Heart Problems and too many symptoms!

[Steph620]

I need some advice. I was diagnosed with Mitral Valve Prolapse in 2003 after years of sinus tachycardia. Over the years I have had 24 hour holters, 30 day event monitors, echos, ekgs, blood work of all types that was all normal, CT of the abdomen, brain and have seen a couple of different cardiologists. One year it shows I have MVP with mild regurgitation, another year it does not show MVP only mild regurgitation. My heart they say is structurally normal and that my PVC's are benign. Every couple of months I get the following symptoms off and on and at different times: shortness of breath, chest pain, delayed gastric emptying, hot flashes no sweating just flush feeling all over body (had blood work and my hormone levels were fine), acid reflux, feeling like food is getting stuck in throat, when I stand it feels like blood is rushing to my head, nausea, heart jumping in the 150's or 160's for no apparent reason (such as sitting up in bed or heart slightly racing and shortness of breath where it wakes me up from sleep) and then my heart takes off, it corrects itself within a few minutes after a do the vasovagal manuevers, stomach issues going from constipation to upset stomach (especially when my heart rate increase), headaches upon waking (my blood pressure is always normal), skipped heartbeats and the list can go on. Can anyone relate. My cardio says oh you are fine its not going to kill you but I have become so depressed I rarely leave home. These symptoms with racing heart seems to always happen when I have been sleeping as well. PLEASE HELP. How can feeling like this be OK and how can an echo show one year I have MVP then another year I dont. Also I just had an EKG today and it showed nonspecific ST changes...now I am worried about that but my cardio mentioned nothing about it.....I just want to scream!

[MichelleP_3811]

The question specifically is when you had the monitor did you have the jump in rate.  If not then it has not been diagnosed, if you have then it has been diagnosed likely as being caused by something outside the heart.  

So the key question is w
as the jump in one beat or gradual.  I know when I have sinus tachycardia from being dehydrated it can take while for it to come down but my svt I would be at 100, jump in one beat to 230, then jump back down in one beat to maybe 110 or so.  It would stay a bit elevated but not to the point of causing any symptoms like I would feel with the sinus tachycardia.  If you are not going over 200 it is probably not likely to be what I had but it could be a run of pacs causing the tachycardia.  Those do start and stop pretty quick but don't get to the speed my avnrt did.  But again, if you know that your change from one rate to another was captured on a monitor then you have been diagnosed   If not then you need to be persistent about trying to catch it.  This said, it would be helpful if you had an episode at least once a month or you may be wasting your time and money trying to catch it.   But it can be a long process getting to the bottom of things.  Just try and get as familiar as you can with your symptoms and what you are feeling so you can be as descriptive as possible with your doctor.  But I do suggest trying the things I mentioned first before trying for another monitor.  Clear as much of the activity up as you can so you can get a clearer picture of what is what.  I honestly did not know I had ectopics until after I had my svt cleared up.  I thought it was all related so we can get a bit confused about what is really going on.  The more you know the better you will be able to get a handle on what is going on.

[Steph620]

Also every 30 day monitor every 24 holter never caught anything other than PVC's

[Steph620]

so if it comes down fast its SVT but if it gradually comes down it is more than likely sinus tachycardia? For instance it comes down pretty fast from 168 to like 130 then takes a little while to go below 100 like 30 minutes

[MichelleP_3811]

I am not so familiar with ekg knowledge but know that a lot of times that sort of thing changes often and isn't significant.  If the doctor didn't become concerned about what they saw then it was likely the changes aren't anything concerning.  I would question the doctor though for your peace of mind.

If it is coming down gradual then it is likely not accessory pathway.  That type of svt it is quite apparent it starts and stops in one beat.  One second your heart is racing manically and the next it is normal.  Even doing the vagal maneuvers will produce a sudden one beat change.  But vagal maneuvers will also help sinus tachycardia to help slow down the breathing and slow down the rate gradually.  

I would suggest trying the sleep study to see if there is some sort of issue that is contributing to you waking up with a rapid heart rate.  I also know I had an old alarm clock and it would wake me with a jolt.  I would wake up with my heart racing until I bought one that I could make quieter and now I don't wake up in a panic because the alarm is blaring.  And then finally try and work on the acid reflux.  Try these things to see if it helps lessen your symptoms.  If it  doesn't then revisit the doctor to see what he recommends to help you feel better.  Sometimes going on beta blockers helps people to feel better but I would try seeing if you can clear up some of the other issues first before taking meds.    

[Steph620]

Thanks. for your post. I will wake up and my heart rate will be fast like around 110 and then it all of a sudden gets up to 160 almost 170 and I take several deep breaths and its starts to come down. I know some of it could be panic. My ekg yesterday showed non-specific ST changes...can you shed any light on that?

[MichelleP_3811]

First and foremost, in all the times you have had a monitor do you know if the racings has been caught.  You say you wake up in the 150s and 160s then it all of a sudden races.  How fast is it going?  Does if feel like it starts and stop in one beat?  Has this transition from one rate to suddenly racing been caught?  If it has then you likely do not have an accessory pathway svt but if it hasn't you need to keep trying to get it captured.  An ablation can correct the issue for good most of the times but it needs to be recorded for it to be officially diagnosed.  

Beyond that I would work on an sleep issue you may have as the previous poster suggested as well work on any stomach issues you may have.  It sounds like you may have some acid reflux and it is actually a very big trigger for getting ectopic beats and causing shortness of breath.  Clear up the acid reflux and you may find your heart calms down quite a bit.  Though if you do have true accessory pathway svt it may not clear up the issue totally but it should help.  Finally do try and work on any stress or anxiety you have in your life.  They are big triggers for ectopic activity as well.  Lessen that and you may find your heart to be calmer.  My last bit of advice is to try and drink a lot of water.  It really will help flush out toxins and help your heart function better.  Take are and keep us posted on how you are doing.

[JohnWright]

With you heart-rate increasing to 160 at night it could be simple SVT caused by reduced blood O2 levels from Sleep Apnea triggering an extra-pathway somewhere alike around your AV Node. It sounds like you can stop the episodes through chest-pressure applied during Valsalva.

You could have Sleep Apnea which is increasing your heart rates through an increase in CO2 and decrease in O2 at night.

First of all you can hook up to a test machine to measure how many times an hour you stop breathing, but you can also do it the inexpensive way by having someone watch you for a couple of hours while you're sleeping. Look into buying a used a ResMed Climate Line Sleep Apnea machine, for they are one of the best, and find out on YouTube about how to set it up and use it to help prevent night-time not-breathing episodes.