SVT

[pops30]

Hello I'm a 30 year old man, 35 pounds overweight  ex smoker..
After a couple months of having these symptoms:

malaise,
lethargy,
mood changes, irritability,
tachycardia bouts with near syncope
waking at night with racing pulse and can't breath in

chronic heavy and dull chest pain
throbbing deep in upper central chest
general widespread chest pressure especially after an SVT
feeling too weak in the chest to take a full breath of air

My loop recorder found a SVT of 160 during my sleep (i woke up, couldn't breath, heart racing, in a panic..not the first time that happened)

During awake hours, it takes something to set off my SVT's.  Minimal excitement...anticipation for things good or bad....getting ready in a hurry to go places...

I'm sure that previously to feeling generally bad (malaise chest pain etc) that my pulse would get up during these situations but only now I am so darn sensitive to the least tachycardia (forceful heart pounding sensation and lightheaded even at 110)..

Main thing I am wondering, is there an external source (outside the heart) to cause my symptoms especially since during awake hours it takes something or another to set the SVT off,   I'm scared of going to the EP and jumping right into a heart cath.    

I am wondering if it could be adrenal related or maybe even sleep apnea?   I do have a deviated septum and nasal airflow problems, thats been diagnosed previously.   I am also concerned some stress hormone is being release too much or quickly?  

Some guidance would be much appreciated,  thank you

[pops30]

Please doctor, follow up--- Would my 3-lead loop recorder have been able to differentiate between benign SVT (likely the non sleep apnea kind)..... and a-fib (the sleep apnea related type) ??


Thanks a bunch.

[Cleveland Clinic]

Sleap apnea mediated tachycardia is usually of the atrial fibrillation type, therefore, unlikely in your case.  There are rare adrenal tumors (phrochromocytomas) or brain tumors (norepinephrine releasing) that could cause this but they are truely extremely rare.  simple blood tests would rule out such a possibility.  SVT at a heart rate of 160 could be atrial tachycardia (this can also be sleep apnea related), AV nodal tachycardias and accessory pathway tachycardia.  An EP would be your best choice.  You don't have to start with an EP study.  They may start some meds and see how you feel.  Of course, because you are young you would have to be on these meds for the rest of your life, possibly, therefore an ablation (once an ablatable rhythm is diagnosed) is a great option and can cure you of this condition.