Aa
PAT
Recently I have had two episodes where my heart has raced and I become nervous (like with that shakey feeling before you vomit). I has occurred 2 times and lasted several hours each time. I could tell when it started and stopped. My doctor called it PAT and told me to do the valsava manuever and if they don't work then to take lopressor. He did an EKG in the office and that is it. My family is not happy with this diagnosis and I am fearful to take the lopressor without having a health care professional around. Family and friends are saying holter, cardiologist and ED next time it occurs. What do you think?
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PAT (paroxysmal atrial tachycardia) will usually not convert with valsalva or parasympathic stimulation. Some supraventricular tachycardias will, but that's usually the ones involving the AV node (AV nodal reentry tachycardia or junctional tachycardias). An atrial tachycardia origin from another "pacemaker" in the upper chambers for some reason.
The fact that a tachycardia run isn't monitored on EKG (?) means that your doctor doesn't know what it is and isn't. If it is, and the doctor actually gave you the diagnosis PAT, it's not necessary to do a Holter test, but you should still see a cardiologist, and more important, bring your EKG prints that verify the tachycardia.
So here is what you should do:
If the tachycardia is registred on EKG: Bring the EKG prints to your cardiologist.
If not: When you have a tachycardia event, get to the ER (or your doctors office) as quick as you can. Not because it's dangerous, but you need to verify what it is and isn't. A 12 channel EKG is way better than a Holter print. If you are affected by the tachycardia, don't drive or walk, get someone to drive you there or call 911. If this isn't possible, ask your cardiologist for a Holter (if you have the events daily) or an event monitor.