32 yo femail with PVCs and inverted T-waves

[lg78]

Past hx dx of MVP through ECG's, TEE & EKG's.  No meds taken.
On Thurs,  I walked  up our driveway, which is about 10ft long & on a slight incline, my heart began to skip beats. It did this several times. Each episode lasting 2-3 seconds & SOB was experienced. I became lightheaded w/ each palpation. I sat down for 20 min. My b/p was 100/79 with a HR of 85. 30 min later, I was still having palpations, my b/p was 90/72 with HR of 90. 30 min later,  fingers began to tingle, & lips became pale.  My bp was 80/60 with 100bpm HR. I made my way to the ER.
At the ER, SPO2 was 95, so 3L of O2 was given. I experienced another palpation, which set off alarms at the nurses station. It was a PVC that lasted 3-4 seconds. The nurse explained I experienced V-tach & I was admitted to the hospital. While there, I had continuous O2 for SOB & EKG's around the clock, as well as cardiac panels. My EKG's revealed inverted T-waves. I had a cardiac MRI which revealed no blockages. I also had a stress test. My resting HR was 72. Less than 1 minute after beginning the stress test, my HR soared to 135. 3 minutes into the test, I had a 3-4 second PVC. I endured the stress test for a total of 7 minutes, reaching my goal HR of 165bpm. I had to lay down after the test to get my HR to come back down. It stayed around 120bpm for 20 minutes. I then had another MRI, which revealed nothing new.
ECG was done & the cardiologist said I don’t have MVP & I am to a tilt-table test for further information. I also had a thyroid test, which revealed a normal thyroid. Cardiac panels came back normal & imbalances were detected.
I spent 3 days in the hospital, with absolutely no news or medications. My last night in the hospital, I experienced a hotflash with sweaty palms. My eyes became bloodshot & I experienced mild angina. I was given a Xanex & told to sleep.
I am in the dark as to what is wrong with me & would love insight as to what COULD be causing this to occur.

[CCFCardio MD2]

I'm sorry to hear that you're having such a difficult time.  I'm sure it's very frustrating to have distressing symptoms with no real answers.  Your symptoms could be due to a number of different etiologies.  If you truly have mitral valve prolapse, you are certainly at risk for arrhythmias (irregular heart beats).  Some of these arrhythmias are benign and cause no problems, while others can be so significant that they cause cardiovascular compromise (high heart rate, low blood pressure, etc).  It sounds as if your physicians have initiated a work up for arrhythmia, but they may want to consider something like a Holter monitor or Event monitor which is something you wear home that can monitor your heart rate and rhythm.  Your symptoms of hotflashes, sweaty palms, high heart rate can be due to a rare tumor called a pheochromocytoma.  You may want to ask your physician if this is something they want to test for, especially if your symptoms are not explained otherwise.  You should continue with the tilt table test as there is a condition in young women called POTS (postural orthostatic tachycardia syndrome).  Patients with POTS experience high heart rate, low blood pressure, lightheadedness, fatigue on occasion due to an inability of their body to compensate for changes in posture (e.g. going from lying to standing).  Another condition called ARVC (arrhythmogenic right ventricular cardiomyopathy) is rare but can occur in young patients.  It is caused by fibrofatty replacement of the right ventricle which leads to life-threatening arrhythmias such as ventricular tachycardia.  MRI should be a good test to diagnose this, and it sounds as if you had 2 MRIs, so I would say this is an unlikely diagnosis.

Please stay in contact with your cardiologist if you continue to have these symptoms as some of them do sound concerning.  Best of luck to you.

[lg78]

Thank you so very much for your reply. I am back from the TTT and have an informal diagnosis of POTS. So, you were right on the money! All of the symptoms associated with POTS fits the symptoms I have had for quite some time. Scattered out, I never really put much thought into it, but lumped together...it's as if the POTS dx is the missing puzzle piece. I will go Friday to speak to a cardiologist about the test and the tech said I'll most likely begin a regimen of low dose-beta blockers.

While doing the test, I never fainted or became dizzy, but my heart rate increased from a baseline of 80 to 120 in less than 15 minutes. It continued to rise the longer I stood. My b/p was up and down the entire time, never finding consistency.

Thank you once again, this is pretty much a confirmation to what I was told just a few hours ago. This site is a wonderful resource!

[lg78]

That should be that NO imbalances were detected in my cardiac panels.