I am at a point now where I don't know what to do. For the past 2 years I've had about 5 episodes of a very rapid heartbeat out of no where. On 3 of the 5 occasions I was bending over and stood up and then all of a sudden my heart started racing for about 5 minutes probably around 160 bpm. I went to a cardiologist who did and ecg and and echo and says everything is normal. But that's not good enough. There has to be a reason for my heart racing and I need to know why. Otherwise I feel anxious not knowing. My current cardiologist insists I am fine until the episodes become more frequent and longer in duration. But again this is not good enough. What should I do now?
Maybe anxiety pills- you've gotten good news from a cardiologist and it sounds like your anxiety about it is the biggest problem. If you think he's wrong, you could get a second opinion- maybe ask for a thallium stress test if you want the best non-invasive heart test.
It sounds like SVT - Supraventricular Tachycardia- to me. SVT starts and stops very suddenly, and things like leaning over can trigger it. SVT causes heartrates of 140-250ish. Next time it happens, go to the ER and have them do an EKG. They can diagnose it then, and can give you medication to bring your heartrate back to normal.
Generally when you have SVT, your heart will appear normal on an EKG except during actual episodes of tachycardia.
I don't want to take medicine though. I am 30 and all the cardiologists I've seen have said that because my attacks are so far and few between I don't need meds. My problem is that i want to know what is causing my heart to race out of no where! With a clear ekg and echo the doctors think I'm fine but like you said...SVT usually doesn't show up on an ekg so I need more testing but my docs seem to think I am fine. Do you know what causes SVT? I know there are few things but how to diagnose? And shoudl I be scared when this happens? Any chance of sudden death?
The medication that they give you in the ER isn't something you take daily. They inject it into an IV quickly and it converts your heart back to a normal rhythm within a minute. Your body metabolizes the drug within seconds. The med is called Adenosine, and it's actually a chemical that is naturally produced in our bodies.
No, you don't really have to worry about sudden death except for under certain circumstances, and your doctor would have informed you if you fit one of them (like if you had WPW).
SVT is caused by an abnormal electrical pathway in the heart. Episodes can be triggered by dehydration, too much sugar, electrolyte imbalances, heavy exercise, bending over, stress. Each person has different triggers.
You don't really need more tests if you're just having occasional episodes of SVT. It's not going to threaten your life, and it's not a sign that anything else is wrong with you if you've had a normal echo and an EKG. Why do you feel that what your cardiologist has said isn't good enough? What else do you want them to be looking for?
HI Timber,
Well how do I know I don't have WP? I thought an ekg and an echo won't show that? I want to rule out Wolf Parksinson's that's why I want further tests and a second opinion. I also want to know if the episodes are going to get worse and what my trigger is. Do you have the same symptoms?
Thanks
WPW shows up on your EKG, yep. Your doctor would have told you if you had WPW.
I do have the same symptoms as you. I have SVT that occurs very suddenly. It's a really scary sensation. My episodes aren't frequent, so my cardio gave me the option of treating it or just waiting to see if it gets worse.
Your episodes may or may not get worse. Some people here on this board ended up getting it frequently. On the other hand, I had a 5 year break from it for no particular reason. I wasn't on meds or anything.
Pay close attention to your physiology to try to identify your triggers. Had you eaten a lot of sugar? Not had enough water? Were you overheated? And so on. For me personally, my SVTs don't occur out of the blue. Something triggers them and I have learned to avoid my triggers which means that I rarely go into SVT.
When I do go into fullblown SVT, it will generally last for hours if left alone, so I go to the ER and get a shot of Adenosine. Has someone taught you the Valsalva maneuver? If you feel your heart start to race, hold your breath and bear down. Or, lean forward and cough hard. That'll stop tachycardia for some people.
well I will tell you about my condition, it is just like yours. every sense i was 15 years old there has been times that my heart races fast. it comes on so fast and unexspected. im gonna say it has happened to me at least 20 times sense i was 15 years old and i am now 39 years old. they call it tachycardia. i have had to go to the emergencey room many times for this and they give me something to slow it down. i also have nitro valve prolapse. my doctor says that not to worry but if it happens to many times that it does weaking the heart. i am on inderal for my heart and been taking these sense i was 19 years old. i have had a history of chest pains also. hope this helped.
Sounds to me as if it is IST. Inapropriate Sinus Tachycardia. If it is it will need monitoring on a yearly basis but may be fine for the rest of your life.
Sounds to me as if it is IST. Inapropriate Sinus Tachycardia. If it is it will need monitoring on a yearly basis but may be fine for the rest of your life.
It doesn't sound like IST to me. It starts and stops suddenly, and only happens rarely.
It sounds very similar to something I experienced about 10 years ago. Just out of the blue, I was finishing up painting and my heart started racing and I also got sweaty. It scared me that night - lasted about 1/2 hour. Then a couple weeks later the same thing. After going to the doctor, and getting an EKG to confirm it wasn't a heart issue, they told me it was generalized anxiety. I am someone who internalizes stresses and it builds. Apparently, there was too much going on and I had a disconnect in the brain. I ended up in ER almost 2 times a month for 6 months before getting help ... then I had panic disorder as a result. I would get a 2nd opinion. Check with your family doctor and also track what is going on in your life that might cause you stress. I was put on Buspar for a while which helped with focus.
Good luck!
I would have to say that Timber is right on the money on this. I have these symptoms also and that is what I have been diagnosed with. I am on some medications and I have identified some of my triggers but there are more that I have not. I have had this for about 17 years and my episodes are a lot more frequent than yours. My Doctor and Chardiologist have performed many tests on me and tell me that otherwise I have a healthy heart and should not be too concerned about this.
It is scary at first, I know but you will learn to live with it as I have. I didnt know there was an actual technique with a name but I also controll my episodes by holding my breath and either squatting or somehow putting pressure upwards toward the heart. I have gotten very good at it and my episodes usually only last about 30 seconds on the average. Before I started doing this my episodes would last anywhere from 30 min to a day or 2.
I hope this helps you feel a little better because the anxiety will not help the condition any.
I would have to agree with Timber and Weedwacker. It sounds a lot like SVT. I had SVT for 11 years and was on medication for it that long as well. Find out what your triggers are. Mine were mostly sugar and anything with caffiene in it like pop, chocolate & coffee. Anxiety & stress were also a big factor for me. Try a daily supplement of magnesium and get the book called "The Magnesium Factor" by Mildred S. Seelig and Andrea Rosanoff. Magnesium made a big difference in the number of attacks I had. Although, it did not stop them completely. I finally ended up having an ablation, of which I am glad I did! To find out for sure what you have, go to the emergency room during an attack. You will get an ekg, but, you must be in rapid heart beat for them to be able to tell what it is. Otherwise, everything just looks normal to them. At least, that is the way it is with SVT. Good Luck to you!
I have also been having SVT episodes for about 15 years (I'm 47), but have never been actually diagnosed because I haven't had it "captured" on an EKG. There have been times where I might have had 1 a month for a few months, then nothing for 6 months. A few months ago I was having different heart racing symptoms (not like the SVT's) and had a thorough check up by a cariologist. We did find a birth defect, but it doesn't affect the way my heart operates and does not cause any of the symptoms I was having, including the SVT's. I happen to talk to a co-worker about it and she had been diagnosed with SVT's. Her episodes would last 1-2 hours (yikes!) and she did get it recorded. She told me to take magnesium (which I do), cut back on caffeine (which I pretty much cut out) and I've only had one episode in the past year. Who knows why I had it, but they always scare me and this particular time I was driving and felt very light headed. The bearing down does not help me, usually I try to lie flat on the floor (if I can) and it seems to go back to normal in 5-10 minutes.
Hi autumnmoore, I'm a 24 year old male and might be able to offer some advise through a story... hopefully it will give you some perspective and what to expect from your problem..
I had about 10 random episodes of PSVT or Paroxysmal (paroxysmal means sudden) supraventricular Tachycardia, which is a rapid heartbeat originating from above (super) the ventricles (atria) within about a 4 year period. My PSVT episodes were triggered by either ceasing exercise or interestingly enough, by accidental vagal maneuvers, usually bending over or squatting quickly. btw, Vagal maneuvers are supposed to stop tachycardias!
SVT is caused by extra conductive tissues that exist in your heart. The easiest way to explain your SVT episodes is this: when you bend over, the pressure that is put on your chest creates a conduction in this extra tissue. This can be felt as a single palpitation, or extra (or even lost) heart beat. This odd-ball beat is enough to cause a ricochet effect in your heart. The AV node in your heart is trying to continue to maintain a normal heart beat, but that extra heart beat gets thrown into the mix and creates an entirely separate rhythm in addition to the normal rhythm. So you have basically just doubled your heart rate.
Luckilly, you have options…
Radio Frequency Ablation is a treatment that I recently had for what sounds like the same exact problem you are having. Heres my story about it.. About 4 weeks ago, I triggered an episode of PSVT by bending over to pick up something off the ground. Up until that day, my docs thought I was having episodes of atrial fibrillation, (which are not necessarily dangerous, so they didn’t care much about it). I knew all along that they were wrong and I finally decided that these episodes needed to be documented on an EKG. I also have anxiety problems that are exponentially increased when I have these episodes. So this time I decided it was time to call 911 and get to the ER. The Ambulance showed up in about 4 mins and I told them I was in A-fib (cause thats what the docs had been saying it was all along). So they hooked me up and they were like.. "uhh.. no your not, your in SVT". So whatever.. it was news to me. haha. So they rushed me to the nearest ER.
In all my episodes before, I just waited them out. Vagal maneuvers never worked, but the SVT's just seemed to stop after about 20 mins. This time it wasn’t stopping. I’m guessing that was due to my high level of anxiety. The paramedics finally got an IV in my arm in the field and decided i needed 6cc of adenosine, which is a quick acting chemical that disrupts the AV node's ability to carry an electrical impulse and basically stops your heart, then hopefully it starts again. (there is always a crash cart on stand-by when adenosine is used). The first dose was ineffective. It was the paramedics first time administering adenosine and he wasn't aware that you need to just slam the dose into the IV as hard as possible. I arrived at the ER still in SVT at 260 bpm, they stripped me naked (embarrassing at first, but now i just laugh about it) and the doctor gave me a 12cc adeonsine shot in my IV. She administered it correctly said "this is going to feel weird". You feel the drug make its way to your heart and then BAM! Death knocks at your door and boy does it suck! you feel your heart stop, you get nauseated and writhe and strain, then suddenly your heart starts again in a normal sinus rhythm and you feel just fine.
For whatever reason, I went into PSVT 7 more times that day and was given an adenosine shot each time and it worked. What a day! I was admitted to the ICU so they could figure out what to do. I saw an electrophysiologist the next day and they decided the RF ablation was my best option. Cryo ablation was also an option, but has a higher incidence of failure (I don't know if that is proven, but its what the doc said)
The Ablation Process
After a few days of waiting in the ICU (there were scheduling problems) I went in for the ablation at a different hospital with a catheterization lab. Apparently the ablation can be routed from the femoral artery/vein or through the carotid artery in your neck. Mine was in the femoral (groin). They shaved me (again, embarrassing but funny now that i think about it now) and you get taken into a large room with tons of amazing looking equipment. You lay flat on this very hard metal bed and you are given an initial sedative to calm you down. After the prep work is done, you are given the stronger sedative. Apparently, they are using a brand new anesthesia. It doesn't put you completely out.. you are awake, but so relaxed and out of it you don't even know what's going on. It also has an amnesia component so that if you are aware of any of the procedure, you will be more likely to forget it later. I do not know the name of this anesthetic.
I remember the nurse shooting the drug into my IV and then I was gone. I remember my eyes being open, and hearing people talking, but I didn’t really care about anything.
The electrophysiologist runs the catheters to the proper locations in the heart and begins testing various locations in the heart to create a complete electrical map of your heart. Once done, he chemically or electronically induces the SVT (or whatever tachycardia problem you have) to pinpoint the problem area. (One interesting thing i remember is one of the technicians was working at a terminal that I could see.. the doctor would tell him to increase my heart rate to a specified rate, and he would turn a dial and i would feel my heart increase to exactly that beat. when he was done, he would turn the dial back down and my heart would slow down. very strange!)
Once the problem spot (or spots, i had several) is located, it is ablated and tested again to insure that the SVT or other tachycardia CAN NOT be induced or sustained at that particular point. If the electrophysiologist is unable to induce the problem, the ablation is considered a success. One risk that is always a possibility is ablation of an incorrect, normal, functioning electrical pathway in the heart. If this happens, an implanted pace maker will likely be necessary. Unfortunately, no surgery is foolproof or guaranteed, and this is especially one of them. Be sure to always ask the doctors about the involved risks!
I am able to remember enough of the procedure to tell you that there is not much pain. When they ablate the problem areas in the heart, you can feel it. Its a sort of wierd burning sensation that to me was similar to really bad heartburn or indigestion. The rapid changes in my heart rate during the surgery were also somewhat uncomfortable. I do also remember trying to adjust myself due to being unformfortable and forgetting that i was having surgery. I was promptly scolded for moving.
Once the ablation was done and I was in the recovery room, and when I woke up enough to realize what was going on, the first thing i thought of was how much my back, more than anything hurt. Laying flat on that metal bed KILLED my back. The procedure took about 3 hours (it was originally estimated to take only 1 hour). I was still too out of it to tell someone in the recovery room about how much pain i was in, so i just dealt with it. After about an hour or so, I was taken to my new room. Within an hour or so, I developed some pretty severe aching pain in the entry point (groin). A shot of demerol took care of that (even though i found out at that moment I was allergic to it and went into shock!) I didn't care too much, cause the pain was gone.
I was released the next day around 5 pm. I had moderate pain only when attempting to walk or stand. When i was laying down, I had no pain at all. The doctors said it would be a 2-3 day recovery. Unfortunately, my recovery was more like 2 weeks. I had to walk very slowly and very hunched over for a long time. I think i was an exception to the case though.. I think i have sensitive arteries and veins, as i had problems with hardening and calcification with my IV's in both arms and the pain in my groin/abdomen was exactly the same as my arms.
I am about 95% back to normal now. Although i do notice much more frequent palpitations (possibly PVC's, but im trying to figure that out still). They almost always occur when I go from a standing position to a laying position. They are very strange, and actually rather alarming.. but I think that’s something I'll need to deal with over time. I've come to realize, as I'm sure you have, that cardiac issues can be quite traumatic and frightening. I've heard that the ablation procedure can not stop the extra beats (palpitations) that induce SVT, but it actually eliminates your heart's ability to sustain the SVT. So you get the initial beat, but it cant cause a sustained episode. I think that might be what i'm experiencing and apparently this constitutes a successful RF ablation. I think i just need to re-learn to trust my body and what my heart is trying to do.
To sum up, I would say that if your doctors feel that you would benefit from an ablation, then do it. It is considered to be a minor operation and has a very high rate of success on the first attempt 90-95% with relativly low occurrences of negative side effects. It sounds very scary (and some might feel that it is) but looking back, I think having an ingrown toenail removed a long time ago was more traumatic than an ablation.
Sorry that was so long! I wish you the best of luck!!!!! Let me know how things go.
Re: fast heart beat 
