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Forum Name: Arrhythmias

Question: Are tachycardias deadly?

tiredmom82 - Thu May 24, 2007 1:00 pm

im a 25 year old female with sinus Tachycardia diagnosed with a holter monitor. Last night I woke at 1 am with extreme Nausea, a burning Headache and severe Shortness of breath, I felt as if I was having Tachycardia but couldnt feel my heart beating my pulse was fast so I put my hand over my chest and I could feel the Tachycardia it was beating so fast but also felt like it was not beating at all. I sat on the floor and tried to bear down to relieve it but it wouldnt work I just became very dizzy. I don't understand this at all. I have had a Headache for about 2 weeks and some numbness in the back of my neck to the right its also tingleing. Im a little scared and don't know what to make of this could someone help with this?

John Kenyon, CNA - Fri May 25, 2007 2:19 am

Hello tiredmom82 - What you're describing sounds like classic supraventricular Tachycardia (SVT) although it's impossible to be certain without having seen an EKG rhythm strip taken during an episode such as you describe. However, you say also that you were diagnosed with "sinus tach" via Holter monitor. Sinus tach has a theoretical high end above which the rate almost surely is coming from some other focus than the sinus node, although still supraventricular in origin (above the ventricles). The additional symptoms may or may not be secondary to the extremely Rapid heart rate. Again, it's difficult to tell at a distance, but sudden bouts of Rapid heart rate can cause any number of secondary symptoms including Headache, dizziness, Shortness of breath, etc. The fact that your rate was too fast to count suggests SVT also. I would strongly recommend that, if you haven't already done so, you be seen by a cardiologist (I'm not clear from your post whether or not the Holter monitor was ordered by a cardiologist or a general practictioner). It would be even better if you could be referred to an electrophysiollogist, a cardiologist who specializes in the diagnosis and treatment of Arrhythmias. If this problem occurs occasionally and/or lasts for long periods of time (more than 10-15 minutes) it should be diagnosed and treated, etiher with medication or possibly radio frequency ablation (this latter is a minimally invasive procedure which can, in the majority of such cases, eliminate the problem once and for all). The most common cause of SVT in young, otherwise healthy people is actually a problem in the atrioventricular (AV) node between the upper and lower chambers, when an abnormal nerve pathway allows electrical impulses to multiply and the heart rate to speed up to sometimes remarkable rates. When this happens sometimes the heart beats so fast that it doesn't have time to completely refill after each beat, so that it is difficult to feel a pulse at the wrist at all (readial pulse deficit). This is not a life-threatening problem (if my guess as to the cause is correct) but is certainly a lifestyle-threatening one, which can interrupt normal activiities (including sleep) and create a lot of Anxiety and undue caution in trying to live a normal life. It should be corrected so that you don't have to wonder when it will do it again and curtail activities because of that concern. Again, I strongly urge you to try and get referred to an electrophysiologist, who likley could pick out the site of origin from a resting EKG and might want to perform an EP study. If such a study revealed the exact site of origin of the episodes, it could be ablated right then, via radio frequencies (RF ablation) and the problem solved once and for all. It is certainly worth a look! If the other symptoms continue once this problem has been brought under control, then you would want to look at them separately. I think, though, it is likely they are somehow secondary to the episodes you've been experiencing. Good luck with this and please do let us know what you learn.

tiredmom82 - Fri May 25, 2007 9:52 pm

Thanks for the post I will do exactly that. The holter was ordered though my primary care but read by a cardilologist and that when I started to see one. He then changed practices. I went to the er yesterday my doctors wanted me to go because I woke up at 1 in the morning with sinus tach again and it wouldnt go away I was scared really dizzy and feeling sick it lasted the rest of the night and all day when I went to the er my resting rate was 112 and when sitting it was 128 and when standing it was 140 I had no relieve from it they ran an EKG and xray and labs the eco showed sinus tach and all the rest of the tests are fine. I have a uti and there not sure if this was causing the long lasting symptoms, but the er doc def noticed that posture changes my rate.. so I don't know what that means. I do know that I feel just awful and im having numbness in the back of my neck and forhead don't know what that means either but I see my doctor in one week... which I think stinks. The er doc talked to my doctor so I guess its sinus tach all along. They put me back atenolol but only 15 mg they said that where I am only 95 lbs that I should of never been on such a high dose like I was before. I know that this condition what ever it is, is not stable and I don't know what to do becuase Beta blockers never worked well before anyways. I also know that I get tachy after I eat to which I don't understand. I have broken blood vessels all over my body my hair falls out and I am always cold. On top of that I keep having problems with my bowel swelling up and hospitalizing me. I had Colonoscopy and I showed nothing but the surgeons always want to do exploratory surgery. Over all I am not well but I have to say that this scares me the most. I am trying to keep on top of my health but theres always a new problem to add to the list. My doc trys to blame it on anorexia because I can gain weight and I am to thin but my appitite is so great if I don't eat every 2 hours like clock work im sick, thyroid is fine they rechecked it in er and my Blood sugar is good. don't have crohns or colitits, I did have a positive ana test. But what ever is causing these issues I hope its comes to an end soon. THANKS so much for listening to me im feeling a bit alone with all of this.

John Kenyon, CNA - Sat May 26, 2007 3:49 am

Hello again! Well based on the heart rates you mentioned in this post, this is consistent (barely, though, when standing) with sinus Tachycardia rather than SVT, but it is clearly inappropriate Tachycardia (not justified by the activity going on at the time it happens). This, in itself, is also not life-threatening, but the underlying cause has to be found. While SVT is usually caused by an irritable focus in some part of the mid-to-upper heart, sinus tach usually is caused by either a metabolic problem or some flaw in the autonomic nervous system (that part of the nervous system that controls involuntary bodily behavior). If your bloodwork has all been normal then you may have what is known as dysautonomia, which is just a fancy way of saying your autonomic nervous system isn't working as it should. It "thinks" your heart needs to speed up at the wrong time. There are tests and exams that can usually pin this down, but it usually winds up being treated initially with Beta blockers (to slow the rate) and sometimes an exercise regimen. It is a frustrating problem if this is what's going on. If it should be a metabolic problem (and thyroid has already been ruled out) and can be identified, then it is fairly easy to treat. You have supplied some additional interesting facts that could bear on your problem. While the thyroid is supposedly fine, some of the tihings you mention, such as your low weight, hair loss and cold extremities would suggest some sort of thyroid problem. Then again, you had a positive ANA, which suggests strongly the presence of some sort of autoimmune/connective tissue disease. This can be very undifferentiated and so can cause all sorts of seemily unrelated and crazy symptoms. It may account for some of your complaints, and it may even ultimately explain the Tachycardia, although the inability to gain weight makes it sounds like your metabolism is running too fast and that would be accompanied by a faster heart rate, among other things, which brings us back to the thyroid, which seems to be OK. This could take some time to sort out, but if you do suffer from an autoimmune problem it can affect almost any body system at any given time and so could be responsible for all your symptoms. Aside from a cardiologist, your doctor may wind up referring you to a rheumatologist, as they are currently the most knowlegeable about connective tissue disease. With that postive ANA it is a very likely possibility. And again, while not usually life threatening, it can be a very, very frustrating problem, as when one problem is solved often a different one will pop us. I wish you all the luck in the world in looking for the solution to this, but I do believe you can at least take some comfort in the knowlege that there is not likely any serious, impending problem, but more likely a long-term, intermittent series of aggravations. Please do stay in touch and let us know if you learn anything new.

tiredmom82 - Wed May 30, 2007 10:35 pm

So I went for my appointment today and my dr whom I convinced that I eat talk with an endocrinologist and they decided that I should be checked for phaeochromacytoma which I know nothing about, given that I eat every 2 hours he thinks that I have a super fast metabolism, my thyroid check out okay so he thinks that its phaeochromacytoma so I have to do a 24 hour urine, and see cardiology and have a holter put on again tomorrow. Plus I get to see gastro. I think that maybe, big maybe that it is metabolic, I guess I do have symptoms of this he stated I sweat all day long it literally drips down my arm I just always thought that it was normal for me. But thanks so much I think your posts have been somethng real for me. Which by the way I did mention to my Dr. I told him isnt Tachycardia a symptom of somthing else and he agreed so hes going fishing and seeing what he can find. I have had kidney surgery when I was 18 because I had a lump in my abdomen that was painfull and the urologist said that my kidney was displaced and he had to put I back because it was in danger of pinching my ureter. I don't know if that maybe had something to do with this, I know that I have a graft on my right kidney to hold it in place and I wonder if that could be irritating my adrenal glands I don't know im just so happy the my dr see's it for what it is (not anerexia). He even went as far as saying that my Tachycardia is from anerexia. Today I told him that im not hearing it anymore and im glad he is attempting to change his view. Once again I thank you for you help.

John Kenyon, CNA - Thu May 31, 2007 3:52 am

Hello - Wow! Well that's one possibility I'm surprised I didn't think of, but it's good news because it really would explain most of the symptoms. It is entirely possible that the surgery involving your kidney could have irritated the adrenal gland sitting on top, or may have simply stirred up something that was waiting to happen. At any rate the diagnosis really does fit, and this is often a relatively simple fix. Pheochromocytoma is caused by one or more adrenal tumors. If there is just one and it's on the actual gland it's easy to locate. However, they can also occur in various parts of the viscera, and finding them can sometimes be a chore. But once treated or removed they can no longer produce the excess adrenaline which causes the symptoms, so there is definitely help on the horizon! Best of luck to you as you and the endocrinologist figure out the best way to mange or fix this, and thank goodness it was finally figured out! If they are right (and the 24 hour urine test should make that clear) you may be looking at a huge change for the better. The history of surgery involving a kidney makes it seem all the more likely to me. Please do keep in touch and you are very welcome. You've done the most important part of the work by being persistent. Again, good luck to you and please keep us updated.

tiredmom82 - Sat Jun 02, 2007 12:15 am

Well my lab work came back not the 24 hour urine but my blood work.... My doctor wrote in his notes that I have low potassium, low bun and low creatine.. don't know what that means! My throid again her ran and that came back my T3 was 125 1 month ago and now its 147 don't know what that means, my T4 is 8. 3 and my TSH is .54 so I see him in 3 weeks to follow up, his notes that I can see and I told him that I could state that he belives eating disorder again..My holter is being read on monday and hopefully that can shed some light! But I guess when I had my EKG is showed more sinus Tachycardia don't know the rate though he dosent mention. Im pretty much lost right now im upset because I don't know what to do I just feel awful. At work today I couldnt even function my heart was just pounding to much good thing I had the holter on. I counted my pulse and it was 180. Im just so tired and I think that if my urinalasis dosent show anything then im just going to get a different doctor, I can I guess prove to him that I don't have an eating disorder so I guess its about that time. I guess im just in fear for my life now. Kinda scared more then ever because I can no matter what get my heart rate down. Im finding it hard to work because its to much for me. Laying in bed is my only relief. This is the second time my potassium has been low the first time was when I found out I was allergic to asprin, and sick as a dog. Are these labs consistant with pheocromacytoma? You seem to be the only one that listens to me and I so appreciate that!! Thanks Rachael

John Kenyon, CNA - Sat Jun 02, 2007 1:42 am

Well more has come to light, then, if not everything as yet (I'm still anxious to see what the 24 hour urine test yields, if anything). The fact that your T4 is a little higher than normal and your T3 is normal (but higher than before) and your TSH is higher than normal (but not through the roof) would normally suggest possibe underactive thyroid, but with your symptoms, one would expect the opposite. Those symptoms would be more consistent with an overactive thyroid and what you sound like you could have is Graves' Disease, except that the numbers of your thyroid panel argue against that. However, there are two other possibilities. One is that you still may have Pheochromocytoma, which you won't know until you get back the results of the 24 hour urine test. The other is that higher-than-normal TSH levels are sometimes seen in people with disease of the pituitary gland, and if that should be so, then the symptoms would be consistent with that as well. It's going to require the endocrinologist looking at all the results as a whole to figure it out, but it really does sound like either Hyperthyroidism (which it almost certainly isn't), Pheochromocytoma, or a problem with the pituitary gland. You have stated that you have a ravenous appetite, so to be thin and having difficulty losing weight would seem to rule out an eating disorder - unless it is bulimia, which I'm sure you would have mentioned. This probably keeps coming up because of your low potassium levels, something very common in bulimics. In fact, for people with bulimia, the loss of potassium due to self-induced Vomiting is usually what leads to the disease being fatal if not treated. From all youve stated here, that cannot be the problem, so I'm looking at a glandular, metabolic issue, one of three possible, and one of those seems to be ruled out (hyperthyroidism) because of your thyroid test results. The BUN and Creatinine levels being low usually have no meaning, although low Creatinine is sometimes seen in people with MS, but again, none of your symptoms suggest MS even remotely. I think it's really important to get the 24-hour urine results and see how that fits into the overall picture. If that doesn't expose the culprit then your doctor will need to rule out a problem with the pituitary gland. By the way, a heart rate of 180 is definitely in the SVT range and can be exhausting and very frightening. It isn't normally life-threatening, but it can leave you feeling as though you've just run around the block. It needs to be moderated by some means, just so you can function while the rest of the detective work is being done. Beta blockers are usually the best way to slow this down. The labs you've gotten back so far don't tell you much about Pheochromocytoma. The 24-hour urine test will, if that is the case. If not, you'd do well to find another doctor. Best of luck to you, and hang in there. The circle is at least getting smaller. Something should turn up soon.

tiredmom82 - Sat Jun 02, 2007 9:25 pm

again another problem my breast are leaking from multiple ducts it is cloudy and is sticky im comfused, again! Not a single chance in hell I could be pregnant.

John Kenyon, CNA - Sat Jun 02, 2007 10:25 pm

Hi there - This is one more symptom that is seen with certain endocrine problems, including thyroid issues. It may also show up with pituitary problems (and the two can of course be related). That's not to say it couldn't be some other, independent problem, but given all the rest that's been going on, it seems likely to be related to an endocrinological matter and should be brought to the attention of the endocrinologist as soon as possible. This may actually be a helpful development, although it probably seems like just one more Headache right now.

tiredmom82 - Mon Jun 04, 2007 12:12 am

my TSH is .54 and my T4 is 8. 3 and my T3 is 147 up from 125 from a month ago. my TSH is down from .6 to .54 in one week.

tiredmom82 - Thu Jun 07, 2007 9:00 pm

minimum heart rate of 53 beats per minute and a maximum heart rate of 159 beats per minute, Rare asymptomatic atrial and ventricular premature contractions. I don't know what that means but my doctor told me once again I need to eat more, and that im fine is that right? bachycardia, sinus Tachycardia and premature contractions? They did say that it was all sinus. I have to follow up with cardiology. But that dosent sound like nothing to me.

John Kenyon, CNA - Mon Jun 11, 2007 6:33 am

Hi - The thyroid numbers are more suggestive of hypo rather hyper activitity of the thyroid, while the symptoms you describe seem to suggest precisely the opposite situation. I still feel an endocrinologist needs to look at your pituitary functioin. As for the cardiac figures you've provided, the only one that jumps out as troubling is the high rate of 159 (if that is while at rest). While not life-threatening, it has to be annoying beyond belief. The low rate of 53 is actually OK, and rare atrial and ventricular contractions are both totally normal and found routinely in the healthy general population. It's just that unusually high rate that attracts untoward attention, and it is the underlying cause that must be uncovered. If it's not SVT then it has to be due to an endocrinological or metabolic imbalance. Again, an endocrinologist needs to be involved, although so does a cardiologist to rule out some electrical abnormality. Hang in there. You've eliminated a lot of the more serious potential causes, but this still needs to be understood and managed so that you can be happy and function normally. Please let us know what you learn. I'm encouraged that there are only rare premature heartbeats, as that really is a "nothing", as is the lower resting rate. We'll be waiting for further word from you.

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