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Short Of Breath, Lightheadedness, Chest And Back Pain. Have SVT And Bigeminy. How Long To Wait?
I am a 19 yr old male with congenitally corrected transposition and a hx of 3 ablations for WPW and atrial flutter. Now I have had episodes of ventricular bigeminy lasting over and hour with intermittent SVT which they are guessing is avnrt. When I have the bigeminy and SVT I get short of breath, lightheaded and get back and/or chest pains. No one will give me a clear answer when I need to go to ER versus just riding out the symptoms. How long can I wait them out before it becomes dangerous? My last visit to the ER I was switching between bigeminy and possible SVT. The doctors could not agree whether it was VT as the monitor said or SVT. My heart rate would jump to around 220. After an hour I was given amiodorone bolus and then adenosine X2 doses.
Tue, 13 Aug 2013
Dear patient,
Given the duration of the tachycardia, it is unlikely to be VT and most likely SVT; if you do not have a functional accesory pathway, SVT is usually not life threatening but can give you symptoms. If symptoms are limiting, you should for sure go to the ED. There are medications that you can be prophylactically to prevent SVT, but the best bet for you as a young individual is to undergo an EP mapping study and see if the focus can be ablated.
Yours truly,
Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Given the duration of the tachycardia, it is unlikely to be VT and most likely SVT; if you do not have a functional accesory pathway, SVT is usually not life threatening but can give you symptoms. If symptoms are limiting, you should for sure go to the ED. There are medications that you can be prophylactically to prevent SVT, but the best bet for you as a young individual is to undergo an EP mapping study and see if the focus can be ablated.
Yours truly,
Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
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