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Arrythmias and Other Heart Symptoms - Perhaps due to Mystery Auto-immune Disease


My doc thinks I may have developed a collagen vascular disease 2 yrs. ago. I have many symptoms since: raynauds (diagnosed), overall cold intolerance, digestive problems, swallowing discomfort & esophagus spasms, etc.

I also have cardiovascular symptoms: For 1+ years have had SOB on exertion (or at night), pounding heart and elevated pulse after exercise or eating, & increasing palpitations. Tests done: 4 echos, event monitor(EM), stress tests, EKG's, PFT's, lung CT-scans, & right-heart cath. due to suspected pulmonary hypertension (results normal). Abnormalities from above tests: 1)EM showed short bursts (5-15 seconds) of sinus tachycardia & SVT's. The palpitations are quick to start & quick to end seemingly with no trigger. 2)The RHC showed a high cardiac output (7.83) & high venous saturations. 3)Two echos showed apical &  apical-lateral hypokinesis but later echos showed none. 4)My last PFT's were at 75% diffusion.

I started Toprol-XL which has slowed heart & helped some with palp's. & helped with exercise - but more snorting at night.  Questions: 1)Is there any significance to having BOTH sinus tach & SVT's? 2)Doc tells me not to worry about the SVT's but some of your information says they can be dangerous - is this true? 3)If my blood vessels are constricted in my body, could my heart be trying to compensate? 4)Since I have 2 kinds of SVT arrythmias -is there increased chances for VT? 5)Two echos at same clinic six months apart showed heart heart size increase but doc says this is due to test error - sound right?, 6)Where do I go from here?

14 Responses
Avatar universal
Mr J.,

Thanks for the post.

I think the key to your health care is to determine the correct diagnosis of your collagen vascular disease.

Different collagen vascular disorders have different cardiac manifestations.  Scleroderma, for example, tends to cause widespread fibrosis with subsequent conduction abnormalities, diastolic heart failure, and pulmonary hypertension.  Lupus, on the other hand, leads to pericarditis, myocarditis, and pulmonary hypertension.

Determining the correct collagen vascular disease will determine what type of cardiac work-up is appropriate, as well as help determine what type of therapy may be required.

Hope that helps.

Avatar universal
Hi Hankstar!
Did the 12.5mg of Atenolol drop your heartrate or blood pressure way down.  I want to start taking that or Inderal for my PVC/PAC's and PSVT attacks and see if it helps but I'm afraid because my resting heart rate is already in the 50's alot of the time!  Thanks alot.
Avatar universal
Dear Dr.,

Thanks for your response.  I don't want to seem ungrateful but you really did not answer any of my questions.  My doctor has done extensive testing for two years and so far we cannot find a "name" for my illness which leaves me in the position of simply having to address symptoms - and my most concerning symptoms are the cardiac symptoms.  So, could you please take your best "stab" at my specific questions.

Avatar universal
If your symptoms are trully collagen vascular disease (specifically scleroderma or CREST syndrome which is almost the same (the second is more mild)) then you should be on ACE-inhibitor such as monopril for kidney protection. All other treatments are only supportive and symptoms oriented. Your doctor should have done autoimmune antibodies tests to confirm or rule out specific autoimmune disease.
It general you should be seen by rheumotologist for it.
Avatar universal
Also many rheumotologic diseases, if it is truly what you have, have  great overlap with one another so it is sometimes difficult to make a correct diagnosis, this is why you should be seen by a specialist in this area. If your doctor suspects Scleroderma or CREST syndrome you should be on monopril or other ACE-inhibitor.
Avatar universal
I've seen claims that both autoimmune diseases and arrhythmias (and allergies, CFS, etc.) can be caused in part by a viral infection.  In such cases, one might experience unexpected reactions to antivirals found in foods, especially certain herbs and spices.  In case you have noticed such a phenomenon and this interests you, I'd say more.
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