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Old 10-17-2006, 03:02 PM   #1
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question for mnmnmnmnmn

Hi there, I was wanting to know, you mentioned in a previous post to me that you have exercise induced svt. My question is, did that show up on a treadmill test? I am curious what happens if it shows up, do they then shut the test off, or continue you until you reach your maximum heart rate? I know my Dr. wants me to do the treadmill test to see if it really is svt, and I'm nervous, because, here comes my anxiety issues, when I start to exercise, my heart rate goes up, when I feel my heart rate go up high enough, it starts skipping really bad, and then I have severe anxiety, which keeps the heart racing, and it takes me a while to calm down and get the heart rate down again. So, with that in mind, I am hesitant on the test, and what if it does show svt on the test, is that bad? Thank you again for talking to me, Michelle

 
Old 10-17-2006, 09:01 PM   #2
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Re: question for mnmnmnmnmn

Michele....not a problem hun, it actually helps to deal with this by talking about it. So post questions to me, i dont mind at all. When i had my treadmill test, which was the very first test i did after the holter, I was very pleased with it. It documented EVERYTHING to a tee. When you go to the treadmill they hook you up and see what you intial heart rate is. That will determine what your "goal" heart rate is. They then start the test by you walking at a slow pace, taking your vitals signs often. They then slowly increase the speed and slope, holding it for like 2-5 minutes and then increase again. The test is stopped as soon as you say to stop. So if you get anxious, short of breath, if you heart rate is too fast, etc. However know this, your maximum heart rate will likely be in the high 100's like 170 or 180. Because usually this is not SVT, this is normal to an extent for you heart to go that fast, that is what you do to get a "cardio workout" as they call it. But they will stop the test if you have SVT. So if you heart rate suddenly shoots up then they will stop it. And like i said even if you heart rate is only like 150 and you arent at your maximum heart rate but you are too anxious all you have to do is say so and they will stop. This was an awesome test for me because it documented what my heart does when i exercise and for me how it doesnt come down when i stopped. And they do have the proper people there to deal with emergencies so feel comfortable knowing that. YOU arent going to die, lol (lot of laughs). Maybe this test will show that you dont have SVT, that you just get a fast heart rate, which will help with your anxiety i am sure. Or maybe it will show that you have SVT and they can get you on a beta blocker to help out. But I definately recommend that you do this before you start ANY heart medications. If you do have SVT then all it means is you need to have a medication like Atenolol, a lot of ppl are on it for that same reason, even if it isnt SVT just fast, that is a pretty benign drug. If i were you I would recommend you do the test, you will be in control of the test so just stop if you dont feel good. Its just like walking on a treadmill with a bunch of wires hooked to ya. You'll be fine. Keep posting here, i will check back on ya.

 
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Old 10-18-2006, 08:35 AM   #3
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Re: question for mnmnmnmnmn

Hello, do you know if SVT and ST can be misdiagnosed on an EKG? I just don't know why they said it was if it wasn't. From what I've read abot SVT, it is a very fast abnormal rhythm, and st is a very fast rhythm, I don't read anywhere where it just jumps way high and then just all of sudden drops low when you go out of it. Am I confused? I really hate this waiting, I just want the Cardio to look at the strips again and give me another answer. Michelle

 
Old 10-18-2006, 09:24 AM   #4
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Re: question for mnmnmnmnmn

Svt is an abnormal heart rhythm. It can occur due to limited oxy flow to the heart muscle, electrolyte imbalance, high level of medication, a problem with electric conduction (usually associated with electrolytes), etc.

ST is electric trace on the graph of the EKG. It may be significant depending on the lead output (6 or 12 leads). All tests should/are viewed in a clinical setting. For instance a blood test would/could reveal electrolyte imbalance. A bundle branch (channels for electric current) block or short circuit could be the problem. CAD could cause SVT, etc.

Do you have any more information on the ST reading?

 
Old 10-18-2006, 09:41 AM   #5
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Re: question for mnmnmnmnmn

Hello, thanks for your reply. I'll tell you my history. By the way, thank you for talking with me, my regular Dr. is out so I can't call her to talk to her about it. I have had pac's and pvc's for 6 years now. I had 2 previous holters that showed them, with otherwise normal holter. In 2003 I had an echo, it showed EJ fraction of 69% (whatever that means), a trace of TR and MR identified. And mild mitral valve prolapse. They said I was ok. This last year, I have been very stressed out (I have an anxiety disorder) due to some serious things in my life. I know when I have anxiety, my pac's and pvc's get worse, so then I naturally obsess about them. Anyways, this last year I started getting anxiety attacks, and it makes my pulse race fast, like 160. When I get my pulse up that high, it starts skipping really bad, which scares me more, and it takes me awhile to calm it down. I mentioned this to my Dr., who is trying me on Xanax for the anxiety, but becuase of the skips, she ran another holter. This is what it said. "2 brief episodes of SVT rate 154, exercise induced? Otherwise normal 24hr holter study." Under the Supraventricular Events, it reads "Total Beats 236, Couplets 56,
SVTach Runs 6, Longest 6 beats at 23:19:30, Max Rate 178 BPM at 16:16:09,
Max SVE/Minute 10 Beats at 22:43:, Max SVE/Hour 10.5, SVE/1000 2.2" Under the Rate Dependent Events it states "Heart Rates: Min 52BPM, Max 154BPM, Avg 81bpm." I apologize if that was more than what you wanted to know. I just don't k ow how to interpret it, and my Dr. just called me last week with the news, and that I need to see an Electrophisiologist and would call me back and now she is out of town. I'm frustrated and scared. Michelle

 
Old 10-18-2006, 01:35 PM   #6
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Re: question for mnmnmnmnmn

Maybe I wasn't clear in my previous post with the answer to the question in part, "can SVT and ST be misdiagnosed on the EKG and why they said it was when it wasn't." I attempted to illustrate situations where the EKG result is not a heart problem.

"They" are saying SVT and ST indicate by EKG results something that requires support by other clinical findings before there can be a decisive opinion whether or not there is a medical and treatable problem. They are saying it cannot be supported with other findings at the time they made the statement to you.

It appears your heart is functioning properly and no enlargement of chambers (noted by EKG, an enlarged heart could cause arrhythmia). Only slight regurgitation of valves and that is not a problem.

Your anxiety has to controlled before there can be any decisive dx. You understand that anxiety can cause the arrhythmatic problems, and that could mask another underlying problem. It doesn't appear your heart has sustained any harmful effects (emotions can) at the present time.

The electrophysiologist should be able to explain the EKG finding and why there may or may not be any reliance on the result.

 
Old 10-18-2006, 05:57 PM   #7
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Re: question for mnmnmnmnmn

Thank you for your response. So, from what I read from you, and forgive me if I sound stupid, but, can severe anxiety cause the holter to look like SVT, and it really not be, or can anxiety cause actual SVT? I must have confused you on my earlier post, it never said anything on my hotler about ST activity, only the SVT, the two brief episodes. I agree that my anxiety needs to be controlled, I am driving myself crazy, but I am trying. I am taking Xanax right now, but so far hasn't gotten any control on it yet. Thank you, Michelle

 
Old 10-18-2006, 07:18 PM   #8
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Re: question for mnmnmnmnmn

michele.....kenkeith is confused about what you and I are talking about so just skip that stuff. I think for you sake of mind Michele that you need to see an electrophysiologist but you arent going to let this rest until you do. But hunny, everything is fiiiiiineeeeeeeeeeee. Anxiety can cause your heart to race. So likely when you exercise you now get yourself anxious about it and that in itself can cause SVT or ST (sinus tachycardia). Only having 6 beats of SVT, which is what that EKG reading said, is extremely mild. That is absolutely nothing to worry about. But I know that you will need a physician in order for you to feel comfortable with that, I understand that. BUT, michele you have to quit worrying about this until you do. I can almost guarantee you that you will have to wait at least a month in order to see this specialist. You need to somehow find confidence in a physician that you can trust, and that may be the EP doctor. But until then, you HAVE to quit worrying about this. If you do have problems then just go to the ER. You arent going to die. All you are going to do is get yourself more upset about this and cause more problems. Everything that you posted other than the SVT is very good cardiac results. I would do anything to trade hearts with you !!!! You had 6 beats of SVT, i have more than 5 hours of SVT a day and I am still alive and kicking hun, so trust me you are going to be fine. QUIT WORRYING. Go do your treadmill and make your appointment to see the EP for your sake of mind and to thoroughly get your heart checked out by someone who specializes in this. Trust what he/she says, they deal with this day in and day out. Your doing just fine Michele, hang in there!!! P.S. yes SVT and ST can be misdiagnosed by many physicians, as well as the machine that interprets them, that is why they have specialist like EP doctors to differentiate between the two.

Last edited by mnmnmnmn; 10-18-2006 at 07:20 PM.

 
Old 10-19-2006, 09:00 AM   #9
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Re: question for mnmnmnmnmn

I'm not confused at all. I answered the question directly. "How can there be a positive reading on the EKG and then call it a misdiagnosis"? If you don't understand then that is your problem but don't be rude.

On this board (from my observation) conduct ourselves with proper decorm, and don't accuse someone of not knowing what they are talking about and confused.

Last edited by started04; 10-19-2006 at 09:15 AM.

 
Old 10-19-2006, 09:46 AM   #10
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Re: question for mnmnmnmnmn

I'm sorry if I got both of you upset. I am just trying to work through my fear over this, and I just was asking if anxiety could actually cause the SVT, and/or if whoever interpreted the SVT could be wrong. I didn't know if SVT and ST look the same on an EKG strip or not. Again, sorry to get you upset. I very much appreciate both your responses.

 
Old 10-20-2006, 09:04 AM   #11
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Re: question for mnmnmnmnmn

mnmnmnmn - Hello, I still haven't heard back from my Dr., left a message yesterday but no return call. If I don't hear back from her by this afternoon, I will just make my own appointment. I am hoping they look at the results, and say, "so what, this is a normal result". haha. Xanax is slowly helping, but I know with my anxiety it will take some long term therapy for me.
I have read some of your other postings and was just curious about your history. Your pretty young, (I'm 35) and yet your pretty knowledgable about this. I know you said you had tried an ablation. What led up to doing it? Was it every single day in the 200's? I've been trying to think these last few days and write down things that I remember what my heart does. See, for the last 6 years, I've been obsessed over the pac's and pvc's, so never really paid much attention to the heart rate. I wrote down every time I can remember my hr going into the high 100's or even 200, and it was all during a panicky time. I never have it while just sitting or relaxed. An anxious event brings it on. The only other times was when it was really hot outside and if I'm walking in the heat it brings my hr high, sometimes exertion, like lifting something heavy, and of course hard exercise, but I can tell you I have not even tried to do a heavy walk for 3 years because I'm scared it will bring the skips on. So I am out of shape, even though I am perfect weight. I guess that is one reason I am nervous for the stress test. I'm afraid I will fail it, since I'm so out of shape, and then my anxiety attack comes on when I feel my hr rise, and it makes me hyperventilate, and then they will misinterpret all that as I am having SVT or something else wrong.
So, when I'm having an anxiety attack, my heart rate goes in the high 100's or 200, I wonder, can that still be regular sinus tach? I'm just babbling, sorry. I only have this place to come talk. My friend here who is the heart nurse has me so scared, the one telling me to get the EP study done. I guess that is what started the whole process of me worrrying, then when I get on here and read what everyone else has written I wonder why she is going overboard. She told me the reason for the EP study is because that is the only way to tell what "kind" of svt it is. She said you have to know what kind of SVT it is before they will tell you what to do for it. So, that is what got me going. Anyways, loved to hear back from you. It makes me feel better, thanks! Michelle

 
Old 10-20-2006, 09:39 AM   #12
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Re: question for mnmnmnmnmn

A different perspective with holistic approach. We know anxiety is almost always due to a chemical imbalance in the brain and an over/under activity of electric impulses in a particular area of the brain . Treatment usually is an attempt to adjust the chemical imbalance and the imbalance is almost always due to stress. Pyschologists and psychiatrists may have a different view on treatment (modification of behavior vs medication and adjusting behavior) But there is agreement the underlying cause is stress and the ability to cope with adverse situations.

Stress also has effects physiologically on the human anatomy. It can cause arrythmia, high blood pressure, digestive problems, headaches, etc. as does anxiety. There is no convincing evidence anxiety causes heart problems, but individual traits in handling stress can cause heart problems and anxiety.

 
Old 10-22-2006, 01:27 PM   #13
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Re: question for mnmnmnmnmn

Wow well i guess first of all i should clarify what misunderstanding that kenkeith had so as to maybe calm down his misinterpretation. Kenkeith i was referring to you being confused about the statement you made about SVT and ST. The answer you gave about how the ST is an electic trace on graph. I took that as you were describing the ST segment, and since we were talking about ST (sinus tachycardia) that is why i said you were confused. So I apologize if I misunderstood what you put. I cant help the fact that you took that personally, but i meant nothing of that, so please dont be so rude, it was just a misunderstanding, and i meant nothing bad of you.

Michele, no hun you didnt upset me at all. I am quite knowledgable about a lot of heart issues but because of the site rules i can not post why But i am sure if you think about it you could figure it out. I understand why your friend wants you to have an ep study. It technically is the only way to differentiate between certain arrhythmias like sinus tachycardia/atria tachycardia/svt. However it is possible for your physician to get a better idea of what it is based on how you react to some medications. Usually they will have you try some medication first and see if that calms your fast heart rate down before putting you through an EP study. However I am sure that there are some physicians out there that would rather just do an EP study first. It just depends on how the doctor likes to diagnose it. For me, yes i had a lot of tachycardia every day. I first tried several different types of drugs (of course i did do tests like holters, treadmill, tilt table, etc in the mean time) before i had my EP test. By trying these drugs my physician was able to rule out certain things like just sinus tachycardia because i didnt respond to a couple drugs and then did respond to other drugs. We left the EP study as a last resort if drugs did not control my arrhythmias. But then once i had it we were able to know what the problem was and specifically what drugs might help and which wouldnt. I still think that as opposed to putting your heart at risk in doing a procedure like an EP study, you should first try to work on controlling your anxiety, especially since you have documented that it happens around an anxious time. You might be able to add a cardiac drug to help slow your heart rate down while you work through your anxiety. But definetly follow up with your heart doctor. As Kenkeith said, anxiety can produce many symptoms of other problems, so you have to be sure that before you get diagnosed with something else, that it is not just the anxiety that is producing it. Be sure to explain to your physician how much anxiety that you have and the events you have documented. Documenting the events you have is a very good idea, keep up with that. Hang in there hun, remember thankfully you wont die from this, might stress yourself out, but wont die. Keep me posted hun.

 
Old 10-22-2006, 02:43 PM   #14
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Re: question for mnmnmnmnmn

Hello, I have been taking my Xanax every day now for a week, and boy am I tired!! Hard to want to do anything, and I'm on the lowest dose, in fact, lower than the lowest dose. It doesn't take much for my body to react to meds. Anyways, my Dr. called me Friday and said she talked to either a Cardiologist or Internal Dr., and they said my holter results weren't that big of a deal, not that abnormal, and what she should do first before sending me on over to a Cardiologist is to try possibly some low dose cardiac drugs, probably like what you were talking about, and seeing which ones I react to. And also in the meantime do some blood work. And work on the anxiety. I called a long time friend of my parents, He was my previous Dr, but he knows my history and works with a Cardiologist. He told me that my svt is no big deal, and I told him about how it normally comes when I have an anxiety attack, and hr goes up to about 200. He did say that was pretty high, but since I get it down myself, it's still ok. I'm not obsessing over it much anymore, due to the Xanax and the reassurance of everyone. I am monitoring my pulse though during the day time, just for a reference as I try to sort this all out. Can you answer a few questions maybe - I posted earlier about what a normal heart rate is supposed to be during the day, when your not resting, but up moving around. Mine can go anywhere from 85 to 135. Like doing housework, or laundry,etc. And when I took a shower today, when I get hot, (and this also is anytime, when I get hot) my pulse always spikes, it was 140, then went to 135 then to 130 and then stayed that way for about 45 minutes I think. If I bend over in the shower or sit down, it will go down, but if I stand back up it goes right back up there. Soon as I sit down it drops to about 80-90. When I've monitored it, and noticed it's 130, I can't even tell, no symptoms. I am really just trying to understand it all, as this is all new to me. I've always hated the pvc's and pac's, which scare me bad, but the fast heart thing I've never thought about until this last month.
Thanks again for all your input, it means a lot to me. One other question, since my hr can get down to 58 -60 during sleeping, I am a little nervous about a bb bringing that down more. I mean, since it is a drug to slow your heart rate, right? Thank you again, so much! Michelle

 
Old 10-22-2006, 07:07 PM   #15
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Re: question for mnmnmnmnmn

Michele, well its sounds like you are headed in the right direction. At least you have made some progress. The one thing that i recommend, is to get set up with a cardiologist. Just demand to see one. I think that anyone that is starting a heart medication for anything related to the heart that they should be seen by a cardiologist. That is why there are specialists. And maybe a heart doctor would have a recommendation for a medication that would work well with your anxiety problems. To answer your questions about the normal heart rate... its a tough question. Normal heart rate is 60-100. But obviously when you exercise or exert yourself you heart rate will go up as its suppose to. It varies upon your age as well, and i cant remember how old you are. Also if you are in good shape, like some athletes have heart rates as slow as 40's. A very very rough estimate of what your maximum heart rate could be is to take your 220 minus your age. That is a VERY rough estimate of what your maximum heart rate would be if you were doing something like cardio fitness program. When i did my treadmill they determined my heart rate to be 80% would have been 180. So if you are working around the house, that is a form of light fitness so yes you heart rate could be above 100. It all depends on what you are doing, how in shape you are (or out of shape you are), and what you baseline heart rate is. As we say in the medical field, a concerning heart rate is one that is not tolerated, whether its too high or too low. And your concern about about your heart rate at night and the affects a heart drug might have on it, is a valid concern. Likely your body will compensate because your body dictates what your heart rate needs to be when you are asleep, and if it doesnt tolerate a lower rate it will either raise it, or it will let your know!!! That is why i think it is important to just touch base with a cardiologist. Keep with the xanax, hopefully your body will get used to it. Have you considered some counseling to help with anxiety?? I mean like something regular like at least once a week or so to help get some strategies for dealing with things like your heart??

 
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