I am new here and just wondering if anyone has ever had any experience with Pectus Excavatum causing their SVT. I had a very severe case of Pectus Excavatum. My heart was displaced completely over into the field of my left lung, rotated, and slightly compressed.
Needless to say, after I had my first child, I started having heart arrhythmia which was later diagnosed as SVT. I have yet to have a doctor tell me specifically what kind it was. I did see a cardiologist, my GP, and an electrophysiologist and none of them seemed concerned even though I ended up in the ER with these rhythms multiple times. They just told me that they will not kill me. I have been placed on metroprolol extended release (50mg) and have been on that for the last year and a half which is when they finally caught me in full out SVT mode on an event recorder. I have a few questions for those of you with experience with SVT.
Is it important that I know what kind of SVT I have? I had my cardiologist and my GP tell me it was simply SVT and then Atrial Tachychardia. Are these terms interchangeable?
I had a nuclear stress test and multiple echos done. Should I still be concerned since they are telling me they saw no structural issues? They managed to miss the structural issue which was the fact that my heart was completely displaced, rotated, and compressed so I am having some trouble with trust of doctors at this point.
Lastly, since my surgery was completed about a year ago now to correct the compression on my hear from the PE, they are now reducing my beta blocker dosage by 1/2 as they do not think I need them anymore and want to slowly bring me down off of them. I am obviously very concerned about this as the SVT episodes that I did have were incapacitating and very frightening.
I am just looking for any knowledge on this subject and insight from those of you that have been dealing with SVT. When I did have my episodes, they didn't terminate quickly. While I may have had shorter runs at lower heart rates, the ones that scared the crap out of me were the ones that were sustained HR between 160 and 170 and I couldn't move without feeling I would vomit or pass out. It should be noted that what seemed to finally help was icing my neck.... and trying to cool myself somehow. These runs were truly scary. This all came after some extended bradycardia that I experienced after my daughter was born. I kept telling people something was wrong and nobody listened. I'm just happy they were finally able to catch it on a recorder.
While I have come a long way since then, I am still very nervous about this upcoming reduction in medication and looking for any experience.
I apologize for all of the questions. I am new here and just looking for any insight.
I think the usual comment about structural issues applies to ventricular arhythmias rather than SVT, but I could be mistaken. SVT is a abnormal rhythm that originates above the ventricles and I have heard doctors use different terminiology in this area. For a pretty good description of SVT, check out Doctor Patrick Chou's webpage at the cleveland clinic website. The doctor has a video posted that describes atrial tachycardia, afib, SVT, AVNRT, and ventricular arhythmias. I must say this doc does a great job of explaining a fairly complicated topic in a way that newbies can understand.
When I still had my SVT, my heart rates went up to 250bpm, and i felt a little light headed, but never afraid. Some SVT's can be fixed with a high success rate; maybe you could ask your doctors if or when an ablation could be an option for you?
".......Is it important that I know what kind of SVT I have? "
I think it is difficult for a cardiologist to determine what kind of SVT you're experiencing except for perhaps Wolf-Parkinson-White syndrome as that leaves a telltale EKG signature when in NSR. So the fact that they aren't telling you what kind you have is most likely because they don't know if it's AVRT or AVNRT or perhaps something else. Both produce the same basic results. I'm not an expert but I would think that because AVRT is an accessory pathway and typically located away from the AV node that it would be easier to eliminate (This is the type that I had). AVNRT on the other hand involves a reentry circuit within or just adjacent to the AV node. These pathways are formed from tissue that behaves very much like the AV node, and in fact some physicians regard them as part of the AV node. AVNRT is five times more common than AVRT, so the odds alone favor it being that. AVNRT also favors females in 75% of the cases of SVT.
While your heart may be displaced, and otherwise oddly positioned, that doesn't mean that it is not structurally sound, and I think this is perhaps what they meant when they informed you of the results of your echo.
You'd think that having SVT nearly all of my life, six to sixty until getting it fixed three year ago that I'd be used to it; a thousand episodes maybe? I don't really know. But each one was anxiety provoking and I always felt that this was THE ONE, the one that I either couldn't slow down, or the one that was going to get me. I'd have them three to five times per month, and towards the end, they were coming not when I was active, but the opposite. I'd be driving home from work on the interstate. Who was going to help me if I needed assistance? Perhaps I'd be dining with my wife in a nice restaurant. Would I make a scene trying to sow it down? Mine required intervention in order to slow them. I had a very stable and reliable accessory pathway, so once it started up, it was self sustaining, running on and on for minutes.... hours if I had let it. But each one caused angst even though each one was successfully converted all of my life. It is perfectly normal to feel this way. But understand that if you are young and reasonably healthy, that it isn't going to harm you and it will not cause long term effects on your heart.
As for your medication, 50mg per day is a rather low dose. At one point I was on 200mg per day although I'm currently on 75mg mainly as a prophylaxis. I don't know why they are easing you off of it. When I had my electrophysiology study, I was told to just stop taking it prior to the procedure. There was no "withdrawal symptoms" or rebound effects. Metoprolol has an approximately 5 to 7 hour half life, so it's eliminated from your system rather quickly.
By the way, I believe the term AT and SVT are both atrial arrhythmias. But I believe they can be different, although I've read that SVT has replaced AT.
I hop you can get your problems worked out. Cardiac ablation was very successful for me as well as many other who have passed though this forum. Just remember that if you see problematic stories of ablation, it is because those have come here seeking help while the successful ones have moved on. With a success rate in the ninety-plus percent range, odds are in your favor should you ever decide on getting your SVT fixed. It is undoubtedly much less painful than what you've most likely experienced with surgeries for you PE. Best of luck!
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