Tachycardia Concerns!

[Intandem]

I have been diagnosed with Supraventricular Tachycardia along with a sinus arrhythmia. This is a result of negligence on my part and not watching what substances I put into my body.

I am only 21 but experience SVT (or PSVT?) on a weekly or bi-weekly basis, depending. I'm not quite sure what triggers my SVT but it is quite nerve racking. I experience chest-discomfort on a daily basis and also find it difficult to catch a full breath, although I do if I try yawning a few times.

I have quit smoking cigarettes, marijuana, drinking alcohol, and partaking in other substances (stimulants) for over 2 months now.

I am quite frightened, to the point where I am afraid to go for walks as the last episode was triggered going for a brisk walk after returning from seeing my doctor who gave me my diagnosis. I sometimes feel a light sensation in or around my heart area, a butterfly sensation along with a light discomfort when I breath at times (although this may be in my head?).

I have been prescribed Teva-Dilitizem, taking one 30mg tablet daily. I have been on it for only a few days now but do not notice any effects as of yet.

I am concerned about my health and whether or not I am in imminent danger, especially whilst exercising. I've had 2 ekgs performed as well as an echocardiogram and they've all returned positive results except for the sinus arrhythmia and SVT that a holter monitor picked up (heart rate shot up to 170). I believe my cardiologist also said my left ventricle is slightly enlarged but that could be due to stress.

These palpitations are driving me crazy and I am paralyzed by fear in not knowing when the next episode of SVT will occur. So now I don't move anymore than I have to.

My main inquiry is how much danger am I in? Is it safe to exercise (mainly walking) with SVT? Even when I experience SVT whilst walking at times?  If my echo came out fine but I still have SVT/tachycardia, does that mean my heart is healthy and can take the palpitations/SVT without risk of sudden death or atrial fibrillation/ventricular tachycardia? Do you recommend that I exercise anyway and that it is safe to do so? My doctor told me exercise is good for the heart and to cut down if I experience palpitations. Well that same day while walking I had an episode and sat down to get my heart rate down while trying to take deep breaths and not panic. I hate this!!! Anyhow, I am hoping for a 2nd opinion from someone who may have an idea of what I am going through! Thanks!

[tom_h]

4+ years since writing the comment above, and I'm doing well.  I'm approaching 65 now and glad every day that I made that decision.

[Rexmarco]

Hi may I know how are you now?

[tom_h]

"I have been diagnosed with Supraventricular Tachycardia along with a sinus arrhythmia. This is a result of negligence on my part and not watching what substances I put into my body. "

If it's any consolation to you, your heart was probably "mis-wired" all along. Trashing your bod with various substances only revealed it.  You said your cardiologist noted that you have a re-entrant form of SVT.  AVNRT I think is the most common form.  AVRT (which had) is a less common form. In a vast majority of cases, both of these forms are curable with cardiac ablation.

SVT is far from a "death sentence"; on the contrary.  Many of us here participate in high aerobic sports, and compete on a high level.  I might have had SVT the longest of any current member on the forum, at 54 years.  I believe "ireno" is a close second.

So don't beat yourself up over it.  But now that it's been revealed, learn to cope with it and control it rather than letting it control you.

[dolphin8808]

My HR goes high with minimal effort as well. Always has. When I work out, it hits 200 bpm within a few moments of doing cardio. Even getting up in the morning and moving around can cause my HR to go high. It can also be deconditioning.

My PVCs I think bother me more then anything though. I hate that strong thump.

[Intandem]

Thank you :)

I had palpitations yesterday whilst accompanying my dad to his procedure. He has cancer and had to have a stent put into his liver and I was his designated driver.

While I was in the waiting room I had a palpitation, either a skipped or forceful beat but I told myself to remain calm and that my heart is alright. By doing this I was able to handle the palpitation as I accepted it as a normal thing.

On the way back from the hospital and just a little ways out, I experienced another palpitation, this time it felt like a flip flop but I once again told myself to remain calm and that it is nothing to worry about.

I had a third and final palpitation later that evening which was forceful and flip-floppy and the strongest one of the day, yet I still told myself to remain calm and that it is normal. On the last one I felt my heart rate increase slightly but because I remained calmed and refrained from panicking, it ended quickly without complications.

So now I am wondering if when I do experience these palpitations, that fear/adrenaline feeds the heart rate/palpitation and increases the likelihood of an SVT episode?

Although I still don't understand why my heart rate would shoot up to 170 BPM after 20 mins of cutting the grass, which is a relatively low intensity work out.

[grendslori]

This new diagnosis is probably nothing to worry about as your doctor is telling you. You are going to be evaluated, which is good. One thing you may want to consider doing is to really go through and read some of the posts on this site and consider the ages of the patients writing on here. Many of them are in their 40s,50s and older. Many of them have SVT and are still living and going strong. This is not a death sentence for you, these types of arrhythmias are a pain to live with, but that is about all. You have a long life ahead of you, try and enjoy it.

[Intandem]

She said it could be caused by stress and that it is mild. I have been scheduled for a chest/lung x-ray this monday. My doctor is also sending my results up to the University of London cardiology center seeking a second opinion. However she is confident that both exams will return fine and is not too worried about my condition.

Should I be worried about a slight left atrial enlargement? Is she wrong in her diagnosis? Why would she tell me I have nothing to worry about if there wasn't anything to worry about? I believe she is a good doctor.

[grendslori]

So why is your left atrium enlarged???

[Intandem]

mild left atrial enlargement  oops, I misheard the Doctor when I went in for my assessment. So my left ventricle is not enlarged, such a relief. She called me back today and reread the results from my echocardiogram.

[Intandem]

Well she is sending my reports into the London University Cardiology center which is the best in Canada, for a second opinion. Is 3-6 months too long to wait? I called her yesterday and she said she didn't send them yet, I called her again today and left her a message, hopefully she gets back to me!

[grendslori]

I hate to say this, but right now I am so ticked off with the way you are being treated, I can't believe it.

Here's a peice of advice for you: Ask your doctor this question:

"If I have any kind of issue with my left ventrical, which is the primary beating chamber of my heart and I have an SVT attack, is my left ventrical going to be able to handle trying to keep up with the SVT?"

I would love to be a fly on the wall to watch your doctor's jaw hit the floor as well as loving to hear what she has to say in response!!

You are just 21 years old, it is not fair to you to be blown off this way!

[grendslori]

A normal BP is 120/80. That is the relaxed normal BP. If you are at the doctor's office the bp you had would be perfectly normal. Usually they look more at the lower reading, than the higher. The top number is the systolic reading, the lowere is the diastolic reading. If the lower number is higher than 90, then they might consider you having High Blood Pressure. If your BP is normal all the time and you are not being trated for HBP, and there is any kind of issue with the left ventricle being enlarged in any way, you NEED to get that checked out! There could be a genetic component there that needs to be looked into. If there is nothing to worry about "right now" exactly when does she start to worry about it??? I seriously think you need to find another doctor who will take this a bit more seriously. At least get a second opinion from a good cardiologist, preferrably one who is at a large University Hospital where they are much more apt to see patients with these kinds of issues.

[Intandem]

My blood pressure is 137/81 and if I recall correctly she said it was slightly enlarged

[Intandem]

Okay she said it was reentrent SVT but she won't know for sure until the results come back from the other hospital which can take anywhere from 3 to 6 months :\

I asked her about the left ventricle and she said its nothing to worry about right now, she's scheduling a scan of my lungs.

She said I should be 100% fine so who do I trust?

[Intandem]

Oh geeze

[grendslori]

Another thought: Thickened heart walls (hypertrophy) can develop electrical tracts through the muscle and those tracts are uaually easily accessable from the normal electrical pathways of the heart. That is why you can end up with SVT. What is important to know is if the fast heart rate starts and stops on a dime, or if it speeds up and then slows down. If it starts and stops on a dime, that is caused by the electrical impulse "jumping" over to the track that shouldn't be there; when it stops on a dime, it does so because the impulse "jumping" bact to the correct pathway. It's kind of like a train leaving one track and making a loop then returning to the original track again. A heart rate that increases and decreases over a short period of time is usually caused by breathing, stress and anxiety or exercising. If there is any question of LVH in you, walk as much as you can, but don't do any strenuous exercises until you have been fully cleared for that.

[grendslori]

Okay....an enlarged left ventricle that is caused by stress???? I have LVH, have a daughter that had severe left and right (concentric) hypertrophy that was killing her before her transplant,and having worked in the field of cardiology........I've NEVER, EVER heard that LVH can be caused by stress!!! And I studied A LOT about the different Cardiomyopathies, especially about HCM! Stress will aggreivate arrhythmias in patients with cardiomyopathies and if the cardiomyopathy is serious enough, the walls of the heart, due to a lack of bloodflow, can cause arrhythmias to happen more frequently, but to say stress can cause a LVH, I just can't believe she said that to you. High Blood Pressure is the most common cause of LVH, IF there is no genetic component involved, in other words there are family members who all have the disease. In HBP, the LVH would not be classified as a primary disease, it would in a genetic setting. Go for that next opinion; you need it to understand the LVH!!      

[Intandem]

I'm going to give my doctor a call tomorrow and ask her these questions, I'm not definite on what type of SVT I have.

Is an enlarged left ventricle something to be worried about?

[itdood]

sinus arrhythmia is perfectly normal.  

Dang I wish they would stop noting that on ECGs.  In fact, it's much more worrisome when sinus arrhythmia ISN'T present, but I digress....:-)

What type of SVT do you have?  If the episodes are sinus tachycardia, perhaps you are getting scared when you feel a palpitation of some sort and driving the rate up that way?  It's not uncommon for someone your age to drive the rate up towards 180 or so by getting panicky, and this can happen really fast.

[Mom2four85]

I have concentric LVH, an enlarged heart, HOCM, valve problems, malignant arrhythmia's, PVC's, VT, PAC's, SVT and was advised by my dr's not to exercise the month or so before my ablation until they finished all my testing...afterwards I was told to walk as much as I could and felt like it; but it's best to ask your dr and make sure in your case.

[Intandem]

My cardiologist sent my results from the ekg's/ecg/holter monitor up to London which is the best cardiology center in Canada in order to catch anything she might have missed, my next appointment isn't until the end of January I am assuming as she said it could take anywhere from 3 to 6 months to get in contact with the other hospital/center.

She seemed confident in letting me go home but I still have this thought in the back of my head that something's not quite right. Oh well I've got to put up with this I suppose. We'll see if the medication takes effect in a month or so.

[Intandem]

Thanks guys, I've been reading up on enlarged left ventricles and it doesn't sound good, but my doctor said it could be from stress.

Is walking a good thing to do? Does it strengthen the heart or would I need to do something more intensive (which at the moment I shouldn't until i figure out what's going on with my left ventricle?)

[MichelleP_3811]

Just a side note on possibly what you felt in your class.  I had what is called avnrt.  It is a reentry tachycardia where there is a secondary pathway into the avnode.  I also had pvcs that are an extra beat arising from the ventricles that then cause the sinus rhythm to pause a beat.  It was the pause that would allow the secondary pathway signal to reach the center of the avnode and then get stuck in a circle whereas the electrical signal would go out the entry path and then back around.  There is a lot of literature online to help explain it a bit better but generally if you had that type of svt your heart rate would reach near 200 or more becasue the reentry path is very short.  But again, you need to get it captured to know for certain what is going on but definitely the disruption of a pvc in the steady beating of your heart will definitely give a reentry svt a change to go off.  

[MichelleP_3811]

Yes, there seems to be a breathing component to my pvcs as well. Sometimes when I breath in the heart will skip a beat but it isn't always on the breath in though my heart rate slows quite a bit when I breath in and then speeds up so it is jumping around a bit when I have the pvcs which may be what gives them a chance to fire.  If I hold my breath for any reason like when I bend down to tie my shoe or pick something up I can have a pvc.  But I can also get them just from changing position.  In any event, bp medicine that regulates your heart rate will show some improvement to the pvcs if there is the fluctuating heart rate component.  The more steady the beat the less likely a pvc will sneak in I guess.  That being said, your second comment sounds more like a reentry svt so you may have a secondary condition not related to the sinus tachycardia but you would need to get that captured on an event monitor to have a proper diagnosis.  If it is something you felt during one of your medical tests then I would say the doctors likely captured it and it was nothing more than the sinus tachycardia but if you didn't have one of those episodes captured then you may want to address those instances with your cardiologist who may give you an event monitor to record such an episode when it happens so long as you have enough of them to capture at least one in a month.  But as I stated before the two types of tachycardia feel totally different.  The Sinus Tachycardia feels like a simple fast heart rate but a reentry tachycardia feels more manic like the heart is beating super super fast.  Obviously only you can say for certain how it feels for you but if your heart all of a sudden starts to beat at upwards of 200bpm without provocation then you may have a reentry svt that could be treated but again you need to get that captured first.  However, if you do have a reentry svt and are able to get it treated and fixed you will still likely have the pvcs since it is a completely different animal.  The svt problem arising from somewhere in the atria whereas the pvcs arise from somewhere in the ventricles.  Completely different sections of the heart.  Unfortunately a lot of people who have an arrhythmia problem generally tend to have more than one issue.  And some of the issues we just have to learn to deal with.