How is supraventricular tachycardia managed?

Question

Hello doctor,

I am a 74-year-old male in excellent health, and I am not on any medications. Recently, I experienced a strange sensation in my chest that felt like my heart stopped or skipped a beat, and I felt lightheaded as if I might pass out. I had an EKG, echocardiogram, and Holter test performed. The EKG results were normal. In the echocardiogram, I received a reading of 77 percent and was informed that my heart was in very good condition. The Holter test showed supraventricular tachycardia, but it was not extreme. I have only seen the physician assistant, as the cardiologist is too busy. I would like to send my Holter test reports to you to get your opinion. I have cut back on caffeine and alcohol, which are the only measures I have taken so far.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand you are a little worried about your heart and have been on the Holter monitor for a while. I appreciate that you have uploaded the reports in full for my review (attachment removed to protect patient identity). Since you are not on any regular medications, I can say you are generally healthy. Your heart is functioning well, as indicated by your cardiac output numbers from the echocardiogram. The findings from your Holter monitor appear to be quite good. There are no significant abnormalities observed in your heart's electrical activity. Your heart is operating normally, with appropriate synchronization in its electrical and mechanical activities.

Yes, there are instances of supraventricular tachycardia (SVT), which results from a change in the heart's electrical rhythm due to ectopic activity interfering with the normal rhythm. This can create a sensation as if the heart is jumping in your chest or has briefly paused. It is common to feel faint during this process.

I recommend the following:

Reduce your caffeine and alcohol intake.
If you smoke, you need to quit. If you are a passive smoker, you should avoid that as well.
Limit your spice intake.
Follow a bland diet and ensure you drink plenty of fluids.
Avoid heavy meals; instead, opt for light but frequent meals.
Limit red meat consumption and incorporate more fresh fruits, vegetables, and fish into your diet.
Continue exercising, especially cardiovascular activities, but be mindful of your heart's limits. Set safe boundaries for your workouts.

If you experience heart pounding, dizziness, palpitations, shortness of breath, or pain in your stomach, shoulder, jaw, or hands, stop exercising immediately and contact your emergency physician. Coughing can provide some relief in such situations.

I do not believe you require further investigations regarding your heart's blood supply at this time. However, you should monitor it in the future; your cardiologist may recommend angiography and a thallium scan to check for any blockages in the blood supply to the heart muscles. Any blockage could result in lower echocardiography numbers, indicating that the heart is unable to pump effectively under certain conditions, such as climbing stairs or engaging in physical activity.

Please keep an eye on your blood pressure, blood sugar, and cholesterol levels, as these factors are directly related to heart output. Neglecting them may adversely affect your heart's normal functioning. Your BMI (body mass index) is within the normal range, and I assume you maintain an active lifestyle, which indicates that there are no significant risk factors for you concerning physical activity at this time. I currently do not have data on your fasting blood sugar levels, blood pressure, or cholesterol levels, so I cannot comment on these risk factors.

I hope this information helps.

Thank you.