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Forum Name: Arrhythmias

Question: SVT- chest tightness


 kristineman - Wed May 06, 2009 4:03 pm

Hello, I am a 22 year old female, who is pretty healthy. I occasionally have SVT episodes, and it is almost always after I have caffeine. I have drastically cut back caffeine for this reason. When I have an episode, my chest feels really tight, I feel short of breath and pretty dizzy. The last few days I have been having the symptoms, and no palpitations. When I take a deep breath, my chest feels uncomfortable and tight, just like it does when I'm having an SVT moment.

I have been having this problem non stop for the last 2 days. I'm also wondering if it could have something to do with my lifting a very heavy couch with the help of my friend-as it started that night.

If its possible, could I have just pulled a muscle in my chest? Would that create the tightness when I take a deep breath?

I called my local hospital's "dial-a-nurse" and she sounded alarmed, but it could be because she doesn't understand SVT. She made it sound like I was having a heart attack, and that I should go to the hospital. I'm 99% positive thats not the case, and going to the hospital isn't an option because I don't have health insurance, nor do I have the out of pocket money that a doctor visit would cost.

Was she right? Should I be alarmed?
 John Kenyon, CNA - Mon May 11, 2009 9:06 pm

User avatar Hi there --

First, advice-line nurses are in a difficult position because they are being asked by people "should I be concerned?" and all they have to go on is a broad set of guidelines. If one of them makes a mistake it could be a costly one, so they will always err on the side of safety. This is a good thing, but you also have brought your question here, where we can go into a little more detail. First, there's nothing to suggest, per your discription, heart disease. Also, based on your admittedly sparse but good history and symptoms, plus relative youth, there's very little likelihood this is heart related. The symtpoms are similar to part of what you'd feel with SVT, but that's because SVT keeps the heart working hard and everything rather tight during episodes, and muscle pulls and costochondral strain and irritation, especially from heavy lifting, will cause almost identical sensations. One way to determine if this is musculoskeletal would be to press with fingertips moderately firmly on the affected area to see if you can elicit any pain or tenderness. Also, twisting mostion of the upper body or deep breathing will aggravate the symptom of tightness and possibly tenderness. This is never heart-related. I trust you're not having shortness of breath or dizziness with this current similar symptom, although if it seems to inhibit your breathing you may wind up hyperventilating unknowingly, which can create the sensation of shortness of breath.

It is entirely possible you could right now have a pulled chest muscle and the tightness upon deep breathing is caused by that. It is even likely. Bear in mind also that while this feels similar to an SVT episode, even those do not usually indicate coronary artery disease, and so are not related as a rule to heart attack. I would never say to someone "No, you are not having a heart attack, " even if the person appeared totally fine, without first doing a few diagnostic tests, but given the nature of the complaint and the history and the way we have to work here, I feel it is very reasonable to say that is extremely unlikely. You very likely are suffering a muscle pull, which can cause sensations very similar to brief SVT or atrial fibrilliation (and some people don't even notice when those happen!). If you are also having shortness of breath and lightheadedness then there may be somethng else going one, but you haven't mentioned those relative to this recent discomfort, so I will assume that hasn't happened and so this becomes almost certainly a muscle pull issue. You still might want to press on your ribs in the affected area and twist your upper body, just to see if you get any tenderness response, which would just confirm the muscle problem.

If you ever have any substantial doubt about what might be going on, do not hesitate to go to the ER. That being said, at your age and with your history I don't think this is necessary right now. T

I hope this is helpful. Please follow up with us here and keep us updated. Good luck to you.
 ejattina - Tue Dec 29, 2009 11:05 pm

I wake up every morning with a serious ache in my sternum. I also have a hard time moving with the related back tightness and pain associated with this movement. It kills me every morning trying to get out of bed. I feel like there's someone pushing on my chest, where any movement related in fast motion, and applied stress to my upper body relates in this tight stiffness in my sternum and mid back...

What can this be?

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