Heart arrythmias

[Para999]

I am a 35 year old medic. I suffered from a run of ectopics about 10 years ago and since then have had various problems including a run of SVT about 7 years ago at a rate of 170 with no ill effect.This self terminated after a few minutes of brisk walking. Again another SVT about 4 years ago when the same applied.

Recently i presented to hospital with 15 minute history of multiple atrial ectopics. I subsequently had a panic attack which made matters worse.

I occasioanlly get a few ectopics when standing up quickly.

I have never had any chest pain, ankle swelling, DIB, syncope etc

HR at rest is 75, blod pressure yesterday was 132/74. Glucose normal, full blood count normal, urea and electrolytes normal, temp normal, 12 lead ECG normal, urinalysis normal.Cholesterol was OK a few years ago at a total of 4.6

I am a little overweight 6''1 at 15.3 stone and smoke. I feel sometimes that when under pressure at work or straining then i get a few ectopics that go away quickly.

What is the chance of this being coronary heart disease or something more sinister? Do I need more invesigation.

I have a long standing history of anxiety and feel that I breathe a bit too quickly when under pessure.

[marlinspike]

It seems unlikely that it is heart disease, given your age and the fact that the ecg was normal. Stress and adreneline can certainly trigger missed beats. Bobad is right though - my own ectopics have caused me to have massive anxiety and panic attacks, seriously affecting my quality of life. Have you had an echocardiogram? This would show if your heart was structurally normal or not - if it is normal, then (from what I've read) ectopic beats are harmless, though in many cases very distressing. If you are in distress about these ectopics, see your cardiologist again, just to put your mind at rest.

Oh, and stop smoking - very, very, very bad for your heart - which you know, don't you?!

[bobad]

Since you have had the ectopics since very young, nothing sounds real suspicious to me. Ectopics that start suddenly or permanently worsen are more likely to be caused by coronary artery  disease. The absence of angina is another clue that your heart is probably OK.

Having said that, you are 35 now, and as you know, you're in a higher risk category. I think you need to see your cardiologist and get a stress test. If nothing else, it will set your mind at ease, and perhaps reduce the occurrence of future panic attacks. Panic attacks are not trivial, and can wreck your life just as surely as any serious disease.