Question: My wife is 47 y.o. and otherwise healthy. Since a teen she has had tachycardia assocaited with upper torso
movements. This has increased with age esp. the past two years. One episode her heart raced all night (8hrs). Ekg and stress test results all excellent. ER cardiologist said her heart was excellent - suspected she might have some extra "wiring". Follow-up cardiologist suspected sleep apnea, advised to take more salt. Had a visit with an endocrinologist - thyroid levels ok, cortisol somewhat elevated - suggested seeing an electrophysiologist. Did a monitor for 2wks had 16 episodes - results inconclusive. She is having about 6 episodes per day, duration 1.5-2.0 hrs. Triggers are rapid upper torso movements esp. twisting in a downward motion, like getting into bed. Coughing also elicites an episode. Last night she coughed, XXXXXXX reached 215/min. within minutes. She has been doing the " valsalva" to alieviate it, which is only somewhat effective. What tests do you recommend for an accurate diagnosis? This is becomming quite debilitating for her. Any suggestions would be much appreciated. Thank you! XXXXXXX DDS.