SVT - What Now?

[kepps]

Hi,

I stumbled onto your site here and I hope to find some relief, as I'm a nervous wreck.

I remember having "episodes" from the time I was 5-6 years of age. Over the years, I have researched tachycardia and decided SVT was what I was suffering from. I am a runner and have a history of anorexia/bulemia. I am now 40 years old, free from the eating disorder(s) and am now a personal trainer. I have worked my body fairly hard over the years and have noticed an increase in SVT episodes over the last year. I get them once or twice every 4-6 mos. One of the cardiologists I have seen assured me I have done no damage to my heart from the ED's, etc.

The last few episodes have been harder to break, as normally I could just cough or put a cold compress on my neck and that would do the trick. These episodes do come in waves, as about 6 years ago I experienced more frequent SVT as well and then it just waned on its own for the most part.

I have had several EKG's over the last year, an echo (8 mos ago), and a stress test. Everything came out fine. The cardiologist said I will die from old age as opposed to any heart issues. One would think this would alleviate my concerns but because I've had another episode, I'm a wreck. I finally went to see the chief of cardiology in my home town and she said I would be a great candidate for ablation.

My question: Could myocardiopathy be possible at all? Could they have missed such a diagnosis? Will I be okay? How rare is it to drop dead during a run or heavy training routine?

I'm too anxious to enjoy my long runs like I used to and want my life back. My cardiologist suggested I run in a monitored and more controlled area like the gym as opposed to running along the road. This makes me nervous that she would suggest this.

I appreciate your time and input. Thanks.

[kepps]

I will mention the CCB's during my follow up and thank you all again for your input.

Best,

Kepps

[kepps]

Thank you for taking time to answer my questions. You have put my mind at ease. I am scheduled to consult with an electrophysiologist on 11/16 and will take it from there.

I appreciate your input and support.

Kepps

[sueinns]

Hi Kepps:

I've had palpitations off and on for years but they only became very bothersome (and scary) after a bout with the flu last year.  After months of tests, I was finally diagnosed.  They became almost constant with many episodes of dizziness, especially after working out, so not going on medications wasn't really an option.

Being active is my way of life and the beta blockers brought my heart rate down to the 40 range.  I had zip energy and could not run more than 10 minutes without stopping to catch my breath.  The calcium channel blockers have been a godsend (at least for me - we are all so individualized when it comes to medication).

I understand your fear.  SVT's are uncomfortable and scary and anxiety definitely plays a role (and who the heck doesn't get anxious from time to time).  Meditation has helped me deal with the anxiety part.  

All the best.

[Michael J. McWilliams, M.D.]

Could cardiomyopathy be possible at all?

If you had an echo and EKG are both normal, it does not sound like a cardiomyopathy.   Is there a 1:1,000,000 shot that you could develop one, yes, every shares this same risk.  It does not sound like you have one now.

Could they have missed such a diagnosis?

Sure it can, but it does not sound like you have one.  If your issue is rapid onset tachycardia that breaks suddenly with coughing, that is consistent with an SVT.  The next step is either trying a medication like a beta blocker to try and decrease the number of episode or an EP study to make a definite diagnosis.

Will I be okay?

Nothing you mentioned above concerns me about your long term health except that you are worried.  I think you have three choices: 1. do nothing and live with (not good), 2. try a beta blocker or calcium channel blocker to decrease the frequency of symptoms, 3. have an EP study and possible ablation if a arrhythmia is induced.

As a runner, you probably won't like beta blockers because they will make you tired.  You should see an electrophysiologist to discuss the options.

How rare is it to drop dead during a run or heavy training routine?

If you have a normal echo, a normal EKG, and no concerning symptoms/history, the chances of dying while working out are very low, but never zero for any of us.  I do not think this should be your concern.  Meeting with an electrophysiologist should help.

I hope this helps, thanks for posting.

[kepps]

thank you for your input. I truly appreciate it.

Sueinns - Have you had SVT since childhood? My doctor agreed that I don't have to go on meds, as beta blockers would have me dragging around. I'm a personal trainer and wouldn't be setting a very good example walking around the gym like a zombie. :)

Thank you both once again for your support.

[sueinns]

I was diagnosed with SVT approx 8 months ago, after a frustrating year with palpitations.  The most frustration came from being unable to work out at the intensity I was used to.  But my doctors never told me to stop running - I do several shorter and one long run a week to stay in half marathon shape.  They were not at all concerned about that. Had a stress test, EKG, blood work etc.  All pointed to a normal heart structurally.

Calcium Channel Blockers have kept me relatively stable  (could not tolerate beta blockers) and I am now able to run at a much better pace without feeling like I'm going to pass out.  I still have bad days (a couple every 2 months or so) and am being referred for an EP study and possibly ablation.  Maybe your doctor made the suggestion he/she did because it would make you feel less anxious to work out in a controlled environment.

[sugarpea013]

I think maybe instead of diagnosing yourself with SVT you should try and have an EP study done. There are many possible rhythms that could be going on, all of which wouldn't necessarily be caught on an EKG. I have worn 2 holter monitors and also have had several "normal" EKG's only to be later diagnosed with SVT and IST.  The stress from not knowing is enough to drive ya crazy. You should see about a possible holter monitor and even more imporantly an EP study. Most tachycardias are benign but can be scary and frustrating. You have checked out for having a structurally normal heart, so the chances of you "dropping dead" are pretty darn slim. Cardiomyopathy would be the result from a sustained tachycardia over a long duration.


Again these are just my suggestions. I'm not a doctor but have a lot of experience with my own heart issues. I was also a very physically active individual prior to my diagnose and can totally relate and sympathize to your anxiety  interferring with a good workout. I wish you the best!