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Q. Do my cardiac issues put me at risk for sudden cardiac death?

Answered by
Dr. Pramod Bhanudas Narkhede
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 09, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

I have a long, complicated cardiac history and currently seeing a cardiologist. It started with chest pains, and I ended up having an episode of NSVT last year. I am now on Bisoprolol and Amlodipine. The cardiologist thinks my condition is coronary artery spasm and just an ectopic focus causing the NSVT. I have had a normal CT angiogram with no luminal narrowing and no signs of any blockages or atherosclerotic changes, and a negative stress echo. I have had a normal echo after the NSVT with everything normal and a cardiac MRI. The MRI showed a very mild dilation of left and right ventricle (the cardiologist looked up studies and said mine is not dilated and it falls within the normal range for my age).

I had a normal echo just taken yesterday, which showed no dilation ventricle with normal wall thickness, size, and normal function with 66 % EF. The only finding at all on the echo was a mild tri-leaflet aortic valve, normal cusp excursion, and no regurgitation. I also noticed that every time I am stressed or anxious, my T waves in leads III and AVF on ECG flip. As my other echo did not mention this sclerosis of the aortic valve, has this always been here and because of my NSVT does this put me at risk of an SCD? Also, is it likely for me to have blockages in my arteries now even after a clear CT angiogram less than a year ago?

Since the one episode of NSVT, it has not happened again although I have had on Holter, premature atrial, junctional ectopics, and ventricular trigeminy, all of which are very infrequent. One episode of trigeminy with emotional stress on three-day Holter. Total ectopic beats in 24 hour period less than 30. I am a 31 year old male, who does not smoke and. All the best.

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#

Hi,

Welcome to icliniq.com.

An excellent narrative history. I think you had only one episode of tachycardia of ventricular origin, which was nonsustained.

  • Other reports of few years are not justified with the ventricular tachycardia. You might be having an idiopathic origin of ventricular tachycardia.
  • Please do not worry about sudden cardiac death. You need to do regular Holter. If the ventricular ectopics runs are frequently coming, then you should get an electrophysiological test done and ablation should be done. Continue the medications. It will help control your problem.
  • If any of your family members have a similar heart rhythm problems or sudden cardiac death, then it is better to get an EP study for the arrhythmias.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

Thank you for replying. So, the aortic valve with sclerosis is not to worry about? Because of the clear CT angiogram, it is very unlikely that it is related to heart disease of the arteries? The CT angiogram was only 11 months old. The NSVT was done six months back and this latest echo showing the aortic valve sclerosis was yesterday. In your opinion, my arteries should still be clear? Is the CT angiogram still valid? Thanks so much.

#

Hello,

Welcome back to icliniq.com.

  • At your age, aortic sclerosis is unlikely or very rare, unless, you have systemic sclerosis or calcium metabolism disorder.
  • Please repeat the echocardiogram. Your coronary angiogram is not showing any abnormality. You can recheck by repeating echocardiogram, as the rhythm problem may not be related.

For further queries consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist


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