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Is my wide-complex tachycardia and PVC findings dangerous
Hello and thank you in advance for your advice. Here is my history. For the first 16 years of my life I played baseball and football, I was very athletic. I am 5'7 I weigh 140LBS. my resting pulse is around 65 and I used to be very athletic until about a year and a half ago, so in the summer of 2009 I was working out very heavily, not eating properly, drinking a bunch of caffeine, not sleeping much, and I was frequently around cigarette smoke because at the time both my parents smoked. Slowly I developed symptoms. It started with shortness of breath, fatigue, and a racing heart beat on rare occasion lasting only seconds. Exercise seemed to help, but when I was at rest my symptoms would start up again! My mom took me into the ER where the doctor recommend me to a cardiologist after hearing a murmur. I traveled to my grandparents away from stress and went to a good cardiologist. He assured me I was healthy and had very mild mitral valve reguration with NO prolapse or inflammation. He also saw a few isolated PVCS. He told me to workout as if nothing was wrong. Well over the past year I had to quit sports I have more symptoms so I was sent to an EP and he put me on a 30 day monitor it showed frequent pvcs, and wide complex tachycardia lasting 4beats 6beats 2beats and 8beats. He swears it is not life threatening but isn't it VTACH and isn't that deadly? He is doing a tilt table test and says after this he will give me medication for my rhythm. He says it is to manage my symptoms and get rid of the rythm but that it is not really needed because it is not life threatening only annoying. So my symptoms are
palpitations
chest pain
lightheadeness
weak muscles
weak arms
fatigue
exercise intolerence
stress intolerence
anxiety
short runs of tachycardia
headaches
heat intolerence
hot shower intolerence
exercise and stress make it so much worse.
So what could this be? is my doctor right that it is not life threatening? Is this VTACH?
palpitations
chest pain
lightheadeness
weak muscles
weak arms
fatigue
exercise intolerence
stress intolerence
anxiety
short runs of tachycardia
headaches
heat intolerence
hot shower intolerence
exercise and stress make it so much worse.
So what could this be? is my doctor right that it is not life threatening? Is this VTACH?
Thank you so much Doctor and god bless you! I feel much better about all of this now.
MEDICAL PROFESSIONAL
Dear Kybball11,
It appears that you have a benign arrhythmia only - the rate is not fast (150bpm) and it is not sustained (not >10beats, probably lasting <30 seconds). That is probably the reason for a reluctance to do invasive testing and ablation, since the intervention would entail some amount of risk.
All types of ventricular tachycardia (VT) are not necessarily dangerous. Especially since you are only 17years old and with a structurally normal heart without the scarring associated with ischemic heart disease, relatively harmless arrhythmias are more common.
Therefore, it is a good idea to consider conservative management with attention to the preventive steps that I had mentioned earlier and if required, some drugs to control the symptoms. You could always go in for a more invasive form of treatment if you remain symptomatic or develop further arrhythmias, especially if you develop giddiness and sustained palpitations. If you are extremely worried (though you needn't be), you can take a decision after taking into account the results of a detailed Electrophysiological study.
Hope that this information helps and hope that you will get better soon.
Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.
Best Regards,
Dr. Raja Sekhar Varma.
Thank you and God bless you too. I really hope you get this cleared up so you can live a happy life.
No one like that their hearts do strange things, and I know such a diagnosis may sound really scary. You should by the way be aware that "wide complex tachycardia" doesn't necessarily even mean ventricular tachycardia. Supraventricular tachycardias may be wide complexed too sometimes (especially if they occur when the heart rate is slow) because the heart gets "surprised" and the impulses are conducted a bit differently down through the pumping chambers.
Take care, and do not hesitate to post at our Heart Rhythm Community (I'm one of the community leaders there) if you need reassurance, though none of us over there are doctors. It also seems like your doctor takes good care of you, which is both nice and necessary to get this uncertainty out of your mind :)
No one like that their hearts do strange things, and I know such a diagnosis may sound really scary. You should by the way be aware that "wide complex tachycardia" doesn't necessarily even mean ventricular tachycardia. Supraventricular tachycardias may be wide complexed too sometimes (especially if they occur when the heart rate is slow) because the heart gets "surprised" and the impulses are conducted a bit differently down through the pumping chambers.
Take care, and do not hesitate to post at our Heart Rhythm Community (I'm one of the community leaders there) if you need reassurance, though none of us over there are doctors. It also seems like your doctor takes good care of you, which is both nice and necessary to get this uncertainty out of your mind :)
Thank you and god bless you!
Thank you so much for your input, you seem very kind! That does make me feel much better about all of this, and I really want to send the EKG to this doctor on here, so I am going to work on getting that done today, also to make myself feel safer and more at rest I have decided to go and get a second opinion from a cardiologist in my state who is said to be the best in the state hopefully an answer from her that it is safe and ok and we will treat it will make me feel much much better! I see here in one week and I am excited about doing so!
Hello. Sorry to comment a post on the Expert Forum, but I just wanted to throw in some possible useful information.
We are all afraid of the word "V-tach" because we link it to old people with previous heart attacks and degrading to fibrillation. However, this and short ventricular tachycardias are different events. I can try to explain.
What usually happens in people with previous heart attacks is that scar tissue is created, and this scar tissue will change the conduction system in the heart. Where impulses previously travelled down a straight road, the heart attack creates a roundabout which the impulses have to travel through. This may delay the impulse.
The problem with this is; sometimes a PVC may make an impulse travel around and around this roundabout and for each time it travels around it creates a heartbeat from the ventricles, and you have what is called a sustained reentry ventricular tachycardia. Often it won't break until another PVC or a perfectly timed sinus beat knocks out the electricity from the other side of the roundabout. At a rapid heart rate, this may take a long time.
Another problem (which is probably the most dangerous) is that people with coronary artery disease can't handle a heart rate this high. Such tachycardias may cause a heart rate far above the natural max heart rate, which in healthy people usually is OK for some time. But people with CAD have limited abilities to increase their heart rate because the coronary arteries are blocked. If this would happen during exercise, you could slow down. But you can't slow down a reentry tachycardia, so the heart may starve from lack of blood (to beat at 200 BPM is really stressing the heart) and that's the reason why such arrhythmias may cause fibrillation. In addition, as you know, a ventricular beat (or tachycardia) makes the heart pump less efficient than normal beats. That's the reason why a PAC often is felt as a "double beat" and a PVC as a "skipped beat" (though this rule has lots of exceptions). The atria are there for a reason, to help pumping blood.
In healthy hearts, what happens is often just that an annoyed spot in the heart decides not only to fire one beat, but several. Your heart can handle it and such arrhythmias tends to self-terminate after some seconds.
It's also important that your doctor decides where in the heart the tachycardia origin. This is easily visible on a 12 lead EKG by looking at the axis and the configuration of the QRS complex. For example, it's better if the tachycardia origin high up in the right ventricle, than at the bottom of the left. If your cardiologist saw your EKG (preferrably a 12 lead), did the necessary tests and concluded that your heart is healthy and can tolerate such a tachycardia, I would trust that.
If you can get a copy of your EKG, you should send it to the doctors here. From what I understand, they are some of the best.
Take care, and I hope the doctor will answer your follow up and that you will be OK.
We are all afraid of the word "V-tach" because we link it to old people with previous heart attacks and degrading to fibrillation. However, this and short ventricular tachycardias are different events. I can try to explain.
What usually happens in people with previous heart attacks is that scar tissue is created, and this scar tissue will change the conduction system in the heart. Where impulses previously travelled down a straight road, the heart attack creates a roundabout which the impulses have to travel through. This may delay the impulse.
The problem with this is; sometimes a PVC may make an impulse travel around and around this roundabout and for each time it travels around it creates a heartbeat from the ventricles, and you have what is called a sustained reentry ventricular tachycardia. Often it won't break until another PVC or a perfectly timed sinus beat knocks out the electricity from the other side of the roundabout. At a rapid heart rate, this may take a long time.
Another problem (which is probably the most dangerous) is that people with coronary artery disease can't handle a heart rate this high. Such tachycardias may cause a heart rate far above the natural max heart rate, which in healthy people usually is OK for some time. But people with CAD have limited abilities to increase their heart rate because the coronary arteries are blocked. If this would happen during exercise, you could slow down. But you can't slow down a reentry tachycardia, so the heart may starve from lack of blood (to beat at 200 BPM is really stressing the heart) and that's the reason why such arrhythmias may cause fibrillation. In addition, as you know, a ventricular beat (or tachycardia) makes the heart pump less efficient than normal beats. That's the reason why a PAC often is felt as a "double beat" and a PVC as a "skipped beat" (though this rule has lots of exceptions). The atria are there for a reason, to help pumping blood.
In healthy hearts, what happens is often just that an annoyed spot in the heart decides not only to fire one beat, but several. Your heart can handle it and such arrhythmias tends to self-terminate after some seconds.
It's also important that your doctor decides where in the heart the tachycardia origin. This is easily visible on a 12 lead EKG by looking at the axis and the configuration of the QRS complex. For example, it's better if the tachycardia origin high up in the right ventricle, than at the bottom of the left. If your cardiologist saw your EKG (preferrably a 12 lead), did the necessary tests and concluded that your heart is healthy and can tolerate such a tachycardia, I would trust that.
If you can get a copy of your EKG, you should send it to the doctors here. From what I understand, they are some of the best.
Take care, and I hope the doctor will answer your follow up and that you will be OK.
I was attempting to get an ECG from my doctors office but was unsuccessful in obtaining this information, I am sorry I did try very hard as I trust your opinion and would love for you to review my ECG, the information they did give me was that I have PVCS somewhat frequently usually only isolated, and that once or twice a week it seems like I have very short runs of Wide-Complex Tachycardia that has not been more then 10 beats at a rate of 150 beats per minute. I want to give you more info so that you can better help me but I couldn't seem to get much more from my doctor, he assures me that it is not life-threatening and that medication is only to relieve my symptoms that it is not required really. What do you think I should do, should I see a different Cardiologist here in town? Would you recommend treatment?(ablation)
Thank you so much for replying so quickly, I am 17 years old and on no current medications for any type of problems. My EP cardiologist seems to think that I do not really need any medications but he is willing to try out some in the near future to better manage my rhythm problems. Vtach really scares me and from everything I read it seems like wide-complex tachycardia is vtach, is this correct? Also thank you so much for caring and trying to help me I will try to put a link to my ECG in the next day or two at the latest. My doctor has said nothing about needing an ablation, I feel that I need one and would like to have one done but he has not brought it up at all, what do you think?
MEDICAL PROFESSIONAL
Dear Kybball11,
Ventricular tachycardia is of many types. Though many types are life-threatening, there are forms of VT which are relatively benign. It may even be possible to do curative Radio-Frequency Ablation for certain types of VT.
You could also modify your lifestyle, avoid excessive stress, avoid caffeine, avoid late nights, get a good night's restful sleep and do slow breathing exercises, which might help to reduce the frequency of the palpitations.
Drugs like Beta Blockers, Amiodarone, etc can also help, if indicated. A complete cardiac electro-physiological study with VT induction and mapping in the EP (Electrophysiology) lab can be done, if the results of other non-invasive tests indicate it. This would give a complete diagnosis of the Arrhythmia, and in many cases, ad-hoc RFA (Radio Frequency Ablation) can be done.
If you could tell me your age and current medications and possibly upload a scanned copy of your ECG and give me a link to it, I’d be in a position to guide you better and give you a more specific answer on what kind of arrhythmia it is.
Hope that this information helps and hope that you will get better soon.
Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.
Best Regards,
Dr. Raja Sekhar Varma.
Ventricular tachycardia is of many types. Though many types are life-threatening, there are forms of VT which are relatively benign. It may even be possible to do curative Radio-Frequency Ablation for certain types of VT.
You could also modify your lifestyle, avoid excessive stress, avoid caffeine, avoid late nights, get a good night's restful sleep and do slow breathing exercises, which might help to reduce the frequency of the palpitations.
Drugs like Beta Blockers, Amiodarone, etc can also help, if indicated. A complete cardiac electro-physiological study with VT induction and mapping in the EP (Electrophysiology) lab can be done, if the results of other non-invasive tests indicate it. This would give a complete diagnosis of the Arrhythmia, and in many cases, ad-hoc RFA (Radio Frequency Ablation) can be done.
If you could tell me your age and current medications and possibly upload a scanned copy of your ECG and give me a link to it, I’d be in a position to guide you better and give you a more specific answer on what kind of arrhythmia it is.
Hope that this information helps and hope that you will get better soon.
Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.
Best Regards,
Dr. Raja Sekhar Varma.
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