Heart & Cardiology/Cardiac concerns

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QUESTION: Hello and thank you for this opportunity to express my concerns...i recently went to e.r. bevause i felt skipped beats..o had no idea what they were. They told me they were benign. O felt a little better but always have bouts of tachycardia. I followed up with cardiologist and he&i    set up echo and stress. He said everything was ok on tests. The night of my stress test i woke up and felt heart racing. I had my polar monitor on and my heart rate accelerated to 175...then came down. Up there for a few seconds.
Then the other day when i went to gym i walked briskly for about 40 minutes..my heart rate was steady at about 125...(i am 45 years old)...as soon as i stepped off treadmill my heart rate accelerated to 175 again...just for a few seconds but very scary...
I went on event recorder for 3 weeks and they found pvcs and sinus tach..i did not have event recorder on when my heart rate accelerated (2 times)
Nervous that it is NSVT...Any comments would be much appreciated..

Thank you very much,
Louis

ANSWER: Hello Louis,

NSVT is VERY unlikely.  It starts and stops abruptly, in one heart beat, rather than gradually speeding up and slowing down like normal sinus tachycardia, which is what you probably have, and which is not a threat.  An unlikely possibility is supraventricular tachycardia.  That stops and starts abruptly and usually beats from 180 to 220 times a minute.  You could wear the event monitor until you have the acceleration of your heart to be sure its exact cause.

Please write back if this note doesn’t answer all your questions.

David Richardson


---------- FOLLOW-UP ----------

QUESTION: Thank you very much for your quick reply...you are a good man!  First, it accelerated from about 130 to 175 in about a 10 second period.(guesstimate):.it never went higher than that and then came down gradually. Second, it happened at the end of my workout at the start of recovery and i read that is not ideal...does sinus tachycardia do this during or after exercise? The heart monitor picked up the acceleration so i am pretty sure it stayed in rhythm. My stress test came back normal. I was never much of an anaerobic guy even playing sports for many years...in your opinion do you think i should be very concerned...can u also explain nsvt a little more..i have been so anxious over all of this the past two months..i have two boys and i want to be around for a while.... i really have no desire to exercise...nervous!
Is there anything else i should be doing?
Thank u!!!!

Answer
NSVT stands for non-sustained ventricular tachycardia, 3 or more pVCs in a row.  Not a threat either, tho if it lasts more than 5 minutes, it's a big nuisance.  What you are describing, gradual onset and offset, is normal sinus tachycardia, which is common during and after exercise.  You need not be concerned at all.  Regular aerobic  exercise, walking, jogging or swimming, will reduce these episodes and is valuable in prevention of narrowing of coronary arteries when you're over 45.  To lessen the chances of coronary artery disease when you're in your 50's, eat a heart-healthy diet that stresses fish, fowl, vegetables and fruits and limits fat from mammals, substituting oils like olive and corn oil.  Of course don't smoke, and watch your blood pressure, blood sugar and blood cholesterol.

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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