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1318351 tn?1313385021

How likely is it to have a normal cardiac workup and still have a electric problem?

I have been asking so many questions lately and I have one thing that is so bothering me and thought I would reach out to someone on here.

How likely would it be for someone to have a dangerous arrhythmia if they had a negative cardiac work up? In May of this year, I had a normal echo, normal stress test, normal event monitor besides PVCS and PACS and sometimes an elevated and lowered HR, BP ok and blood work ok too. In 2004 I had a normal EP study and I dont know if this test is still good this amount of years later. How likely would it be to have a dangerous arrhythmia after all that being normal?

I had a 24 hours holter monitor last week and got the results and it was completely normal according to my primary. It did show a couple elevated heart rates and the lowest was 43. There was 2 times my heart was 140 and I dont recall feeling it, once was while I was asleep. Do you think thats normal or should I take the results to my cardio? She said it was Sinus tach.

The reason I am asking this question is because I have been having pre-syncope episodes. I have had 4 where I thought I was going to pass out any minute, they come on fast and are gone within seconds. The feeling is like nothing I have ever felt before and is scary to say the least in fact other then PVCS it is the most terrifying thing I have ever experienced and it is more disturbing because I dont know why this is happening to me. I read that this feeling is mostly due to cardiac problems and that 20 to 30 percent of people that have this feeling and if its due to their heart die within the first year and that has me even worrying more.

I dont feel a fast heart when it happens but then again I dont recall feeling the one on the holter when it said my heart rate was 140 for a minute or 2 either.

I am going to be having a tilt table test but the only thing that concerns me is these feeling are not related to changing positions. The severe episodes I spoke of above happened while I was sitting. One time I had been sitting for about 20 minutes and the other was for a few minutes. Could it still be Vagal? I thought that happened from sitting to standing or something.

The only other thing I can really think of is that once when it was doing it for a while only a milder form, I mean I felt like I was going to pass out but it was not severe as the others. When I say down for my vital signs the guy put the ox meter on my finger and said my pulse was 30 and it read that for almost a minute before it changed to 78. That kind of freaked me out but thats not the number that was recorded and no one mentioned anything.

What do you think?


44 Responses
1318351 tn?1313385021
I made an error the 140 was for 23 beats. There were others like 120 but it does not say for how long.
Avatar universal
You don't give your age (though I have the feeling you are not elderly), and have passed your heart exams many times, so your ticker is almost certainly healthy.  The low pulse rate might have been related to something like bigeminy, where every other beat is dropped or out of time.  Since the pre-snycope episodes occur even when you're sitting, I--having had the same experience--would hazard a guess (given your tests) that you are indeed experiencing Vagal symptoms.  Some people are just more sensitive to signals from inside their bodies, and the irony is that the more you 'listen' to these signals, the twitchier the Vagus becomes.

Again, speaking from years of personal experience, I would suggest you consider two things (bearing in mind that your tests have shown you to have a basically healthy heart):

1. Can you perform all your normal activities without drenching sweat or central chest pain, things like walking, housework, going up stairs--when you're not thinking about your heart?

2. If you can, the chances are miniscule that you have some underlying condition that will cause you to die suddenly, and the chances are great that you are suffering more from a kind of anxiety disorder.  I am not being judgmental:  This kind of thing simply happens, generally without any predisposing traumatic event.  My personal suspicion is that it's a genetic trait.

Cognitive behavioral therapy and certain mental exercises with a good counselor can help, but because my symptoms come on suddenly every few years, without a precipitating event, I favor medical treatment with an anti-anxiety drug.
1318351 tn?1313385021
HI there and thank you for your response. I know that I am not going to have a heart attack:) I had a negative Angiogram in early may of this year, I was having awful chest pains and my cardio wanted to rule out my heart, I think it was my gallbladder and had it removed, I still have pains here and there but not as bad. Sorry I forgot to put my age and I am 28.

I just worry about an electrical problem. I do have a history of SVT and thats the reason for the EP study in 2004 but it could not be provoked long enough for mapping so we just left it alone and I rarely have an episode so we just let it be.

I hope that it is what you mention because we are running out of things here. I have had many test so far and all is well. The only other thing noted was a nystumas, fast beat to the right in my eyes which they thought was caused by ears and so was sent to an ENT which cleared my ears and now I have to go back to the neuro.

I have seen a mental health doctor but she felt anxiety was not causing my problem. I have had an anxiety and panic attacks in the past so I thought it worth a try even though it does not feel the same. She sent me back to my primary.
Avatar universal
The Vagus is a long and very weird nerve with many functions.  In some of us, it behaves quite badly, making us likely to faint when we feel odd internal sensations, or even when we get overheated (I do this sometimes in the summer, and have scared the cr*p out of a couple of restaurant owners).  Tilt-testing is one way to check if you have an abnormal vagal response, btw.  Here's info on vasovagal syncope, and there's lots more out there:

1318351 tn?1313385021
I will check out the info you provided. I will be having the tilt test soon... I have not passed out yet thank goodness but each episode seems to get longer each time even though its just seconds. I also have an appointment with the EP doctor who did my study next week.

Do most people with the vagus nerve just get it one day, or is it something they have had their whole life? Can people with this problem just be lightheaded and never faint?
Avatar universal
We all have that lovely Vagus nerve:


but I think the tendency for it to fire inappropriately and produce the kind of trouble we're talking about is something that occurs in a minority of people who have a tendency to be hypersensitive as adults.  I do have the impression, based on my own experiences, that paying too much attention to little internal 'noises' and getting too fearful about them causes more adrenaline to be released, which worsens the situation.  That's why it's good to get help with anxiety and panic.

Oh, as to fainting, I've only actually fainted dead away once, and that was the result of pain from a severe intestinal infection.  The other near-faint things have been momentary or went away (of course) when I lay down or put my head on my knees. There is another effective and easy way to prevent fainting, though, as described here:


"...crossing the legs or tensing the leg, buttock and abdominal muscles, is enough to stop blood pooling in the legs - the main cause of fainting."
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