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Re: Holter and stress test for 24 yr old (really necessary?)

Posted By CCF CARDIO MD - CRC on August 11, 1998 at 11:44:49:

In Reply to: Holter and stress test for 24 yr old (really necessary?) posted by Filipe Mendes on August 10, 1998 at 07:03:30:

I've been having arrythmias for almost two years now. I think they are PVCs or PACs. I went to several doctors concerned about this situation. Did several ECGs and one Echocardiogram. The 4 or 5 ECGs came out normal, two of them were done on the ER after I felt very dizzy and my heart started pumping really hard. After several visits to a several general practioner I was advised by a doctor on the ER to visit a mental health professional because the ECGs was ok but showed (somehow) that I was a bit nervous at the time. The echocardiogram was ok too, done one year ago. The last ECG I've done was on February. I've had several panic attacks, mostly due to concerns about my heart rythm disturbances.
Until recently I was coping very well with this arrythmias (skipped beats, sometimes stronger, sometimes weaker) so much that it seemed that they were gone. However in the past week or so, I came out very anxious after having a flutter (at least I think it was) and felt my heart stop for a few moments (1 sec or less) during a fast walk and after walking for a while at a fast pace, I can remember a similar episode after playing soccer for a while last year). Then I had an urge to cough which resumed the normal heart rate. This was a week ago, yesterday the same thing happened to me, on a very similar situation. I went to the doctor but she said I shouldn't worry about it, at my age (24) with several ECGs ok and one Echo ok, I shouldn't worry.
She told me that I could do a stress and a holter test so that if that made me feel more confident. THe problem is that this tests are really expensive here on my country and I would like to have an opinion from you, should I worry with this arrythmias that come up with exercise ? (I have no other symptoms, no dizziness, etc.). Is it really necessary to do the stress and holter test ? If they do come ok and I continue to have arrythimias what is your prognosis ?
I do feel a bit tired after some mild exercise, I lid a moderately sedentary life, stopped doing exercise affraid that I have arrythmias while doing it, and sometimes it seems that I feel out of breath and need to take a deep breath to feel ok, or tired while exercising (it might just be anxiety about having the arrythmia I don't know). What is your personal experience on this problems, specially arrythmias that appear just after exercising (they only appear now and then, not always).
Thanks for your support, and thank you very much for having this free forum up for people, I appreciate your work.
Dear Filipe,
Topic Area: Arrhythmia
It is possible you have a condition called supraventricular tachycardia that has just not been picked up at the time of your ECG tests.  I am suspicious of this because of the way you can stop the fast heart rate.  This could be a treatable condition.  The proper way to diagnosis this condition is not with a Holter test or stress test but with the use of a device called an event monitor or loop monitor.  This is a small device a person wears for a week or two or even longer.  It continually monitors the heart rhythm and when a fast heart rate is detected one pushes a button on the device and it records the rhythm.  This can then be sent over the phone lines to the doctor who can review the rhythm.  A Holter monitor only records for 24 hours during which time you may not have any fast heart rates whereas an event monitor can watch until such a rhythm occurs.
If you do have supraventricular tachycardia this can be treated either with medication or with a procedure called ablation.  Ask you doctor about getting such a test.  If you have any more questions feel free to write  back.
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist

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