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Forum Name: Arrhythmias

Question: ectopic beat and IST


 manijee - Mon Nov 02, 2009 6:26 am

i m 24 year old n a medical student. i have a problem for last 2 years that my pulse is more than 110 in resting condition. for last 1 year i daily and very frequently feel palpitation and some times shortness of breath and jolts in my chest. my echocardiography has done and every thing is normal in ecg rate was 88 rythm was normal but there was ST elevation probably because of early repolarization. my cardiologist said that i m suffering from inappropriate sinus tachycardia and ectopic beats and is a benign condition but other cardiologist said its not such benign. my question is that is it life threatening can it lead to cardiomyopathy. please help me i m very tensed because of these arrhythmia
 John Kenyon, CNA - Tue Nov 10, 2009 11:13 pm

User avatar Hello -- IST in itself is completely benign but often may have an undiscovered underlying cause (often metabolic, more often due to a flaw in the functioning of the autonomic nervous system). Many people are made very anxious and distracted by the relatively trivial symptoms, because they are so very subjective. In fact this won't lead to cardiomyopathy, and many people have a normal resting rate that runs between 80 or 90 and 110. Many of these also have frequent (or intermittent) premature beats, mostly PVCs, as the parasympathetic side of the system (vagus nerve) attempts to slow the heart rate according to circadian rhythms, relaxation response, digestion, etc. This is also normal and benign, even though it can feel terrible and be very disruptive and productive of a great deal of anxiety. Some people develop such levels of anxiety due to this that they achieve a chronic state of anxiety and this of course only serves to maintain an increased resting heart rate and produces more palpitations. Again it is benign, but the anxiety is far worse than the physical symptoms and often the two become conflated. For certain patients the best approach is to treat the symptoms to restore some feeling of security and calm, and the most effective way to achieve this is by use of lowest-possible dose of a beta blocker, the best probably being metaprolol (brand name Toprol XL). This is not a "cure" but can slow the resting rate, reduce the frequency and perception of PVCs and PACs, and actually have a calming effect due to blocking of uptake of adrenaline. If all attempts at psychosomatic correction (reassurance, relaxation exercises, cognitive behavioral therapy) fail this is sometimes a viable way to manage the symptoms and attendant anxiety, but as always it's better to avoid medicating if there is a way to eliminate the problem without meds.

I hope this is helpful to you. Your problem is extremely common, especially among young women and also among med students. Often it can be managed by reassurance, adaptation and the knowlege it is harmless, but it is essential medical providers offer reassurance along with simply telling the patient there's nothing seriously wrong. I hope I've helped accomplish that for you here. Please follow up with us as needed. Best of luck to you.
 questionnone - Sat Feb 13, 2010 9:25 pm

I am 20 and have the same thing. I have IST and PVC's and have had two episodes of PSVT. Currently waiting until I see a new EP but for now my current EP has me on metoprolol 50mg twice a day. My resting was about 94 in my family doctor's office and a month or so later after going to the cardiologist it has began to be 100+. Echocardiogram came out normal but the treadmill stress test did it. My heart just goes too fast with little exertion and while resting. I have a neck injury that many doctors doubt can be the cause of my problem (cracked my neck diving under a wave) but I am going to seek a chiropractor that has the right equipment to see if there is anything wrong. I would like to exhaust all possibilities before I settle for medicine for the rest of my life or an ablation. What I also noticed within these past two days is that for many years I have had this habit of sucking in my stomach, like the exercise they call "vacuum" where you suck in your abs. I have done it for so long that now it is only natural for me to breathe in and out with my abs sucked in but I noticed that when I let my stomach sit naturally (let it stick out) it is harder for me to breathe but my heart rate is slower. I want to get a sleep apnea study as well because friends and family have told me my snoring is really loud, scary loud.
 manijee - Fri Feb 19, 2010 12:47 pm

thanks dr .
now my condition is that my blood preasure is now sustained at 130/80, and daily it gets elevated to 140/90. palpitaion and etopic beats occur frequently .
i have two questions that i wana ask

1 . can i get normal with out medicine ? i am very afaird of beta blocker and don't want to take it at this younger age ?

2. can i get pregnant with this condition ?

waiting for your realy

thank you
amreen ali

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