SVT or just a Panic Attack?

[crazycam]

Hello,

I am needing some help. I recently have been having these episodes where my heart will will sky rocket, it feels like its up to 200, chest feels like it will explode. These episodes last between 10-15 mintures. Now I can tell you when I feel my pulse shoot up, yes I am panicing, who wouldn't?? But I have been seen by 2 Cardiologists, one of them during my stress test, I had this happen and my pulse was 180 before I got on the treadmill. This led him to think I might have SVT. So he sent me to an electrophysiologists, he ran tests, monitored me for 30 days. However I never had one of these episodes during the monitoring period. I just had this last night. I was standing in my bathroom about to do my business, when I heard a knocking sound in my chest, from heart was tapping on my chest wall which I have not heard before, then I felt this sensitivity in my chest area and my heat began to sky rocket. It felt much like it did that time it was registered at 180, almost faster, and I was sitting down! My question, sorry for the rant. Could I have PSVT, or this is this common for panic attacks? Should my pulse go to nearly 200 during a panic attack? I find that hard to believe. Is it safe for my rate to be this high? Again it stays that high for about 10-15 minutes until my breathing finally calms it down. Thanks.

[tom_h]

WPW has a telltale marker.  But most SVT's are concealed. An EKG in sinus rhythm will show nothing.

[crazycam]

Also the elctrophysiologist having doing a 24 hour holter, 30 day holter said it looked perfectly fine. I mean if I had SVT wouldn't it have shown up somewhere, or only when I have an episode?

[crazycam]

He did. He thought I might have SVT but wasn't certain because he is not an electrophysiologist. So he sent to one. That guy gave me a 30 day holter, but I never had one of these attacks when I was using it. I called him and will see him on Wednesday. Should I ask for another 30 day holter until I am able to record one of these events?

[MichelleP_3811]

Yeah, I am with Tom it seems kind of fast.  Did the cardiolgist not look at the ekg that was issued on the day of the stress test?  It may be he wants to see how it starts as opposed to how fast it is going because a fast heart beat looks the same on the ekg as an accessory pathway svt.  I think it is good you are going to get the longer monitor especially since you state it happens at least once a month.  A good loop recorder should do the trick.  When you have an episode you will hit a record button and then phone in the reading.  At that point the cardiologist will see what your heart is doing before the episode starts and should be able to determine from there what type of tachycardia you have.  If you do indeed have an accessory pathway svt they can offer you an ablation to correct the problem for good.  If it turns out it is stress then you will likely be offered medication to help alleviate the symptoms.  

[crazycam]

Well I had a panic attack during a stress test. Right before I got in the treadmill, I was only standing, and my pulse had already reached 180. They nurse was shocked, but she looked at the EKG and was like "Look's good though". So I don't know. I wasn't able to check it at the time of the attack, alll I know is it felt insanely fast. I guess that's the panic though. Could be decieving how fast it really is.

[tom_h]

Anything is possible I guess.  My wife had really bad panic attacks.  When she told me her heart was racing, I'd measure it and it was always below 150.  Her definition of "racing" was a lot different than mine!  I've gotten my sinus heart rate over 200 on occasions, but it was all out, pedal to the metal, full smoke physical activity.  It is extremely difficult to reach those rates. My "resting" SVT rate in later years was around 200.  To feel that rate at normal respiration is both interesting and frightning at the same time.  It's amazingly fast, and seemingly impossible for a muscle to cycle that fast in rhythm.  So, I'm only suggesting that perhaps folks who report heart rates of 200 during a panic attack are blurring the line between anxiety and SVT.  Believe me, I had it for 54 years, and each episode of SVT was wrought with anxiety!  None of them were fun, and all I wanted was for them to end.