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Had a case of sudden heart rate, EKG was fine, had panic attacks. What should I do?

Dear doctor Perry, I am 29 years old lady, I am married and having a 2 years old child, I had a case of sudden increase in heart rate during night (actually I wake up in the middle of my sleep and have a racing heart beats) . This was 4 years ago... I went to a cardiologist in my country and he said probably I have SVT but my ECG was OK! So he told me he will bring me a psychiatrist to check me too. In the end my case was diagnosed as panic attacks! I took cipralex for 3-4 months as well as xanax . When I was pregnant in my 7th month, panic attacks came back again ! And are still coming every now and then without a specific reason! And they always come while I wake up in the middle of the night. Latelty I noticed that I have skipped heart beats , and they are everyday not just occasionaly.. Please tell me what is this? Can I have a heart disease that was mistaken for panic attacks!!
Asked On : Thu, 17 Jan 2013
Answers:  1 Views:  22
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

It is possible that BOTH may be there!
Routine ECG may not detect SVT – unless done during the episode.

     If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (HOLTER) is necessary to analyse and plan for further management,

     ECHOcardiogram is useful to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).

      TMT (Treadmill exercise ECG) is done to exclude Ischemia (reduced blood flow).

     LABORATORY work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation.

     If there are no clues and if the problem is still bothering to the extent of interfering with life style, Electro Physiological Studies (EPS) can be carried out. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
The treating doctor may suggest them depending on need, based on his assessment of the situation.

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Fri, 18 Jan 2013
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