Heart & Cardiology/RBBB and SVT

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Question
Hello,

I've had issues with tachycardia and SVT for the last five years. It came on during my first pregnancy. It has gone through stages of being absent and also occurring numerous times a day. My main problem now is just tachycardia, especially when exercising and breathlessness. Sometimes I get skipped beats and ectopics when resting or bending over. I had an ECG two months ago as I started feeling worse with chest pain. ECG was normal and so was bloods. The pain appeared to be an injury. Now in the last three weeks I've had terrible indigestion, pain in chest and back. I had an ecg last week which showed a new Right Bundle Branch Block. I've never had this and was surprised by the findings. The dr said it's probably benign but I am worried.  It made me feel anxious to think that my heart is not working properly. Especially with svt problems too.
Is it possible for someone like me, who is 29 and eats a very healthy diet, is slim, could have possible heart attack or heart disease? My grandfathers had heart disease and one had a pace maker later in life due to a valve problem he was born with. My cousin also has WPS. Could I have WPS that's gone undetected? Can an SVT and RBBB occur simultaneously? Will I have a greater susceptibility to electrical problems in the heart like v-tach and v-fib? Is a new RBBB a cause for concern when it wasn't there the other month?  Thanks, Melanie

Answer
Hi, you can read basics about heart disease at http://blog.myheart.net

Most SVT's and skipped beats are benign, and as a cardiologist the usual approach is to rule out the serious things first. It sounds like you have seen a Dr, and had some basic tests and the fact that they considered it benign is reassuring. Although given the tachycardia, right bundle and some of your symptoms i think its best you see a cardiologist. In addition to an EKG, given your change in symptoms and EKG i would probably obtain an echocardiogram in your case to ensure normal heart function and underlying structural heart disease. I don't have the benefit of having taken a full history and physical though.

Given your age of 29 and your reported healthy lifestyle its highly unlikely you would have underlying coronary artery disease and that would be very low on my list of concerns (unless you smoke and are diabetic etc..). In terms of having an SVT alone, i wouldn't worry as that is not likely to progress to Vtach or vfib.

One concerning feature of your history is the presence of the new right bundle, breathlessness, the atypical chest pains, and the presence of a tachycardia. A possible cause for the combination of those symptoms is a blood clot in the lung. I need to stress again, that if i were you i would talk to a physician about all of this as they have the benefit of a full history and physical, and in my opinion that is worth a lot more than diagnosis over the internet which can be inaccurate and anxiety provoking!

In summary, please go discuss these symptoms with a Dr, its reasonable to see a heart doctor and they may consider tests such as an echocardiogram. Ruling out serious causes and underlying problems will remove a lot of your anxiety regarding this.

Hope that was helpful  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

Organizations
http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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