Anxiety or SVT or Both

[heartfears]

in march of 07 I was arguing over something stupid with my father , I started feeling really hot then my heart started pounding it was reaching like 180 bpm.. I took about 4 hours for things to get back down to normal. (with .5mg of xanax not much I know) Then after that episode similar ones followed in the weeks after - I went to my Doctor. Now I had just been in for my Check up January 9th. and I had AN ekg taken and you know all the usual stuff you get at your checked up I had them mail me a copy of the EKG from then you can see it here. http://img127.imageshack.us/img127/6663/ekgmikego4.jpg - Please give me your opinion on that and if it has any relevant meaning.  The rates im having last 2-4 hours and are 140-180 bpm. they happen with panic attacks. Once I take the beta blocker it brings the rate down in about 40/60 minutes.
But I told her everything to my knowledge. I know I said "heart rate 180" My Anxiety is especially bad at Dr Appointments ( she has known about my anxiety since I was 18/19 )She had the nurse use a pulse machine to take my pulse which was 101bpm then my bp which was like 145/97 it has been higher - at home its normal. She then proceeded to listen to my heart from of the chest and back for about 4 minutes - Then she asked if I had any questions on medications and I asked about a battery of things to be honest ) And we decided to try a Beta blocker - I started metoprolol 25mg April 1st along with a xanax increase to 4mg a day as needed.. after 3 days she droped it to 12.5 a day and ive stayed there ever since (the beta b locker is breaking the 25 mg pill in half and taking it once a day) And for awhile my heart rate was in the 60's but lately its back up to the high 80's to about 100 at times. and I still have the attacks panic or not im not sure.
But does this sound like SVT? Could Panic be the cause of these rates? What do you recommend I do overall(please be very detailed if you can)? What do you think about this in general?

[heartfears]

Thank you Dr. McWilliams.. It does help to hear that.. I wanted your opinion on tests.. Do you think a 24hr holter monitor would put this issue to rest? And Thank you again for your help I has helped me beyond words.

[Michael J. McWilliams, M.D.]

aboslutely.  it is always worth a monitor to see if it is sinus tachycardia, but yes, anxiety can do this.

[Michael J. McWilliams, M.D.]

It sounds like panic attacks/anxiety.  Beta blockers will treat the heart rate.  There are better medications for panic attacks though like SSRI's and tri cylclic anti depressants.  If the beta blockers make you feel better then stick with them, if not, try one of the other classes of medications typically used for anxiety.  Consider seeing a psychiatrist or psychologist -- they are often better with medications.  This is probably something you are going to have learn to live with so I think counseling is a good option.

As an EP, I don't usually deal with anxiety related normal tachycardia -- that is usually done on the primary care end.

[heartfears]

I had someone claiming to be a DR tell me anxiety/panic can't make my heart race like that.. should I disregard that?

[heartfears]

Thank you for your response. I had one last question.. just I guess reassurance purpsoes. You do think that Anxiety/Panic (and the chemicals it produces) can make a heart race at rates 140-180 for 2-4 hours ?

Thank you

[heartfears]

Age 22 not overweight - dont smoke - dont drink. dont exercise

[heartfears]

and by weak I mean like it can feel like it progressively I dont know if that makes sense like today for example it feels weak in my chest but strong in my wrist..

[heartfears]

I wanted to add on I have periods where it feels like my heart feels likes it's beating 'weakly' in my chest. Could that just be a perception issue?