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Ectopic beats followed by tachycardia with wide pulse pressure?

I'm 18, don't smoke, don't drink, or have a family history of heart defects. I sometimes get early beats (usually three in a row followed by a sinus pause), but this was my first experience with a tachycardia.

I was stretching in bed one night about to go to sleep when I had 4 straight early beats (boom-boom-boom-boom) and then my heart rate exploded. It was pounding in my chest. I used my dad's blood pressure gauge and my heart rate was 157 bpm and a bp of 153/66 just like that. I didn't have any lightheaded-ness or trouble breathing (although I did have a really tight feeling in my throat) but went to the ER anyway. By the time I got there and an ECG my heart rate had gone down to 101 and they said it had come back normal in terms of beats. After that my heart rate and blood pressure slowly returned to normal by the end of the night. Blood tests came back normal (had a slightly high RBC and calcium levels but that was dismissed by personnel) and I was discharged that night.

My doctor referred me to a cardiologist with a good rep, all my tests (echo, stress ECG, Holter monitor for 48 hours, and an ultrasound of my neck because he heard a possibility of kinking in my carotid artery) all came back normal, and I was told not to worry about it. I didn't have any symptoms for a few months. Just in the past couple weeks, I've noticed that some times when I run up the stairs fast, my heart skips a beat for about 30 seconds. When I take my pulse with my fingers when there would normally be a beat, I just feel it move slightly. I cycle 3-4 miles a day and never noticed this or had any symptoms of lightheaded-ness/dizziness/palpitations (aside from the usual heart ringing in my ears when I'm done), it only happens when I run up the stairs.

My questions are this, if anyone can answer:

1. What happened to me on that night I went to the ER?

2. What's going on with my symptoms right now?

3. Should I have sufficient reason to schedule another visit if I've already been cleared by a cardiologist?

Thanks to anyone who can help me! I'm a bit of a hypochondriac and just want to rule anything out.
1 Responses
1807132 tn?1318743597
Hard to say for sure what happened the night you went to the ER without catching it on a monitor.   I had an svt called avnrt that would be triggered by premature beats where my heart rate would beat in the 200s.  It would start and stop in what felt like one beat.  This said, it could have also been your sympathetic nervous system kicking in.  The pattern of slow beats may have tricked your heart/head connection into thinking your heart was beating too slow so it sped it up.  Or it could have been sudden anxiety/panic attack about all of the pauses with the heart.  Anything with the heart can be scary to us and our fears can come out despite our best efforts to be brave about it all.  This said, if all your heart tests have come back normal then odds are whatever it was as well as the premature beats are not a danger to you so try to not worry too much.  It will just bring them on more. The best we can do is address the biggest triggers for premature beats.  Avoid caffeine.  Watch sugar, carbs and foods that cause acid reflux.  If you have acid reflux address it.  Watch becoming dehydrated.  do a proper warm up and cool down when exercising and address any generalized anxiety you may have.  Other than that do your best to not let the premature beats take up space in your thoughts or it could take over your life.  Take care.
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