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Am I crazy? Or am I being a good advocate for myself?
Quick background: Palpitations here and there for years-- worse whenever I took decongestants, so I've learned to avoid those. I had a Holter done in '01 and that's when I learned what the D in Claritin D meant, so I guess the Holter was normal and they said don't take the med anymore. I also vaguely remember mentioning I had to sleep propped up on pillows in my first trimester of pregnancy years ago and they sent me for an ECHO and said I had MVP. No one said anything about follow-up and I can't say I ever thought much about it since.
I started working out over 3 years ago and lost (and kept off) 60 pounds. Last summer a neighbor asked me to run a 1/2 marathon with her. I knew I could run 3 miles (5K) so I started trying to train with her. But I was having more palpitations and SOB with running. I finalyl gave up and said "My heart just seems to not want to cooperate with me!" I never got it looked into....just stopped running more than 2-3 miles.
So about 6 weeks ago I started to jog at the gym and had a big palpitation and I thought "Damn, I hate these things" and it suddenyl went into what we assume was SVT. I am wearing an Event monitor now. So far I have been told it shows nothing-- even though I have hit record for palpitations, chest tightness, SOB suddenly in the middle of a workout. And for about 3 weeks i have an intermittent chest pain that comes on after exercise, sometimes I come home and fall asleep for an hour after my workout. What is going on?
1. Will SVT cause changes in the heart?
2. Do all palpitations come from electrical, or are some structural, like are they the MVP that I feel? And is that why the event monitor can't "see" them.
3. Should the MVP from pregnancy have gone away, or could I really still have it? The EP doc was concerned only with the SVT. So I had to advocate to change to a regular cardio doc to have the MVP assessed. Am I crazy or being a good advocate?
I started working out over 3 years ago and lost (and kept off) 60 pounds. Last summer a neighbor asked me to run a 1/2 marathon with her. I knew I could run 3 miles (5K) so I started trying to train with her. But I was having more palpitations and SOB with running. I finalyl gave up and said "My heart just seems to not want to cooperate with me!" I never got it looked into....just stopped running more than 2-3 miles.
So about 6 weeks ago I started to jog at the gym and had a big palpitation and I thought "Damn, I hate these things" and it suddenyl went into what we assume was SVT. I am wearing an Event monitor now. So far I have been told it shows nothing-- even though I have hit record for palpitations, chest tightness, SOB suddenly in the middle of a workout. And for about 3 weeks i have an intermittent chest pain that comes on after exercise, sometimes I come home and fall asleep for an hour after my workout. What is going on?
1. Will SVT cause changes in the heart?
2. Do all palpitations come from electrical, or are some structural, like are they the MVP that I feel? And is that why the event monitor can't "see" them.
3. Should the MVP from pregnancy have gone away, or could I really still have it? The EP doc was concerned only with the SVT. So I had to advocate to change to a regular cardio doc to have the MVP assessed. Am I crazy or being a good advocate?
I'm not quite sure if I understand your question, but I'll try to answer, sorry if there is anything I misunderstand.
All parts of your heart are able to fire electrical impulses. Of course the sinus node, but also atrial tissue, the AV node and ventricular tissue. If you've ever had muscle spasms, you will see the same goes for other body parts, too. If you have a structural anormality, you will likely have more ectopic beats (beats not originating from the natural pacemaker, the sinus node). All ectopics will be visible on a monitor.
However, if you ask about palpitations that are not visible on a monitor, this must be strong or fast sinus beats. This is also possible. Essentially it's difficult or impossible to see the difference between a noticeable sinus beat and a not noticeable sinus beat on ECG. Some structural anormalities can cause hard and unpleasant heart beats, originating from the sinus node. I'm not sure if MVP can cause that.
All parts of your heart are able to fire electrical impulses. Of course the sinus node, but also atrial tissue, the AV node and ventricular tissue. If you've ever had muscle spasms, you will see the same goes for other body parts, too. If you have a structural anormality, you will likely have more ectopic beats (beats not originating from the natural pacemaker, the sinus node). All ectopics will be visible on a monitor.
However, if you ask about palpitations that are not visible on a monitor, this must be strong or fast sinus beats. This is also possible. Essentially it's difficult or impossible to see the difference between a noticeable sinus beat and a not noticeable sinus beat on ECG. Some structural anormalities can cause hard and unpleasant heart beats, originating from the sinus node. I'm not sure if MVP can cause that.
The evening I had SVT my HR went from 130 to 230 and stayed exactly at 230 for a few minutes-- along with the feeling I would faint, tunnel vission and a cold, clammy feeling. The EP doc said it was SVT and he suggested an EP study and an ablation if needed to prevent it from occuring again (since I obviously have a funny little pathway somewhere). I was the one who asked for the event monitor to catch the palpitations, too, since I'd like to know what they are. So my question was : Are all palps caused by an electrical issue and therefore should be caught on a monitor? Or can I feel palps from a structural issure (ie. MVP) and therefore i feel them but he can't SEE them on the monitor?
But yes, I agree to some extent that the tachy can be from anxiety. It's just strange that I have had off and on anxiety for years, and the exercise has been a greta source for keeping it controlled. It's just annoying that suddenly it's the opposite now! Like my exercise is causing anxiety and tachy and palps? Ugh, I don't like it if thats what it is!!
But yes, I agree to some extent that the tachy can be from anxiety. It's just strange that I have had off and on anxiety for years, and the exercise has been a greta source for keeping it controlled. It's just annoying that suddenly it's the opposite now! Like my exercise is causing anxiety and tachy and palps? Ugh, I don't like it if thats what it is!!
I just have to answer this - it's as similar to my problems that it's almost funny!
(from my own experience and actually capturing this on holter) I don't think you have SVT as you think of it (AVNRT). It's most likely sinus tachycardia, but as you probably know, sinus tachycardia is also a supraventricular tachycardia, spoken technically.
In anxious times I feel a bit exercise intolerable. My symptoms are, when running or walking up a hill: One big palpitation, I get annoyed/pissed off and think: Not again!?! The heart seems to settle for a few seconds, and then: High and irregular heart rate, I get afraid, thinking what can this be? It usually stops after some seconds of resting. Next hill, it can happen again, but not quite as bad. After some minutes it's usually back to normal if I stop being afraid.
I got this while wearing a holter monitor. Conclusion: Sinus tachycardia and premature atrial contractions (PACs). Triggered by anxiety, expectations of the arrhythmia coming back, combined with high adrenaline release and somewhat poor exercise condition.
My trick to get rid of this is: During anxious times, warm up 20-30 minutes on an exercise bike in my living room, while watching TV or anything that get focus away from my heart rate. Start running afterwards, in a safe environment, not far from home. As long as you warm up and don't get those adrenaline kicks, it's usually no problem. After some time, when your subconcious mind seems to forget these events, you can exercise as normal.
That you fall asleep after exercise is actually just another sign that you are actually panicking during exercise, the adrenaline withdrawal afterwards make you tired.
A little point of advice:
SVT (the ectopic tachycardia) doen't start with a palpitation. The palpitation is actually the first normal beat after a PAC (or SVT), and a sign that this event is over. SVT is a line of PACs, it's usually completely regular, with a pause afterwards followed by a "thump" in your chest.
SVT or other supraventricular arrhythmias during exercise does NOT affect expected life duration (I found this in a scientific journal some time ago).
You can probably relax about this. If you're getting palpitations, just relax for a short while.
To your questions:
1. No. SVT doesn't cause changes in your heart. Sometimes it's caused by a change in your heart, that you have an extra electrical pathway through the point that connects the hearts upper and lower chambers, and creating a loop making the impulse trigger fast heartbeats in a row. If this is really bothersome, ablation therapy can be used to cut this pathway.
2. Ectopic beats are caused by spots in your heart that are irritated for some reason (adrenaline, mechanical affection (by bending down, for instance, deep breaths, etc), viral affection or of course structural changes like MVP. Since the doctor didn't comment your MVP any further, it's probably very small and not the biggest concern)
3.It may be. It's not easy to say, and I'm not a doctor. Maybe you should speak with him again and ask for another echo if you're experiencing your palpitations get worse, also during rest.
No, you're not crazy. It's completely normal to be scared of these things. The only problem is that this anxiety produces adrenaline and makes the palps worse.
Good luck!
(from my own experience and actually capturing this on holter) I don't think you have SVT as you think of it (AVNRT). It's most likely sinus tachycardia, but as you probably know, sinus tachycardia is also a supraventricular tachycardia, spoken technically.
In anxious times I feel a bit exercise intolerable. My symptoms are, when running or walking up a hill: One big palpitation, I get annoyed/pissed off and think: Not again!?! The heart seems to settle for a few seconds, and then: High and irregular heart rate, I get afraid, thinking what can this be? It usually stops after some seconds of resting. Next hill, it can happen again, but not quite as bad. After some minutes it's usually back to normal if I stop being afraid.
I got this while wearing a holter monitor. Conclusion: Sinus tachycardia and premature atrial contractions (PACs). Triggered by anxiety, expectations of the arrhythmia coming back, combined with high adrenaline release and somewhat poor exercise condition.
My trick to get rid of this is: During anxious times, warm up 20-30 minutes on an exercise bike in my living room, while watching TV or anything that get focus away from my heart rate. Start running afterwards, in a safe environment, not far from home. As long as you warm up and don't get those adrenaline kicks, it's usually no problem. After some time, when your subconcious mind seems to forget these events, you can exercise as normal.
That you fall asleep after exercise is actually just another sign that you are actually panicking during exercise, the adrenaline withdrawal afterwards make you tired.
A little point of advice:
SVT (the ectopic tachycardia) doen't start with a palpitation. The palpitation is actually the first normal beat after a PAC (or SVT), and a sign that this event is over. SVT is a line of PACs, it's usually completely regular, with a pause afterwards followed by a "thump" in your chest.
SVT or other supraventricular arrhythmias during exercise does NOT affect expected life duration (I found this in a scientific journal some time ago).
You can probably relax about this. If you're getting palpitations, just relax for a short while.
To your questions:
1. No. SVT doesn't cause changes in your heart. Sometimes it's caused by a change in your heart, that you have an extra electrical pathway through the point that connects the hearts upper and lower chambers, and creating a loop making the impulse trigger fast heartbeats in a row. If this is really bothersome, ablation therapy can be used to cut this pathway.
2. Ectopic beats are caused by spots in your heart that are irritated for some reason (adrenaline, mechanical affection (by bending down, for instance, deep breaths, etc), viral affection or of course structural changes like MVP. Since the doctor didn't comment your MVP any further, it's probably very small and not the biggest concern)
3.It may be. It's not easy to say, and I'm not a doctor. Maybe you should speak with him again and ask for another echo if you're experiencing your palpitations get worse, also during rest.
No, you're not crazy. It's completely normal to be scared of these things. The only problem is that this anxiety produces adrenaline and makes the palps worse.
Good luck!
Sorry...I am 33 yrs old, non-smoker, occas 1or 2 drinks socially, only meds I take are vitamins, BP usually runs 118/76. I had also recently bought a HR monitor to help count calories while I work-out. I noticed that on days that "felt good" my HR cooperates and I can work-out fine. But then some days I will just walk up the stairs to the machines and my HR goes from 85 to 120 and I get SOB suddenly. Then it seems my entire workout is a struggle because my HR will get high without much effort and it's uncomfortable. That's so hard to explain, but it seems really weird. And it didn't do that before?
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