart during the only brief meeting we had together.
Your last paragraph about "finding out it was something else entirely" is kind of whats been going thru my mind. But since calling back the EP guy and asking more questions has not gotten me past his nurse, I will wait until the next appt and keep wearing this event monitor. But no, I havent had much of a "cardiac workup"-- my PCP drew routine labs at my physical recently (prior to the SVT), ran an EKG (2 days after the SVT), and now I have the monitor on. That';s as far as I've gotten.
def get a full cardio workup, they will probably do the run of tests - ekg, stress test, echo, and whatever else they think they need for your particular case - depending on your insurance you may be able to go straight to a cardiologist of your choice, or you may have to have a referral from your pcp.
getting a good cardiologist and keeping them isn't an easy feat, finding the right Electrophysiologist (EP) may be even harder
None of the 8 or 10 drs I saw prior to surgery ever thought I had a malignant form of PVC's; just an enormous amount that was leading to cardiomyopathy and could be fatal. It was quite a surprise to my dr when I went into sustained vtach and v fib during surgery, he just never suspected it to happen.
Even more amazing, so far I have no cause (idiopathic) for anything that's going on with me - so I'm still searching for answers also :)
I'm not all that familiar with SVT but I've had my hr go above 170+ doing nothing at all, it's scary, but most of my problems originate in the ventricles.
Every time I read about the complications you had during during surgery, I hope my PVCs won't get worse. I'm 67 and they came on suddenly about nine months ago. They're worse when my pulse is slow (lots of trigeminy then), such as when I'm sleeping at night and become less when my pulse is over 85. I had 17,000 PVCs over the course of two days on a Holter monitor. I'm not taking a beta blocker because the EP I saw said they'd slow my heart down, and why do that when my PVCs are worse when my pulse is slower? Guess he's right, and the beta blocker used for headaches in the past made me feel like a zombie.
Here's the thing. If my PVCs become more frequent or I get VT, I could need an ablation. That probably means I'd be treated with an antibiotic. As I've mentioned before here, just about every antibiotic closes my throat. So docs don't like to do surgery on me and one calls me a "surgeon's nightmare." What on earth would I do if I needed an ablation (or more than one)? I've nearly died twice from antibiotics already and it's not something I want to experience again.
I hope you're doing better these days, Lisa. You're such a help to those here who have questions.
Usually when your HR is slower you feel pvc's more and they're more frequent; there's a reason but my brain isn't working right today so it's beyond my capability of thought :(
The need for antibiotics is something to be discussed with your dr, but I don't think the majority of ablations are given after surgery...correct? I only had to have them because of [brain fog] ugh can't think inflammation of the heart (periocarditis maybe?)
I think even with VT, unless it's polymorphic in nature or sustained and long standing in nature that it isn't a problem. I've lived with NSVT awhile; until whatever changed - they still have no clue. Which is the reason I'm still researching and asking questions why, what happened? I'm really interested to see if my ins will approve one of the large clinics for me to go - I won't be surprised if it turns around and my problems are caused by a medicine I took.
If it's a long standing VT problem a preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD) and I would def look into meds for arrythmia's, I just have to find my right combo :)
Step One: Get a full heart workup; everything, including the stress test where they inject a radioactive solution into your heart. If they find nothing, like me, and you still have this heavy feeling or even pressure in you chest - guess what? - it could be serious case of tendinitis in your chest from lifting all the weights. A simple test: press on your chest. Does it hurt? One time I ended up in the hospital, thinking I was having a heart attack. All the pain was simple tendinitis in my chest. As to the palpitations, I have had them all my life, and my heart is very strong. RE: fast heart beat. Could this be just stress or a fear attack? It is entirely possible to stop a fast heart beat episodes or minimize them to 1 minute, assuming a healthy heart. I did it by walking 1 mile a day, and by using the straw technique. See my post.
mysolution I've had a full cardio & ep workup as well as RF ablation, Cardiac MRI, CT's, genetic testing, blood tests etc - they found plenty (it's all listed in my journals and my about me) including malignant heart arrythmia's - all of these things wrong with no known cause - they suspected ARVD but it wasn't conclusive, ANS dyfunction, peripheral neuropathy...list goes on when I was told for 5 years or so nothing was wrong with me
both times that i went into a-fib for over an hour i had a thump in my chest right before and then my heart would take off immediately like it was on the starting line of a race and the thump was the gun signaling it to go.
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