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Palpitations, chest pain, done tilt table test, mitral valve regurgitation, PVCs, tachycardia. VTACH?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
Hello and thank you in advance for your advice. Here is my history. For the first 16 years of my life I played baseball and football, I was very athletic. I am 5'7 I weigh 140LBS. my resting pulse is around 65 and I used to be very athletic until about a year and a half ago, so in the summer of 2009 I was working out very heavily, not eating properly, drinking a bunch of caffeine, not sleeping much, and I was frequently around cigarette smoke because at the time both my parents smoked. Slowly I developed symptoms. It started with shortness of breath, fatigue, and a racing heart beat on rare occasion lasting only seconds. Exercise seemed to help, but when I was at rest my symptoms would start up again! My mom took me into the ER where the doctor recommend me to a cardiologist after hearing a murmur. I traveled to my grandparents away from stress and went to a good cardiologist. He assured me I was healthy and had very mild mitral valve reguration with NO prolapse or inflammation. He also saw a few isolated PVCS. He told me to workout as if nothing was wrong. Well over the past year I had to quit sports I have more symptoms so I was sent to an EP and he put me on a 30 day monitor it showed frequent pvcs, and wide complex tachycardia lasting 4beats 6beats 2beats and 8beats. He swears it is not life threatening but isn't it VTACH and isn't that deadly? He is doing a tilt table test and says after this he will give me medication for my rhythm. He says it is to manage my symptoms and get rid of the rythm but that it is not really needed because it is not life threatening only annoying. So my symptoms are

chest pain
weak muscles
weak arms
exercise intolerence
stress intolerence
short runs of tachycardia
heat intolerence
hot shower intolerence

exercise and stress make it so much worse.

So what could this be? is my doctor right that it is not life threatening? Is this VTACH?
Posted Sat, 5 May 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Raja Sekhar Varma 13 hours later

Thank you for your query.

You have provided with very good information, but I would like to know some more things to suggest you better.

1. I would like to see the ECG and if possible the graphs of the 30 days monitor which shows the Arrhythmia. You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that.
2. I would also like to know the full report of the echocardiogram that was done.
3. May I know your age and current medications you are on?

Ventricular tachycardia is of many types. Though many types are life-threatening, there are forms of VT which are relatively benign. It may even be possible to do curative Radio-Frequency Ablation for certain types of VT.

You could also modify your lifestyle, avoid excessive stress, avoid caffeine, avoid late nights, get a good night's restful sleep and do slow breathing exercises, which might help to reduce the frequency of the palpitations.

Drugs like Beta Blockers, Amiodarone, etc can also help, if indicated. A complete cardiac electro-physiological study with VT induction and mapping in the EP (Electrophysiology) lab can be done, if the results of other non-invasive tests indicate it. This would give a complete diagnosis of the Arrhythmia, and in many cases, ad-hoc RFA (Radio Frequency Ablation) can be done.

Kindly get back to me with the reports that I have asked for, so that I can give you a more specific answer on what kind of arrhythmia it is.


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Follow-up: Palpitations, chest pain, done tilt table test, mitral valve regurgitation, PVCs, tachycardia. VTACH? 9 hours later
Thank you so much for replying so quickly, I am 17 years old and on no current medications for any type of problems. My EP cardiologist seems to think that I do not really need any medications but he is willing to try out some in the near future to better manage my rhythm problems. Vtach really scares me and from everything I read it seems like wide-complex tachycardia is vtach, is this correct? Also thank you so much for caring and trying to help me I will try to put a link to my ECG in the next day or two at the latest. My doctor has said nothing about needing an ablation, I feel that I need one and would like to have one done but he has not brought it up at all, what do you think?

I was attempting to get an ECG from my doctors office but was unsuccessful in obtaining this information, I am sorry I did try very hard as I trust your opinion and would love for you to review my ECG, the information they did give me was that I have PVCS somewhat frequently usually only isolated, and that once or twice a week it seems like I have very short runs of Wide-Complex Tachycardia that has not been more then 10 beats at a rate of 150 beats per minute. I want to give you more info so that you can better help me but I couldn't seem to get much more from my doctor, he assures me that it is not life-threatening and that medication is only to relieve my symptoms that it is not required really. What do you think I should do, should I see a different Cardiologist here in town? Would you recommend treatment?(ablation)
Answered by Dr. Raja Sekhar Varma 19 hours later

It appears that you have a benign arrhythmia only - the rate is not fast (150bpm) and it is not sustained (not >10beats, probably lasting <30 seconds). That is probably the reason for a reluctance to do invasive testing and ablation, since the intervention would entail some amount of risk.

All types of ventricular tachycardia (VT) are not necessarily malignant. Especially since you are only 17years old and with a structurally normal heart without the scarring associated with ischemic heart disease, relatively harmless arrhythmias are more common.

Therefore, it is a good idea to consider conservative management with attention to the preventive steps that I had mentioned earlier and if required, some drugs to control the symptoms. You could always go in for a more invasive form of treatment if you remain symptomatic or develop further arrhythmias, especially if you develop giddiness and sustained palpitations. If you are extremely worried (you needn't be), you can take a decision after taking into account the results ofa detailed Electrophysiological study.

I hope this helps.

Dr RS Varma
Above answer was peer-reviewed by
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