Possible PSVT/PAT?

I have been having episodes of sudden onset rapid tachycardia. I will be sitting doing nothing at all and it will come on. I am in paramedic school right now, and i printed a 12 lead just after i had an episode. My HR is normal in the 12 lead but when the event occurs im near 150-160. My blood pressure has been extremely elevated lately as well, 200/100 ish after the incident. I have had about 4 episodes occurring over a 3 month basis. The last 3 times i have performed vagel maneuvers and it worked. When it comes on get a sudden feeling of weakness, a shaky feeling of nervousness, i get hot and tingly, diapheretic, bounding pulse, with a impending feeling of doom. I also have had weird deffered chest pain, very minor though. I quit all drinking of energy drinks after the 1st episode, and i did chew tobacco often, now nearly never. No anxiety either. Here is a link to the 12 lead. What do you think?

http://i2.photobucket.com/albums/y18/layenxframe/12lead.jpg


Thank You very much for your time.

[Michael J. McWilliams, M.D.]

That is a strip of normal sinus rhythm.  A history like that is either an SVT or a panic attack.  You need to have a 12 lead EKG while you are in the tachycardia.  If the story is convincing, it is also possible to just do an EP study to see if a tachycardia can be induced.  If it can, fixing it with an ablation would depend on the mechanism of the tachycardia.  Probably best to see a heart rhythm specialist (EP) to see what they think.

[Appleman300]

also, i forgot to mention i also have a very small, if not a lack of a P wave.

[Appleman300]

Dr. Mcwilliams, Thank you for your quick response. Being that the event happens randomly how would it be induced? Also, with a BP of 200/100 yesterday and 138/89 today should i be concerned about a stroke? I am only 23 y/o in reletively good shape.

[Michael J. McWilliams, M.D.]

induced by placing temporary pacing catheters in your heart and placing critically timed extra beats to induce.

that is pretty high -- but associated with stress.  it should be discussed with your doctor and followed.

[coffeen]

A related discussion, ablation procedure was started.

[Cmajik001]

A related discussion, PSVT or WPW was started.