SVT's and stress echo

[jwilhelm]

Hi there - I am a 32 year old woman - good bp and normal cholesterol.  I have suffered from palpatations for a long time ( early 20's)  I had a holter and echo done years ago and it came back as PVC's.  Recently my dr rechecked everything and I did another echo and loop monitor.  Echo is normal, but the loop showed short runs of SVT's,  he wants me to now go for a stress echo to rule out cardiomyopathy....this is scaring me greatly.  I am a very anxious person and currently on 40mg of Celexa for anxiety.  I guess my question is are SVT's common and harmful and if my echo came back normal is that a good sign.  My dr said he was just doing the stress echo to complete the study and I shouldn't worry about it.  My palppitations are very infrequent and not at all worsened by exercise.  Is this stree echo necessary and should I be worried that I have some awful heart problem.  What are the causes of SVT's and will they cause me any future harm?  Thanks  Jill

[jwilhelm]

Also - just wanted to note that when I do feel a palp - they only last a few seconds at most!

[jwilhelm]

Thanks Dr. Gopi,  I find that the palpitations are very much associated with stress and lots of caffiene as well - I am cutting back on both!  Being that I do have symptoms is this still considered a benign condition and I should worry too much about it? Will it have any long term effects on my heart?  Also is it ok to continue on a exercise regiment - I am still awaiting my cardio appt and would like to continue going to the gym!  Thanks Jill

[Gopi Aniyayhodiyil, MD]

Dear Jill,

Thanks for the additional information.

Having palpitations a few times every week actually means that you are symptomatic. During the loop recording were you able to correlate the symptoms with the occurrence of the SVT on the recordings? Discuss this with your cardiologist who performed the loop recording. If the symptoms correlate with the recordings, then in my opinion, you should be treated with either medicines or ablation.

Atrial fibrillation is not directly related to SVT. Patients with hypertension are prone to develop atrial fibrillation which can lead to stroke. So do not worry about the relation between your symptoms and your mother’s history.

Best Regards,
Dr. Gopi A

[jwilhelm]

Thank you Dr Gopi - your info was great - The only symptoms I do feel are the occassional palpitation which is why I had the loop done in the first place...They don't really bother me and only occur at most several times a week, not days....if they don't bother me, is it ok not to do anything?  My mother has atriall fibrillation which resulted in a stoke at 53 (also do to high blood pressure)  is this anyway associated with that and should I have this arrythmia rechecked at any time intervals to make sure it has not progressed to something else.

Thanks Jill

[Gopi Aniyayhodiyil, MD]

Dear Jill,

I have gone through your query and noted the details. SVTs (supraventricular tachycardia) are generally very benign. Since you are asymptomatic and your loop showed short self terminating runs I do not think there is a cause for concern.

In very simple terms, SVTs are due to a sudden short circuit in the electrical activity of the heart, resulting in a fast heart rate. It is usually associated with some inherent abnormal electrical pathways in theheart, which in routine circumstances do no play a part in the normal electrical conduction. Generally no treatment is required in asymptomatic patients as it is a harmless condition.

In a small percentage of patients it may become symptomatic and treatment may be needed. Nowadays the abnormal tract can generally be ablated with radiofrequency, which involves a day of hospitalization and is very safe and effective.

With respect to association with cardiomyopathy, since the echo is normal, I do not think the stress echo will show an abnormality. Hope that clarifies your doubts.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Gopi A