Heart & Cardiology/pvc's and svt

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Hi there...my name is Jill and I am 36 years old.  I have had heart palpitations for almost 18 years.  I had them investigated twice.  I wore a holter monitor once and it showed benign pvc's.  The second time I wore a loop monitor had them evaluated it showed the pvc's again and occasional short runs of svt.  I went to the cardiologist where they did a full workup including a echo and a Bruce Stress echo...everything was normal, also structurally normal heart.   He advised that my cardiac prognosis was very good and not to restrict any activites .  Regarding my palpitation they are quite begnign in nature and I was to reduce caffeine, chocolate and stress which is contributing to my svt.  He said there was no need for a recheck and that if symptoms worsened my family dr could prescribe a small dose of beta blocker.   These tests were done 4 years ago and I haven't given them a second thought until recently.  I have an anxiety disorder too mostly related to health anxiety and I came off my cipralex for anxiety a few months ago and the anxiety came back ...I have restarted the cipralex but my anxiety has been focused on my heart and my palpitations, among other things, depends on the day..  I went to my dr and he prescribed the beta blocker which I have not started taking yet.  So here are my questions

1.  I think what is the svt when I experience it is it starts with a palpitation and then my heart beats fast for maybe 3-5 beats and then it stops on its own.  It is very abrupt in start and stop.  It has never ever lasted for more than a few seconds at most.  I can also stop it by coughing or bearing down.  Is what I am feeling most likely the occasional runs of svt they caught on the loop monitor?  They don't bother me really as they are so brief ( I wouldn't be able to even get a pulse it is over that quickly).  

2.  Can my anxiety contribute to svt and pvc's...I notice I experience them more when I am stressed and anxious.  Is svt common?  

3.  I was prescribed 12.5 mg of metropolol to take if I wanted to...with episodes as brief as these is it recommended or would the side effects outweigh the benefit?  Im wondering if it does make me feel the palpitations less the less anxious I would be about them.  The only way it is impacting my life is the anxiety over it which I am working on and now also back on Cipralex.  Also is it ok to continue normal exercise while on a beta blocker?

4. I did see my dr a few weeks ago and he reassured me again that all the tests came back good and to try the beta blocker.  My tests were 4 years ago and nothing has physically changed only my anxiety....can you suggest a way to cope with this anxiety?  My therapist actually says I need to stop going to be reassured as it is fueling my health anxiety...therefore having everything retested is unncessary as nothing has changed symptom wise only the anxiety about it.


So as you can see I am very aware of my anxiety over this and I do realize that it probably isn't necessary to worry so if you have any suggestions or words of encouragement that might help it would be much appreciated.

Answer
1 - sounds like the SVT. The only to confirm that would be with a monitor at the time of the palpitations

2 - yes and yes

3 - you need to discuss this with your personal physician

4 - you may wish to see a psychologist can help put it into perspective

Good luck!!!

Dr. P

Heart & Cardiology

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Frank J. Pearl, M.D.

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Voluntary Professor of Medicine, University of Miami Miller School of Medicine, Miami, FL. Board certified in cardiovascular disease

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