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tachycardia & vagus nerve or hiatal hernia?
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tachycardia & vagus nerve or hiatal hernia?

It all started when I finished my military service in 2007. It was a night that I was pretty much stressed and ate alot. 30 minutes after finishing my meal, my heart started racing and my mom took me to the hospital. my heart rate was around 300 bpm and it was enough to gather all doctors in ER around me at that time. they just slowed down my heart but it all started over again in the morning. they followed the same procedure and told me to see a cardiologist. The cardiologist took a look at my EKG results and told me that I have SVT. He told me its nothing serious and prescribed me a heart beat regulation medicine (Rythmonorm). It helped not at all. Whenever I feel stressed or down, tachycardia starts all over again. Went to numerous cardiologists and they found nothing problematic. And as it is very visible there is nothing wrong with my heart. I can climb mountains by running or do excessive sports and no signs of tachycardia. However whenever my stomach is empty, bend over instantly or I force my stomach muscles, there starts the tachycardia. Sometimes tachycardia starts when I try to take a deep breathe. Valsalva manuevers works but once in a while they don't. So I end up in ER or lately taking a Dideral (40 mg propranolol CCI) helps me so I don't end up in ER. My normal heart rate is around 90-100 but when tachycardia hits me it raises to 160-190 bpm. I feel dizzy, shaking, trembling, panicked. Been to numerous doctors and one of our friends which is a doctor adviced me to see a psychologist and also stressed on the possibility of hiatal hernia. This tachycardia attacks ruined my happiness and I would be much appreciated if a caring doctor or a person who experiences the same kind of problems help me. Thank you
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1807132_tn?1318747197
There is actually a doctors forum if you are interested in getting professional advice.  This section is for members like yourself.  That being said, a lot of members who attend this forum have heart rhythm problems like yourself.  SVTs generally are not life threatening in a healthy heart and it sounds like your heart is healthy.  Those who have very infrequent episodes really don't need to do much but pay mind to make sure the episodes does not go on for a prolonged period of time.  If, however, you are starting to get the episodes more frequently, I was starting to get them weekly, then there is a procedure that can possibly correct the problem called an ablation.  Were you told what type of svt you possibly have?  Did the doctor talk to you about an ablation?  There are different protocol for who qualifies for an ablation depending on the country you live in.  But I would think if the episodes are disrupting your ability to have a functional life then you should definitely qualify but discuss the option with your cardiologist.  And until then try to pay attention to how you are bending and see if you can find a different way to bend so you don't trigger the episodes.  Bending distorts your heart a bit and is likely the way it is getting distorted is pressing on the cells that help to trigger your svt.  Maybe you can try and stoop rather than bend?  Find out what kind of svt you have and ask if an ablation is a viable option for you. Good luck and keep us posted on how you are doing.
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1423357_tn?1373023915
Very simply put, your heart can be structurally sound, while having a defect in its electrical system.  A hiatal can exacerbate you condition by allowing a part of your stomach to push up thru your diaphragm and possibly press against or cause your heart to shift slightly thus activating the accessory pathway associated with SVT.

What I don't understand is why it was suggested that you seek psychological counciling? Your condition has been witnessed and I'm sure recorded, so why that suggestion?

I had SVT for over 50 years, so I fully understand what you're going through, and how it plays with and intertwines itself in your life.  If you're ready to go after a solid control or perhaps a cure, What you need to do now is have a cardiologist refer you to an electrophysiologist that can examine the evidence and work on a resolution with you.
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Avatar_m_tn
thank you for your answers :) the episodes actually got fewer as I started proton pump inhibitor and gastrointestinal motility drugs. Maybe I have been told to visit a psychologist because whenever I think of having a SVT attack, I actually do in about 30 minutes. It gets worse when I board on bus or public transportation vehicles, I feel helpless as SVT might start in the middle of everyone.

I have been told about the ablation but the doctor said that if the SVT attacks do not happen often, there is no need for operation as the operation is not a total cure for this and might cause bigger problems.

Will soon have an endoscopy and a barium xray. I will also see a cardiologist again to refer me to an electrophysiologist. Will keep you all updated. and tom_h, thank you for letting me know that you have been having these attacks for 50 years, as many people around say that with the SVT attacks, I won't be alive at 50 or 60 years old.
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1807132_tn?1318747197
Was your doctor specific about what type of SVT you have?  There are a number that are actually very treatable with high cure rates so I would be interested to know what type you have.  You sound like you have the same situation I had.  I had pvcs which are premature ventricle beats that cause a disruption in the normal beating of the heart.  It is during a pause in the beat disruption that the electrical signal from the previous beat would get caught in a loop around my avnode.  So I had both pvcs an svt called avnrt.  It was pretty easily fixed.  I still have the pvcs and those are a bit more tricky to fix.  Afib can be a bit tricky to fix as can ventricular tachycardia but all of the conditions are only very rarely life threatening so I would also be interested to know who these people are that are telling you that you will die by 60.  You very well could live a long life with most arrhythmias so I would get some clarification on what type you exactly have so you can do some research online and put your mind at ease.  Also, so you know, pvcs that are a big source for triggering svts, can really flare up from stress so it is not surprising when you are stressing about being in public or worrying about an attack that you very well bring it on.  The stress triggers the pvcs that then throw you into svt.  In any event, it is likely you will live a long life even with the arrhythmia so just do your best to try and release your stress about the situation and you will likely see less and less episodes.  
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1423357_tn?1373023915
I got mine fixed a year ago at 60 years old, and no longer suffer SVT events.  My first event was at 6 years of age.  There was some concern that my aging heart would tolerate the high heart rate associated with SVT, especially as I aged.  So I had an electrophysiology study with ablation of the problem area, and have been SVT free since.

A word of caution.  If you know that you're experiencing SVT events, I would downplay the anxiety that accompanies them.  Expressing your anxiousness opens the door for a physician to treat you for panic and anxiety disorder.  This ofen happens because of the concealed nature of SVT.  An EKG will show a normal, healthy heart, beating at a normal rate.  Some basic questions, the patient is given anti anxiety medication.  While that med mellow you out a bit, it does nothing for your actual condition.  So just be careful that you don't lead the physician to a misdiagnosis.
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Avatar_m_tn

search for "vagal irritation and arrhythmia" also " hiatal hernia and gerd " these can trigger arrhythmia....  lots of info on internet  good luck
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Avatar_m_tn
visited the cardiologist last Friday, was diagnosed with Panic Attack and now I am on meds (Cipralex and Beloc Zok). Did not have any more attacks since I started taking pills. I now realize how stressed I was as my chest finally losen up and I can breathe normally and easily. thank you for your help and mental support. And wish every patient a fast recovery :)
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1423357_tn?1373023915
I'm going to be straight with you and say that in my honest, unprofessional opinion, this ibeing diagnosed with panic attack disorder s the worse thing that could have happened to you.  Why? Because in your first post, you said your "heart rate was around 300 bpm and it was enough to gather all doctors in ER around me at that time." No panic attack will send your heart rate that high.  There are no physical activities that will get your heart rate to 300 bpm.  If your data is accurate, I believe that only an accessory pathway will facilitate a rate that high.

So now you're being medicated with something that "dials you down", slows you up a bit.  If you indeed have SVT, it will happen again.  The best thing you can do is get somewhere, a hospital or your physician and get an EKG while you're in SVT to prove that it's not panic disorder.  If you spontaneously convert before you get there, your heart's waveform will look normal and they'll probably tell you that you have panic disorder.  There are so many people walking around with SVT that have misdiagnosed with panic attack and/or anxiety neurosis, and you could now be possibly be among them.  I wish you the best.
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1807132_tn?1318747197
I also don't understand how they can diagnose you with panic disorder since you were already in the ER and doctors have documented the fast 300bpm episode.  It sounds more like avnrt or afib.  Afib might present at a lower beat but actually be upwards of 300bpm.  300bpm is extremely high.  The 190 bpm would be more indicative of avnrt.  That all being said, if you have only sporadic episodes there is generally no need to worry or even do anything about it but I would definitely head straight back to the cardiologist if you get more episodes,especially if you start to get them frequently.  If you are indeed going up to 300bpm you do not want to mess with that.  Also if you have afib you should be on blood thinners.  But I would have to believe if you had afib in the hospital you would have been told.  Anyways, in a structurally sound heart most arrhythmias are not life threatening but you really should stay on top of the svt if it becomes a problem again.  Take care and stay well.
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