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    Suggest treatment for anxiety and chronic appendicitis

Posted on Mon, 17 Jul 2017 in General Health
Question: Haha :D Weird. I just got a mail "generated" I believe it is not you sending it, but wanted feedback for you. And will give you the best feeback possible of course. Funny it was today, because this last night I was in bed, and all of the sudden my heart took to or three of those weird tumbles, or PVC or whatever they are, it felt like haywire or a lump of jello beeing electricuted :p And immediately it went into fast heart rate for about 160 bpm for a minute or so. Then it was over. Made me feel terrible, and anxious. I am now certain I have SVT. Thing is I never cought this on any R-test or ECG unfortunately, so my cardiologist now says it is anxiety and nothing else. Which i do not belive. Reading others stories of SVT, it matches to the point. Any advices for me sir?
Is it dangerous? Who shopuld I see? A electrophysician or what. I am getting depressed by all this:
Heart- and those troubles.
Stomach: Chronic appendicitus
Throat: Silent reflux and thereby choking sensation/Asthma symptoms.m
Lovely, huh? Going silently mad :(
Answered by Dr. Ilir Sharka 8 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:

Welcome back on HCM!

It is true that I didn't send any email to you. It may be from HCM system, because they always ask you to rate the answer of the doctor in order to have an objective feedback for other patients, who want to choose a cardiologist to ask their question.

Anyway I carefully passed through your question and would explain that it is very likely that the episode of haywire feeling and palpitations could be related to a sleep disorder (nightmare) and anxiety.

Gastro-esophageal reflux could also trigger this symptomatology.

But, it is important to investigate further for the nature of these episode, especially if they repeat frequently, in order to exclude a possible cardiac arrhythmia.

Can you please upload that ECG which showed Mobitz II block? I would be able to give a more professional opinion.

I would recommend consulting with a cardiologist or an electrophysiologist and performing a prolonged 7 days ECG monitoring (Holter) in order to be able to detect and register any of these episodes and examine your heart rhythm trend and also the changes in the ECG.

If this test does not help, another option would be implanting a loop monitoring. This is a small device, which you can command and switch on every time that you feel those feelings or palpitations. It does not register all the time (like the Holter), but it registers your heart rate only during those episodes when you switch the device on. Then the heart rhythm and readings are examined by your doctor at the hospital. You can consult with your doctor after each episode.

You can not implant any device as long as there is no conclusion on the type of cardiac arrhythmia.

Hope you will find this answer helpful!

If you have any other questions, please don't hesitate to ask me again!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 4 hours later
Hi yes i Know. It is probably the site sending XXXXXXX No problem at all.
The insident was not sleep related in any way. I was awake in bed. Just layed down to watch a film. Very easy for me to feel heartbeat i am sensitive in that Way so there is no chance of this beeing anything other than heart. It struggled to go back into rythm i remember thinking, for a couple seconds- it just felt like a lump of shaking jello, and the suddenly it did find back to rythm . But then the rythm was 160 bpm. All over in a minute or two. But this happened before. And the shaking heart feeling Sets it off.
Answered by Dr. Ilir Sharka 5 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Yes, your complaints could be indicative of a cardiac arrhythmia.

Anxiety can play an important role in all this clinical scenario, but it is better exclude cardiac arrhythmia first.

For this reason, I would recommend consulting with an electrophysiologist and performing a 7 days Holter monitoring first and then implanting a loop monitoring if the prolonged Holter does not help register those episodes (especially if they occur rarely).

I would like to directly review all your performed test reports ( Holter, echo, ECG, etc.), if you can upload them, for a more professional opinion.

Let me know about everything!

Wishing all the best,

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Ilir Sharka 2 hours later
Okay, I will do that.
But - am I in any danger from these episodes you think?
And yes they are rare. I have had two episodes. One in January, which I was hospitilized for, but when I was there, it had passed.
And the other one now.
I'm sure I've had others, but thought that they were anxiety or something.
As I read other peoples experiences, it just fits so good to SVT. A shaking jello-ish feeling where it doesnt beat in a rythm, like multiple ectopics, and then rapid rate. And then its over.
Had many many holters, and never caught an episode...
Answered by Dr. Ilir Sharka 14 hours later
Brief Answer:
A loop recorder is advisable.

Detailed Answer:
Dear Kaj,

I reviewed your uploaded ECG records, but it doesn't seem clear to be a cardiac conductance disturbance (like Mobitz II, etc.); it seems more likely a routine artifact which is just a recording error.

So, you shouldn't worry too much about!

Anyway, considering your prescribed symptomatology, a cardiac arrhythmia could not be excluded; a SVT may be probable as well.

Coming to this point, you should know that in a structurally normal heat SVT in general is not considered dangerous or life-threatening.

My advice in this regard would go for a discussion with your cardiologist (electrophysiologist) to see the opportunity of implanting a loop recorder (which would be able to record a rare cardiac arrhythmic event like in your case).

Wishing you good health!

Feel free for discussing any further medical issues you may be interested with me.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Ilir Sharka


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