Help with Holter Monitor report

[momof03]

I had an abnormal EKG which was followed by a 24 hr holter monitor which is also abnormal....I am scheduled for a stress echo on Friday.  Can someone help me to interpret these holter results?

Heartrate:
Toal beats 126062
Min HR/min  54    Max HR/in 172  (10:08am)

Tachycardia >100/min:   149
Longest:  Time occured:  1:36pm,  Duration 1hr 12min

Min RR ms  224
Max RR ms   1216

Sinus Rhythm:
min HR/min  54 (5:37am)    max HR/min   153(7:10am)

VES:
VES  total/time: 12     Max/h: 4

SVES
SVES >20%:   Total/time: 90    max/h:  27

The doctor called in a beta blocker to take in the meantime, but I'm not going to get it filled until I get this stress echo done on Friday and consult w/a cardiologist.

Any help you can offer with the results above and what exactly it all means would be terrific :)  Thanks so much!!!

[momof03]

Ok, I finally got the written results from the stress echo.  I alread have an appt set for 12/19 with a cardiologist for follow up (recommended by the cardio doing the echo).  My heart rate was at 140 before they even started the excercise and maked out at 184 within one minute.

Findings:  Mildly abnormal EKG changes in theresting electrocardiogram, ST-T wave changes; no suggestion of ischemia in the exercise stress test.  The patient does have tachycardia at a lo level of excercise.  Reason for termination of the stress test was shortness of breath at 6/10.  Excercise level is 7.8 mets.  Total duration of the test was  minutes.

Echocardiogram:  Echocardiogram at rest is essentially normal with minor eptal hesitancy.  Valves appear competent.  Following exercise, there is hyperdynamic left ventricular contraction and right vntricular contraction.  No mitral valve prolapse or ISHH.

A couple of things i don't know what they mean and can't find :)  What does "septal hesitancy" and "hyperdynamic left ventricular contraction" mean?  Thanks so much.

[momof03]

Thank you sugarpea013!  My pressure isn't anywhere near as low as yours!  Mine today is actually running really high...the diastolic I should say.  Heart rate is up there too anytime I get up and attempt to do anything....most I've done is make the bed and change out the laundry.  My readings throughout the day have been pulse anywhere from 120-145 with BP anywhere from 126/95 to 139/107.  I've been able to tell it too just because of being short of breath after doing hardly anything.  It should be interesting to see how this stress echo goes tomorrow.  

Oh, and it's a good thing I didn't get the BB already.  i got a letter from the hospital that has in big bold letters, :PATIENTS SHOULD BE OFF AL BETA BLOCKERS AND CALCIUM CHANNEL BLOCKERS 48 HOURS PRIOR TO TEST IN ORDER FOR PATIENT TO ACHIEVE TARGET HEART RATE".  

My gut told me not to just go start taking it because the GP said so....I haven't been comfortable w/him in a while anyway and that's why I would be more at ease talking to a cardiologist before taking it :)  Just as an example.....I have a B12 defiency that was diagnosed by an Endocrinologist a year and a half ago.  i've been getting monthly injections ever since.  My level has now dropped back to where it was last year but the GP says it fine where it is and that B12 deficiency has no effect on the heart....SO NOT TRUE!  

Thanks again!!!

[sugarpea013]

Hey there,

I just wanted to throw in I was on a BB for 2 1/2 weeks and my same concern was for the low BP. I already run very low, between 90-70 sytolic over 60-40 diastolic. So as you can imagine I was nervous. But actually it didnt do a thing to my BP! I was on metoprolol. It only affected my pulse and was excellant at controling the tachycardia.

I just wanted to let you know my experience with the BB as I was once very worried myself.

Best wishes!

[momof03]

Thank you connie!!!  I will definately talk to the doc/tech tomorrow about the meds....your personal experience sure makes me feel better about it :)  

Thanks again for your input & I will definately come back tomorrow (or when  I get the results ) and post them.

Cindy

[Momto3]

Hi Mom!

I understand your concern over taking a BB because it can lower your BP.  However, it will not lower it to a dangerous level, and in fact, is often considered beneficial as long as you can tolerate (no dizziness, etc) it.  My BP was always on the low side also (100/55-60) and I was on BB's for years --didn't seem to have any real effect on my BP.  I remember asking the doctor, "So, on TV when someone is having surgery and you hear, 'his BP is dropping' and everyone freaks out, isn't that dangerous?"  He chuckled and said, that is not going to be a problem.  The doctors/surgeons are there to monitor all that stuff....Anyway, my point (it is here somewhere...lol) is that I don't think the BB will lower your BP to a noticeable degree and it is considered a safe medication.  

Since you may not receive your stress echo results on Friday, be sure to discuss the report and whether he/she agrees with taking a BB. You may find the BB helps to "calm" things down and perhaps it will help with the chest discomfort.  Hopefully, your stress echo will give you some more definitive information to work with.  

VES and SVES (more commonly known as PVC's and PAC's) are very common.  

Please let us know what the cardio says -- we all learn a lot here : )

Hope you're having a great day!
connie

[momof03]

Hi Artuaud and thank you for you repsonse :)  I'm not going to start the beta blocker yet because my blood pressure already tends to run low and I'm afraid to start that w/out consulting with a cardiologist first.  This was my GP that had the nurse call and just tell me to go pick it up and start on it>  when i asked her if it is a beta blocker>>>didn"t make me feel to comfortable just taking it :)

The tachycardia # of 149 is the number of occurances.  The max sinus rate at 7:10am would have been about 10 minutes after driving my kids up to the bus stop.....I awakened at 6:10am.  I was having chest discomfort that morning where it felt like someone was punching me w/their knuckles in the chest.  I've been having chest pains, but it normally feels like someone is squeezing my heart in their hands....this felt different.

Is VES and SVES normal for most people?  

Thanks again :)

[Artaud]

Hi,

What kind of help do you need?

You had 126,062 Total Heart Beats while you wore the Holter.
Your Heart Rate was as slow as 54 Beats per minute (mine goes as low as 51 while I sleep) and as fast as 172 Beats per minute.

Your heart was Tachycardic (beating faster than 100 Beats per minute). I am not sure of the 149, unless that was the average heart rate, and the duration of the Tachycardia was for 1 Hour and 12 Minutes.

The RR Data appears to refer to the measurement of the time from one heart beat to another, as recorded on the Holter and measured in units of time (milliseconds, or 1/1000 of a second).

Sinus Rhythm is the rhythm of the heart that occurs in the normal fashion. Your minimum sinus heart rate was 54 beats per minute at 5:37 AM and maximum sinus heart rate was 153 at 7:10 AM (Did the alarm clock scare you ;-)

Definitions are as follows:

Ventricular extrasystoles (VES) PVCs originating on the ventricles. You had 12 of them, and it seems to be saying Maximum per hour, which was 4.

Supraventricular extrasystoles (SVES), PVCs originating above the ventricles. You had 90 of them, and the Maximum per hour was 27.

Why are you not going to have the Beta Blocker Prescription filled until after you see the Cardiologist? Is that what your Doctor recommended?  

Please remember that the above is from information obtained from the Web and personal experience, it is not a Medical Opinion.

It is likely that the EKG Waveforms themselves may have been abnormal, and not so much the Holter Report. The Waveforms are not shown.

Best of health to you and yours.

[momof03]

anyone out there that can help me with this?  :)