Ventricular Tachycardia or anxiety?

[lalaland24]

I am a 25 year old female and have a history of anxiety/panic attacks but they have always been associated with PTSD, one from a traumatic experience (2008) and the other from a car accident in September 2010. For the first time I went to get help for my anxiety and was prescribed .5 mg Ativan as needed. I have only used 6 of them since because I felt better within a little over a month after the accident. Late October I admitted to the ER with tachycardia that wouldn’t go away even with an Ativan. It got so high my throat felt constricted, and all I was trying to do was sleep. I had drank a significant amount of caffeine the night before and they gave me fluids, diagnosing me with dehydration and palpitations. The doctor called my family physician and instructed that I needed to have a holter monitor because something with the EKG was very slightly off, almost nothing to worry about but he said you never mess with the heart. Instead I decided to change my diet. I haven’t drank any caffeine since October, and I drink significantly more water every day than I ever have in my life. Things were better I have been feeling so great! Until last week, when the tachycardia started again. I thought it was an anxiety attach so I took ½ a .5 mg of Ativan which helped, but the very next day it happened again. I have read that Ativan can cause rebound anxiety, so I suffered through it. Then two days later it happened again. This time I felt my heart jump or a sharp stabbing pain, and then my heart rate skyrocketed, and then went down, and back up, and down, very rapidly. I was terrified, but I was at work so I just dealt with it. It lasted a little over an hour.  Another two days later, it happened again, lasting almost 2 hrs, the heart rate was about 120 BPM each episode. No other symptoms. Then again, 3 days later, I was relaxing and reading a book when my HR rose to above 150 BPM without warning, I immediately felt like my throat was constricted and my chest hurt. This time I took myself to the ER. When I got there it was down to 130 BPM, but I didn’t get to see the dr. for over an hour, watching the monitor my HR went from 120 to 80 the entire time up and down. He didn’t mention anything about that, acted as if it were normal. He told me it sounded like VT and taught me that I should hold my breath or splash my face with cold water. Suggested I definitely get a holter monitor. My apt is in a week, but I dealt with it last night and again today at work, my HR just wants to stay at 120 for some reason and I can’t focus. Today I am experiencing slightly harder than usual breathing, and have been yawning a lot. My mother told me that my grandma on her side has had tachycardia issues, and my aunt on my dad’s side had to have surgery for it. I’m just scared to deal with this for the next week every day. If it occurs every day is it anxiety or a heart issue? I can’t figure it out. I have zero other symptoms besides my heart…and no current stressors. I am a mom but I have been a mom for 6 years and it’s not bothered me before. I’m worried to be alone with them because I don’t want it to happen again and scare them. I can handle the 120 bpm, while it distracts me and scares me, it’s far less scary than 150. It lasts for hours. Does anxiety last that long? I’m afraid my family physician won’t be of any help, and what if the holter monitor doesn’t catch it happening? I’m just confused and worried.

[lalaland24]

Thank you so much. I like the sound of SVT much better and you're right it's very possible I misunderstood him.

[is_something_wrong]

Wow, that's quite a post and some scary questions..

You can completely trust that you misunderstood the doctor. Ventricular tachycardia will never convert with vagal maneuvers. Some SVT's will, though.

VT can appear in young people as short runs, but almost never a sustained tachycardia unless the heart is severely damaged. In that case, you would already know it.

If you have "warm up's" in your heart rate (it increases from say 60 to 150 over some time, even if it's just 10-15 seconds, it's almost always sinus tachycardia or atrial tachycardia, sinus is the far most common. If you have a heart rate of 60, and BAM, 150, and it ends with a long pause with normal heart rate afterwards, it's more commonly an arrhythmia.

Forget the VT. See a cardiologist for reassurance if you can.

[bypeep]

I think it's very unusual that anyone would have interpreted a this as VT.  If the ER had detected a true VT in this situation you wouldn't have just been monitored, but more than likely shocked out of the rhythm.  I think that you might be using the wrong terminology?

VT usually has a dissociation from the AV node and vagal maneuvers will usually not work to convert them.  The type of fast rhythm that WILL respond to bearing down, or the cold water in the face trick is an SVT.  Very different from a VT.  SVT originates from the atria and is usually not life-threatening.  VT originates from the ventricles and is much more of a concern.

Search this site for SVT and see what others have posted in regards to outcomes, ways of coping and things to ask your dr. when you return for your follow up.

A holter should catch any sort of rhythm disturbance you experience while it's recording because it's continuous.  

[bbxx]

HI. I read your post and remembered reading on another site where someone asked this question and the cardiologst there said if it is anxiety, it will go faster and faster and slowly slow down, but if its not anxiety, it will go fast in just one heart beat and slow in one heartbeat. I hope this helps somewhat. I am not a doctor but the site was all experts.