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What Causes Supraventricular Tachycardia?

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Posted on Mon, 3 Nov 2014
Question: Started with diarrhea about 2 months ago. This began after a stressful time for me. My son had a serious surgery. I had an SVT the night before my son's surgery and had to go to the ER. However, prior to my son's surgery, my diet had been high in fat; red meat, sauces, ice cream, fried foods for about 3 months. Since, I have continued to have bouts of diarrhea with formed stools at times, usually having to use Imodium to stop serious episodes. Now, after I eat, I get cold. My body aches in the mid part of my back and near my ribs, especially after eating and I have upper belly discomfort. As my food digest , I hear it rumbling and sometimes it feels as though my stomach is raw inside and my colon too. I have gone into an SVT just from too much pressure applied to my stomach; such as a tight waistband or bending over. Standing in one position for too long causes me to have an increased heart rate. My medical problems got worse 3 years ago after a car accident where I was rear ended,I suffered a whiplash and a right arm rotator cuff tare. I have been under extreme emotional stress since we endured a lightning strike and fire in our home since 2009. I have had a lot of anxiety because of medication changes. First I was put on Verapamil, then Diltiazem, then Metoprolol ER. I have high cholesterol and needed a statin, so was put on Crestor. So, when this episode of diarrhea came on , I was on metoprolol er, crestor, gabapentin, amitriptalene for TMJ, and Ativan as needed for SVT anxiety and also, I have been on BIO-Identical hormones for approx. 2 1/2 months. The hormones are a combination of testosterone, biest, dhea, and progesterone. Prior to the Bio Identical hormones, I had been on an estrogen patch of Minivelle 0.0375 mg/day The immediate changes that were made prior to this gastro problem were; Crestor was added 5mg - 3 times a week, however I felt drained on the medication but tried to work through it. Then I had been on Gabapentin 600mg for about 2 months. And lastly the bio identical hormones , as well as the medication that I had been on before: Amitriptyline 10 mg, Ativan 0.25 as needed. I have either a low to normal blood pressure with an elevated heart rate, upwards of 139, or an average heart blood pressure with a heart rate 77-98. I am scheduled for an endoscopy and colonoscopy in a week and am scared that I am going to have an SVT. In the meantime I was told to try Prilosec daily for acid reflux and was on day 2 when diarrhea got worse. I have had a CT of my stomach ; no blockage. I have had an ultra sound of my liver, pancreas, and gallbladder- all normal. All my blood work has come back normal. I am very sensitive to medications and a small amount is usually acceptable. High mgs. throw me into major side effects. I have been given Lexapro which raised my blood pressure, so I had to discontinue, Clonapam - .25 mgs caused me to be out of it for 6 hours. I have been on a Z-pack twice in this last year for what we thought to be sinusitis and it taxed my system. I was diagnosed with the SVT approx. 3 years ago, but the onset of it was approx. 4 years ago after the fire in our home and after I was given a shot of Lydocaine for a dental procedure. My blood pressure issues started at this time too. I have been told by multiple doctors that my stress and anxiety is bad, which I am aware of. Besides enduring a fire, 3 move outs from our home because the insurance company did not fix our home correctly, I have also had my son go through 8 surgeries because of baseball injuries; he is 21 and my daughter went through 3 surgeries- severe endometriosis; she is now only 24. My brother had a massage heart , however died in hospice during these last 5 years. My mother went through corroded artery surgery. I am only adding this just so you know that I am not crazy; I have been through a lot in a short amount of time. My anxiety is high because I am unable to live my life. I either have severe diarrhea , belly bloat, aches, back pain, muscle spasm, electrolyte issues, and SVT's. Do you have any idea as to what this could be? And what might help me?
doctor
Answered by Dr. Divakara (2 hours later)
Brief Answer:
SVT needs more evaluation.

Detailed Answer:
Hi

Thanks for choosing HCM for posting your query

Myself Dr.Divakara, will try my best to give you the most appropriate advice.

You have multiple problems but most important and most bothering among them are your SVT and Abdominal problems.

Coming to your SVT I need to know what evaluation for the cause of SVT has been done by your doctors. I know that too much anxiety can induce attacks of SVT but still evaluation has to be done to find out if any other causes of SVT are there or not.
If I was your doctor I would have done these test to know into the causes of SVT.
Treadmill test, 2D Echo , Serum TSH, Serum Calcium, 24 hour urinary Metanephrines.

Kindly get the above mentioned tests and revert back with reports.

Coming to your abdominal problems it is either due to Indigestion problems or due to some malabsorption disorder. This problem of yours could be connected to the problems causing SVT , for example problems in Thyroid or Adrenal glands can cause both SVT and abdominal problems
You said your blood works came normal but i need to know what exactly were the tests done.
Kindly undergo the Endoscopy and Colonoscopy as scheduled and ask your doctor to do some biopsy and also ask them to test for CELIAC disease too.

I know you are going through lot of stress but stress will do more harm to you than any help. Apart from using medicines I advise you to start doing meditation which will help you a lot in beating the stress.

Kindly revert back with the reports of the test asked.

Any clarification feel free to ask.
Always a pleasure to answer .

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Divakara (4 days later)
Thyroid serum normal, calcium serum normal, however I have dehydrated 2 more times and have had to go to the hospital for fluids due to diarrhea. I am currently working on the adrenal gland urine test and have a colonoscopy and endoscopy scheduled.Any other ideas? I thank you for your input and suggested test. I am following-up with the doctors. I have had to come off of the Bio-identical hormones due t the progesterone diuretic properties and have been put back on the metoprolol succinate starting at 12.5 mgs. one in the am, and 1 in the pm, may have to increase due to blood pressure changes.
doctor
Answered by Dr. Divakara (12 minutes later)
Brief Answer:
Metaprolol is a good choice

Detailed Answer:
Hi

Thanks for the follow up.

I think putting Metoprolol is a good idea. It will control or reduce the frequency of your SVT.

Apart from tests advised previously one additional test is Electrophysiological study of heart. This is an invasive test and we shall consider this if all your tests come normal.

Kindly get back to me once you get the reports of Metanephrines and colonoscopy. Will be looking forward for your reply.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Divakara (25 hours later)
Thank you for replying. You have been a great help. I have another question. Why would I be having diarrhea, then dehydrate, going into SVT or irregular rhythms ? This seems to be the cycle that I am on. Could any of this be due to hormones? Also, my calf's hurt less when I am moving around, but when I sit down or lye down they begin to acke? Do you have any food recommendations? Could the combination of drugs that I was put on have caused this gastro-intestinal issue?
doctor
Answered by Dr. Divakara (11 hours later)
Brief Answer:
SVT due to diarrhoea is due to electrolyte imbalan

Detailed Answer:
Your Diarrhea could be due to either Indigestion, Viral Infections or your Bio Identical Hormones.
Once you get diarrhea there will be electrolyte Imbalance especially in your Blood Potassium and any abnormalities in Potassium levels in blood can trigger SVT. Also if diarrhea is excessive that will put stress on body and any kind of stress can trigger SVT .

Your calf pain could be due to Dehydration , Low Potassium or due to Vitamin D deficiency . I advise you to drink more water , eat potassium rich food like Banana , Tender coconut water and eat Vitamin D rich food like Milk , Curds , Egg white , Custard Apple . Fish

Also It’s better if you could get Serum Vitamin D3 levels tested as if its low you may require Vitamin D supplements.

Hope you find this information useful .
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Divakara

Internal Medicine Specialist

Practicing since :2006

Answered : 2358 Questions

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What Causes Supraventricular Tachycardia?

Brief Answer: SVT needs more evaluation. Detailed Answer: Hi Thanks for choosing HCM for posting your query Myself Dr.Divakara, will try my best to give you the most appropriate advice. You have multiple problems but most important and most bothering among them are your SVT and Abdominal problems. Coming to your SVT I need to know what evaluation for the cause of SVT has been done by your doctors. I know that too much anxiety can induce attacks of SVT but still evaluation has to be done to find out if any other causes of SVT are there or not. If I was your doctor I would have done these test to know into the causes of SVT. Treadmill test, 2D Echo , Serum TSH, Serum Calcium, 24 hour urinary Metanephrines. Kindly get the above mentioned tests and revert back with reports. Coming to your abdominal problems it is either due to Indigestion problems or due to some malabsorption disorder. This problem of yours could be connected to the problems causing SVT , for example problems in Thyroid or Adrenal glands can cause both SVT and abdominal problems You said your blood works came normal but i need to know what exactly were the tests done. Kindly undergo the Endoscopy and Colonoscopy as scheduled and ask your doctor to do some biopsy and also ask them to test for CELIAC disease too. I know you are going through lot of stress but stress will do more harm to you than any help. Apart from using medicines I advise you to start doing meditation which will help you a lot in beating the stress. Kindly revert back with the reports of the test asked. Any clarification feel free to ask. Always a pleasure to answer . Regards.