V-Tach in healthy heart????

[cookienkikin]

I'm wearing a cardio-net monitor and they caught something. A brief history about me is "24 yr old male. cholesterol 245, ive been having this left side chest pain for about a yr now. ive had echo,ekgs,stress echo,holter monitor, event monitor, and blood work. i also have been experiencing pac's and pvc's. all my test were normal besides the event monitor which showed the pac's and pvc's.left side chest pain, radiating down my left arm and into my left hand,cold sweats, feeling lightheaded,about to pass out. I just received a call last night from the cardiologist on call and said that the monitor company called them with some irregularities in my heartbeat and asked if i was alright and talk to me today, today they called me in for a echocardiogram, and said that there was a run of V-Tach on my monitor and the beat was around 127. I felt it when it happened it felt like "back to back PVC's" and I'm assuming thats what they are referring to. I do drink beer everyday, (irrelevant or not)? My main concern is this happening again and developing into V-Fibb, which is deadly. 1.Could this cause v-fibb and SCD in my situation? 2. What could have caused this? 3. Is it possible for v-tach to be benign or is it always deadly? why haven't this ever been caught with the multiple of test that i had, holters and event monitors?? How dangerous is this? My pulse is always jumping around up and down. Thanks"

[Mom2four85]

as a  non & sustained VT patient I understand how scarey it can be when there aren't any answers at hand... I'm a bit rusty so forgive any typo's or anything I forget,,,

there's VT/VTach/Ventricular tachycardia - which is technically a run of 3 pvc's with a HR > 100

most of the time it is monomorphic (all beats of the heart match on ecg/ekg) These tachycardias are generally well tolerated and the patients complain mainly of episodes of palpitations or fast pulse and is not associated with an adverse prognosis. This VT seldom degenerates into ventricular fibrillation, and it is often responsive to drug therapy or RF

then there's VT or VTach - this is the scary kind and will show on an ecg/ekg as a distinct pattern which has has beat-to-beat variations where it originates and is typically called Polymorphic VT/Ventricular Tachycardia

Tachycardia rates between 110 and 150 may be tolerated even if sustained for minutes to hours. However, faster rates (>180 beats per minute) may cause drops in arterial pressure and produce syncope. Very fast rates (>220) are imminently dangerous because they rarely terminate spontaneously and invariably cause drops in blood pressure and low cardiac output.

recurring VT should always be evaluated by an EP (electrophysiologist) just to be on the safe side so an EP Study may be in order to see if they can recreate what's going on and fix it.

I would ask for a copy of your results once your monitor is done; note anything that is listed such as VT, rates , amount of arrhythmia's you're having and anything else listed and ask for an explanation from your cardiologist or ask for a 2nd opinion if your current dr doesn't help or even ask for a referral to an EP

here's some info that a dr here gave me if you want to read more on VT http://www.medhelp.org/user_journals/show/284968/Ventricular-Tachycardia-VT---Vtach

[MichelleP_3811]

It doesn't appear as though erijon is active anymore.  What I will say is, in a healthy heart it is not likely any nonsustained vt will be a danger to you. If it becomes sustained and your heart is unhealthy then there is a chance for it to become dangerous but the odds are nsvt is generally not a threat in a healthy heart.  I would discuss your risk with the cardiologist who has your test results and knows your history but I suspect that you do not have to worry about falling into any dangerous rhythms.  Obviously though if things got worse you should always follow back up with the doctor but I think working on any stress in your life will help to alleviate some of your pvcs issues.  Take care and please do keep us posted on how you are doing.

[SARABELL5454]

HI. I know that this was a few years ago, but I was hoping that you could answer a few questions for me?

I have had an arrythmia orff & on for ten + years. I currently am wearing an event monitor to try and catch the "scary" ones that I in frequently have. We managed to catch one yesterday actually & they called it a 3 run pvc V-tach. I believe that my DR said that it was at bpm?

She wasn't concerned but faxed it to my Cardiologist at University of Chicago who specializes in the electrics of the heart.

I have had massive anxiety about all of my heart issues , which seem to be PAcs & Pvcs.. I have had every heart health test known to man including recently a cardiac MRI that came back % normal.

So my question is this, why when looking online does it state that V-Tach is deadly? I know that there is no way to say for sure what could or counldn't happen, but when is it ok to think that this has transitioned into something else?

Mostly I am wondering if a run of 3 or lets say 5 pvc's (which is technically V-Tach) can turn into something a lot more serious like it lasting for minutes?

Any advice on what I can ask my Cardiologist or how to plhrase it so that I can get some answers would be great!! Thank you

email : ***@****

[cookienkikin]

i also have been having left side chest pain and what seems to be angina, but normal test so far for blockages, could they have missed the blockages bc i never had a angiogram, and this is what could be causing my chest pain, angina pain, and pvc's, and the V Tach episodes?

Does it mean since i had that run that my heart is more prone to ventricular fibrillation and SCD? 2.For it to turn into v-fib would you be able to feel sustained v-tach for a long time and have a chance to get it treated or could it just turn to v-fib in a matter of seconds? 3. in your opinon what do you think is causing my symptoms and v-tach, right ventricule outflow tract tachycardia or what? 4. is my conditon and symptoms something that gets worse overtime or is it what it is and stays this way?

[cookienkikin]

could it be Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy? how would that be diagnosed? would that fit my symptoms of chest pain and the PVC's and VT and other symptoms that I feel? if a dangerous arrythmia (V-Fib) is triggered during EP study, how often is it converted back to normal and what are the chances of death resulting from this test? im REALLY concerned about could it be Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy!!

[is_something_wrong]

Thanks for your update.

Now you've seen an electrophysiologist. As you probably know, electrophysiology is a specialization within cardiology, and an electrophysiologist is an expert on arrhythmias.
In other words:

You cannot find anyone in the world (except possibly better electrophysiologists) that know arrhythmias (incl IVT) better than him. You're going to do an EP study next week, and in this process you will burn away the spot creating your VT anyway, so now you really have no need to worry.

I'm not worried (on your behalf) of your arrhythmias. What is somewhat concerning, is what you are going to do after the EP study/ablation, if you feel chest pain, palpitations, or if you get afraid of cancer. You really need to work on the mental side of this, and as I wrote, the fact that you cannot spend your entire life trying not to die.

Quick answer to your questions:

Can you explain an EP study?
About as angiography, but they are not looking for narrow coronary arteries (as long as you're there, you could ask them to, just to get rid of your angina fears, too). They stimulate certain parts of your heart, trying to provoke reentry-arrhythmias, and they inject adrenaline to provoke non-reentry arrhytmias. You will get a LOT of PVCs and PACs :) If they find something, they ablate the spot / pathway

How safe are they to do?
Very safe. (0,1-0,2% serious events, and in AVNRT ablation, 0,5% needs a pacemaker)

If he triggers a deadly arrythmia can they easily terminate it and keep me safe?
You'll probably have three defibrillators, an electrophysiologist, another cardiologist, three nurses and injections of adrenaline / isoprenaline within 5 meters. The answer is yes. Though I doubt they will manage to induce Vfib.

What if he has to do an ablation, how safe is that?
About the same. The heart can get a bit irritable some weeks afterwards, creating some PVCs and PACs. In some cases, fluids can leak out in pericard causing chest pain and some other symptoms. In that case you need to drain them, a fairly easy procedure.

Just how benign is "Idiopathic Ventricular Tachycardia"? Can it develop into V-Fib?
I won't answer this question. Reason: I've answered it 3 times before, and most important: You've asked an electrophysiologist this question, and you've got an answer. You REALLY should learn to trust him, any advice from lay people, including me, on this forum, in this specific questions concerning arrhythmia, are quite worthless, compared to an electrophysiologist.

[cookienkikin]

Echo, stress test, stress echo, holter, and event monitors have all been normal besides "PVC's and a 26 beat run of ventricular tachycardia at 127bpms that self terminated". I seen an EP today and he said that he thought it to be benign and called it Idiopathic Ventricular Tachycardia and I started asking questions and he said that just to be safe he wants to do an EP study next week. Can you explain an EP study? How safe are they to do? If he triggers a deadly arrythmia can they easily terminate it and keep me safe? What if he has to do an ablation, how safe is that? Just how benign is "Idiopathic Ventricular Tachycardia"? Can it develop into V-Fib?

[erijon]

Here's what you were told last week by a very prominent Cardiologist that went to Harvard Med School and did his Cardiac rotation and grad work at Yale plus was the head of Cardiology at the University of Virginia;

"V-tach at 127 is very unlikely to lead to v-fib in someone with normal echo and EKG, and is certainly benign, not deadly at all, not even dangerous.  Find out how many PVCs in a row occurred.  If only 3, certainly no problem.  Even 10 or 20 in a row at 127/min would not be dangerous.  Low blood potassium or magnesium can make PVCs more frequent and might lead to non-sustained vtach, which is what you had.  A lot of beer, several quarts, might lead to low potassium or magnesium, so I'd stick to one bottle of beer two or three times a day, or less if you don't mind.  I'm not alarmed.  I think you're safe."

This is the same response you always get from Internet doctors. What more do you think those of us on this forum can tell you? I doubt if anyone here, no offense, is more qualified to tell you what you're looking for than this doctor.

[is_something_wrong]

I hope you understand, but some of your questions are close to impossible to answer.

26 beats = approx 10 sec, non sustained. No, not very long.

It's not easy to see the difference between SVT with abberancy and VT on a 1 channel EKG. But at rate 127 it's a bit unlikely to be SVT, but possible. Anyway, slower are usually more benign.

It's IMPOSSIBLE to say if you have an unknown conduction disorder. It would probably have to be caused by ischemia, heart attack, myocarditis or cardiomyopathy, or congenital.

Idiopathic V-tach is usually benign.
Idiopathic V-fib, never heard of. Must be less likely than being hit by lightning.

[cookienkikin]

i agree with your advice 100% its just so hard to live with this and tell myself not to worry when i feel what i feel everyday and night, that it affects  verything in my life.  i got a copy of my cardionet monitor report and on it it has the (Urgent Ventricular Tachycardia 26 beats at 127bpm, self converted into normal sinus rythm).  Is that long of a run dangerous?  I faxed an EP the report in houston and his physcian assistant said that he wasn't in and she couldnt actually READ the report just could see what the computer printout said and that she was really concerned with the v-tach and if it was her family member she would advise them to get in as soon as possible because this type of rythm is lethal, but my cardio here doesn't seem that concerned about it and set me up with an EP thursday.  My cardios physician assistant here said they he said that he thinks it ,might be SVT, instead of VT.  I felt the run when i had it and it started with a PVC feeling.  Could it be SVT? If it is indeed VT how worried should I be? This could turn lethal on me? Could I have some kind of conduction disorder that was never caught? What about idiopathic V-Tach, or Idiopathic V-Fib?

[is_something_wrong]

Hello, I'll post my last reply here, maybe my message to you failed.

I will try to answer as best as I can, but some of your questions are extremely difficult to answer without being a doctor (which I'm unfortunately not). Anyway, I'll give it a try.

Old questions:

1. You won't get an answer for this question no matter how hard you try I'm afraid, of course, the answer is close to "no" but we don't get any guarantees in our life. If your heart is structurally normal the answer is as close to no as you can get.

2. If your heart is structurally normal, just an over-active extra pacemaker that most likely will cause NO harm.

3. In structurally normal hearts, almost always benign.

New questions:

1. In a structurally normal heart, v-tach is caused by other mechanisms (not re-entry) than can cause V-fib. They are two different conditions. V-tach caused by increased automaticity don't degrade to Vfib in normal hearts. If a doctor finds V-tach, it's always indicated to find the cause. That's the reason he wanted to do echo.

2. LQTS is easily found on a normal EKG as very specific changes. You don't have LQTS.

3.  Hangover cause adrenaline excess (that cause arrhythmias). If this is bothering you, the only cure is to quit drinking, I'm afraid. If you don't, you must accept the extra palpitations / PVCs. The cause for your vtach is (probably) an overactive little pacemaker triggering some extra beats in a row.

4. Answered above.

5. No.

6. R on T is extremely rare, but equally frightening. A single R on T pvc is not likely to cause harm, but if you get thousands a day combined with LQTS or heart disease, it's dangerous. It makes an impulse that is conducted in some parts of your heart and not in others, creating an electric imbalance possible of causing what is called Torsades de pointes VT.

A little point of advice:
You seem to be very worried about cardiac events. The problem is - you will never find out when you are going to die - and you will never get any guarantees in your life. The exercise itself is a waste - you will never find an answer.

The question is - what are you going to have on your mind now? Do you want to be a good father for your baby, or do you want to spend all your time worrying about heart disease? We only have a limited number of days to be alive - and we should spend those days doing things we like, not worrying about dying. You cannot spend your whole life being afraid to die. You don't want to look back at your life as an old man thinking about how much of your life you wasted by worrying about all the things that never happened.

[no_fate]

Hey,
I'm a 23yo male who's been having leftside chestpain for over a year as well as left arm pain.
6 months back I used to still have panic attacks and back then the pains were definately more pronounced.

Apparently, at our age we can't yet have advanced coronary artery disease.
If the stresstest, echocardiogram, etc. all reveal we have a healthy heart,
then i guess we shouldn't think much of our symptoms and just accept them.

Some people have killer headaches for their whole life but can still live a long life. It's not because the body is giving the pain signal that's there's something seriously wrong, it could be but not necessarily.



this week  I've also had a run of SVT/VT/NSVT(?) for the first time in my life, and i've been having a lot of PVC's (especially lately).
It's easy to worry about this stuff but it's just not helping.

Even if we'd drop dead next week then  the worrying isn't going to help us. all we can do is visit one (or two) cardiologists, converse a little on medhelp and stay calm about it...  

- good luck ;)

[erijon]

Dr. Richardson just answered all these questions for you in great detail AGAIN on the other forum 2 days ago. Dr. Pearl will no longer answer your questions because you've asked them so many times.  You were told last week that there is nothing to worry about and your condition is not likely to cause V-fib or SCD. His last words were "your PVC's will not kill you". You really need to get some help with your health anxiety issues. It doesn't matter how many times you ask, the answers have always been the same. I really think you should focus on your anxiety and less on the heart issues. You have been told by any doctors on the Internet as well as your own doctors that you don't need to worry yet you still do. To me, that is the real issue. Is there a chance a doctor can be wrong, yes but as many as you've asked, all telling you the same thing, not likely that they have all been wrong. I think you need to stay away from the Internet as well as many of the questions you ask are way out of the realm of possibility and are the result of too much reading on the Internet.

One other comment, you state in all your posts that you "drink a lot of beer" and these doctors have told you that this can lead to low potassium or magnesium which can be causing your PVCs, yet you continue to drink. Also, you always state that your cholesterol is 245, stop the beer and see how much it will drop, that's a good place to start.

My point is you are worried enough to keep asking these questions and going in for tests after test yet you won't give up the beer, seems a little odd to me. It's just another example of doctors giving you advice and you not accepting it. You mention you have a child on the way, time to get over this so you can be the best father possible.

[cookienkikin]

I'm wearing a cardio-net monitor and they caught something. A brief history about me is "24 yr old male. cholesterol 245, ive been having this left side chest pain for about a yr now. ive had echo,ekgs,stress echo,holter monitor, event monitor, and blood work. i also have been experiencing pac's and pvc's. all my test were normal besides the event monitor which showed the pac's and pvc's.left side chest pain, radiating down my left arm and into my left hand,cold sweats, feeling lightheaded,about to pass out. I just received a call last night from the cardiologist on call and said that the monitor company called them with some irregularities in my heartbeat and asked if i was alright and talk to me today, today they called me in for a echocardiogram, and said that there was a run of V-Tach on my monitor and the beat was around 127. I felt it when it happened it felt like "back to back PVC's" and I'm assuming thats what they are referring to. I do drink beer everyday, (irrelevant or not)? My main concern is this happening again and developing into V-Fibb, which is deadly. 1.Could this cause v-fibb and SCD in my situation? 2. What could have caused this? 3. Is it possible for v-tach to be benign or is it always deadly? why haven't this ever been caught with the multiple of test that i had, holters and event monitors?? How dangerous is this? My pulse is always jumping around up and down.
im so worried that this will develop into v-fib. 1.can you please explain to me how this can be harmless and not kill me? when it happens i can feel it and my chest feels all weird, i get really hot, and left side chest discomfort like right over my heart. the nurse said that the dr thought it MIGHT be SVT but wasn't sure and had a EP look at it and he scheduled me an appt to see him a week from now. im so scared and dont want to wait a week, obviously he found something dangerous if the EP wants to see me, right?? i have pvc's all the time and i guess that it what lead to the v-tach, they said from the echo that my heart was strong and normal. could this be an electrical problem, 2.could it be long qt syndrome that was never caught? 3.why would my heart be going into v-tach, its not normal?? i do notice after i drink alot of beer its worse the next day, 4.could that cause me to go into V-Fib? 5. is it more dangerous since i feel all the symptoms from it? i have very forceful pvc's. 6.what is a pvc's that occurs on a T wave, if a pvc occured at the wrong time could it kill me? please shed some light on this whole issue for me. THANK you so much!!!!!!!!!! i have a baby on the way and im so scared that these are harmful and i wont be there for him.

[is_something_wrong]

1. Read my reply to Nurse2b1982 (about PVCs) from yesterday - a lot of information about VT there.

2. Probably just that a pacemaking cell in your ventricle fired a little salvo of PVCs and not just one.

3. Definitely possible, it usually is. Everyone probably have a run of VT throughout their life. If you are very bothered with PVCs, it's far more likely to happen.

[cindy707]

The doc started me off on Toprol which worked but made me sleepy but i put up with it....then i did ALOT of research and chose the ablation for the VTach thinking like cookie did that i was gonna drop dead at any minute which is not so in most cases...the ablation worked 100% and i have never had the V Tach since and yep i had PAC's and PVC's among a couple of other little goodies and lost those as well w. the ablation.  I ended up on a very low dose of antenolol which worked for me...got my life back and here i sit at the computer in the cheering section of our community never forgetting how Jerry and alot of others helped me thru my scary times and now its time to pay it forward as they say......

[BillTheCat]

You mentioned that meds worked for you...what med?  Did you have PVC's?  Did the med help them?

[cindy707]

Well this is where you make them earn their moneymy friend.  Alot of times docs will rule out certain things due to age but that isn't here nor there.  You have a right and deserve the answer.  I mean they need to step up...if they felt they needed to call when the monitoring center called them what are we doing now diagnosing over a phone?  Boy would that save us all alot of money in the future.  Nope...if it was my body first thing in the morning i would call in and tell them you want an appt. now because the on call doc said you had a run of V Tach and you want to be checked out and everything possible ruled out.  There is no way the docs know how you are feeling unless you tell them....i seriously doubt you will experience SCD not because of your age but because you haven't experienced any of the symptoms that would be progressive leading up to the red zone here.  This is why its so not cool to let patients sit and wonder if they'll even wake up in the morning...i hate it when they do this to people.....alot of the symtoms that you are describing in the first post are classic anxiety symtoms....this is where you take control of your life back and make them give you the answers.  Call in the morning and don't stop until they agree to see you TOMORROW....don;t let them put you off.  For tonite tho....i seriously wouldn't worry...i'd be madder than anything that they left this like this with you....

[cookienkikin]

no meds, just went and had echo done and it was normal, never even seen the Dr., just echo and go home, and last night when the Dr called me about the short run of v-tach he was like how old are you, i said 24 and he was like ohh, and didn't seemed concerned at all.  i feel as if they arent treating it seriously like it could lead to SCD, its like they arent worried about it, are they not being aggressive enough or is it really not a big deal and not deadly at all??

[cindy707]

Hi i read your post and understand your anxiety with the diagnosis that you got.  It is almost impossible to know if your v tach will go into v fib or not and pretty much depends on your own heart.  As i am sure you were told it is a very fast rhythm of the heart that originates in the lower chambers of your heart and is actually in most cases pretty treatable.  I was diagnosed w. it and chose to have an ablation done for v tach and a couple of other things and the ablation is in alot of cases successful in the 80% range.  And no it isn't always deadly and like i said it can be treated.  I personally felt like i was sitting on a time bomb just like it sounds like you are feeling and decided to get pro active and do something about it because i didn't want to live my life feeling jumpy every single time i could feel my heart for one reason or another.  My doc put me on a beta blocker in the beginning to try to regulate my heart so it wasn't jumping all over the board with my heart rate and rhythm and for me it worked and i decided to take the next step to give myself a little insurance with the ablation and was glad i did it.  That part for me is history and i have never had another episode since the procedure was done.  Its funny...everyone wants to know how dangerous each of our situations are and i think we all wish that we knew the answer good bad or indifferent...the hardest part is not knowing and having that fear in the back of our minds.  We always seem to make it worse on ourselves.  What did the heart doc say he/she felt would work for you?  The simple question is :okay now we now what it is how do we fix it permanently?"  If the doc gave you meds to me that would be the first start...i would talk to them about the possiblity of the ablation and if you are a candidate for it with your diagnosis for me it worked ...good luck and keep us all posted....