A&E / heart question? ❤️

[Tangerinesoda]

perhaps a bit niche but really hoping someone can help

I was in a&e recently where it was picked up that I had a fast heart rate. The doctor said he wasn’t sure if it was SVT or a normal (but just extremely fast) heart rate. The ECG was unclear and my heart rate was 180. We tried different things to bring it down and I was advised about a medication we could try to bring it down. Apparently it stops the heart for a second and makes it go back to normal again.

I was terrified at the thought of it (especially after hearing how awful it makes you feel) and was too frightened to get it done.

Im waiting to see cardiology now. But in the meantime, if it happens again then I’m worried about getting the medication. I understand if it’s SVT it will work, but the doctor wasn’t certain it was SVT and said it might just be a normal but fast heart rate- if this was the case and it’s not SVT, would getting the medication cause problems? Just terrified of my heart stopping and not starting again. I’ll ask for more information at my appointment but just in the meantime I wondered if anyone could offer any experience or knowledge about it? Thanks 😀

@Hoglet70 i know who you mean and yes it does sound very very similar!

Like @WiddlinDiddlin said, heart issues can be very scary. SVT can cause extreme anxiety, which of course only exacerbates your rapid heart rate. It's a vicious circle. When my daughter first started having SVT episodes, she was terrified. As was I.

I've never been reported before so this is exciting!

Even if you did recognise someone, really poor form to out someone like that. Send a private message saying you think you’ve recognised them or just ignore. Especially when posting about something serious.

If it was the person I 'mistakenly' thought it was then I have heard 29 different versions of this already on a public forum. The person I 'mistakenly' thought it was posts utter shite and then changes her story every ten minutes and forgets the whole world can read it and actually remembers stuff. As I said, I was mistaken and apologised to the OP. The user name and the use of the word 'niche' just made me think ooh I know this person.
The OP has had sensible advice and someone got to feel self righteous and report me so I think everyone is happy!

Thank you lol.

Oh wow, honestly I promise I’m not this Emma person!

thanks for the advice everyone, yeah that’s it it was adenosine! I was too scared when I heard the part about it stopping my heart even if just momentarily

Why did you just say that then @Hoglet70 ? You made yourself look like a troll 😅

I've just popped my trolling cherry 😂

I think you're talking about adenosine. It's very useful for stopping SVT and even if it doesn't stop it, it can be really useful for working out what the underlying rhythm is (sometimes, if it's very fast it's hard to tell)- because it can stop your heart - but that's literally for seconds and can give your heart's electrical activity a chance to restart normally). Yes, it can make some people feel awful, but that will literally be for 30-60 seconds - that's it, it's such a short acting thing. It would only be considered if other measures (eg valsalva manoevres, ducking face in cold water etc have failed)

The alternative, is a general anaesthetic in order to use an electrical cardioversion, but that requires you to be starved and isn't immediately available (you need an anaesthetist and a slot in theatre), so giving adenosine is much more quickly and easily available. Patients will be continually monitored whilst giving this drug and it can be lifesaving in rare cases where a patient is very unwell with an SVT.

Ooof, I wouldn’t wanna have to take some horrible medicine if I had a poorly heart either.

Wow, there's some strange people on this thread. Sorry OP, hope you get seem soon and get some reassurance.

I’ve been an A&E nurse for well over 15 years. Looked after loads of patients with SVT and given the medication you’re talking about (Adenosine) loads of times too. Although there are risks I have never had a situation where a patient has had complications from having it. 99% of patient do have those seconds where they feel a lot worse but it resolves quickly. If it isn’t SVT that you’re in then it will just slow your heart rate down briefly then it will speed back up again, it won’t cause any issues, it may give the doctors a chance to see if there’s any underlying rhythm that they can’t see due to the speed once it’s slowed down a bit too.

When is your next appointment ? Maybe better talking to the gp for advice ? If anywhere like her you could waiting ages for a hospital appointment

Op- what were you symptoms? I wake up in the night a lot with chest pains and I've been to a&e and they couldn't find anything wrong with me. I'm terrified I'm going to have a heart attack . Do you get cheat pains when you stretch or yawn ? As I do as well also I took a sip of ds ice blast and got chest pain. It's so worrying

Adenosine?

The is it SVT or very fast heart rate doesn't make sense to me. SVT is a HR over 100.

I think what the Dr might mean is that it might be paroxysmal SVT or it might have an underlying cause, I was going to list a couple but you then google them and scare yourself.

Some people have an extra electrical pathway, this can be ablated to get rid of it.

If you have an extra pathway then adenosine can put your rhythm back to normal sinus and the pathway will show on the ECG.

You might never have an SVT again, I only get it when my thyroxine is low, which is the opposite to most people.

If you do get it again, please do not be scared of the drug, it can make you feel crappy but this is for a few seconds.

Things you can do at home that may help if you have another.

Face into a bowl of cold water.
Ice cube rubbed on the end of your nose.
Swallow a large lump of ice cream in one go.

Hi. I had frequent tachycardia episodes and was blue lighted from the doctors when I presented myself as my heart rate was up at 238bpm!

I was treated with varapamil which sounds similar. I had 3 nights in ICU and was diagnosed with wolf Parkinson white and had an ablation. It took a while diagnose as it can be a sneaky syndrome to present.

I've had to odd episode since but i frequently hit 180bpm in spin so seem to I've a fast heart.

I hope you are feeling better.

If it’s that or death then I’d do anything to improve the situation.
I don’t take my heart medication I would be dead in a week, it’s a no brainer surely?
🙄

As others have said, the medication is adenosine. It makes you feel a bit shit for about 5 seconds, max, but the way doctors describe gives people massive anxiety, and it irritates me. Phrases like 'Impending doom' and 'Heart stops' yes, of course a ,education that slows your heart will make you feel a bit WTF, that's unpleasant, but so is a heart rate of 180. It's very transient, and really isn't that bad!

Haha yeah that’s how it was described ‘impending doom’ I was like absolutely no way I’m having that, then as soon as I heard them say it makes your heart flat line even momentarily I was like no way because I was terrified it wouldn’t start again! Yeah 180 definitely wasn’t comfortable at all, i didn’t want to make a fuss so I was like yeah it feels fine but being totally honest it was an awful feeling

A cardiologist should be able to tell which rhythm it is from the ECG. They can then tell you what the best treatment is for it. I know adenosine sounds really scary but it only takes a second. You might also be offered cardio version which is the same thing just done with an electric shock. They are very safe and you would be supported by staff throughout. However it does depend how often it’s happening - what were you in A&E for? You may have had a condition which triggered the SVT. If your heart is back in a normal rhythm now and doesn’t go honky again you may not need anything done at all.

As an aside tachycardia (which is a normal heart rhythm just with a rate over 100) and SVT (which is a slightly different rythym) are different things @sashh

OK a rhythm originating above the ventricles that is above 100 bpm. One that could be initiated from various loci, including an atrial ectopic focus or some form of reentry circuit. But I was not presenting a paper at a conference.

Hence not mentioning wpw or lgl or bundle of Kent.

And no a cardiologist may not be able to determine the underlying rhythm.

And cardioversion can be chemical eg adenosine or electrical using a defib.

SVT refers to a group of arrhythmias, it's not just one thing. Sinus tachycardia is actually a type of SVT. Others include AVRT, AVRNT. SVT tends to be colloquially used to refer to AVNRT. AVNRT is one of the most common occurrences of narrow complex regular tachycardia - the normal flow of electricity through the heart top to bottom is disrupted and loops back through rapidly causing extra beats - anything that briefly pauses electricity in the heart can reset this - with the Valsalva manoeuvres they tried - blowing into a tube, flick your feet in the air, face in water being common ones this 'vagal' action causes a pause in the electrical flow of the heart. This can also be achieved by drugs (adenosine) or electricity (cardioversion/defibrillation).

Sinus tachycardia is a rhythm people normally go into as part of normal everyday life - exercise, anxiety, stress, illness/fever. At 180 that's quite high if you're resting and not normally reached in anxiety or illness for example, however if you were intensely exercising that would be a 'normal' heart rate.

At a rate of 180 SVTs can look very similar on an ECG. Whilst at that rate you'll probably need some rate control regardless, what they're trying to do is establish the cause of that tachycardia, and whether it's due to a conduction abnormality in the heart, or whether there's another pathological cause requiring treatment.

I.e. if the rate is 180 and because you're shocked - blood clot, bleeding, sepsis, or you've got a metabolic disorder - treat that condition and the heart rate will resolve. If it's due to a conduction abnormality then try to reset this/consider whether any further treatment is required to reduce recurrence.