Should I worry after a non-sustained ventricular tachycardia episode?

Hello doctor,

I have a long and complicated cardiac history and am currently seeing a cardiologist. It started with chest pains, and I experienced an episode of non-sustained ventricular tachycardia (NSVT) last year. I am now on Bisoprolol and Amlodipine. The cardiologist believes my condition is due to coronary artery spasm, with an ectopic focus causing the NSVT. I have undergone a normal CT angiogram, which showed no luminal narrowing, blockages, or signs of atherosclerotic changes, as well as a negative stress echocardiogram. After the NSVT episode, I had a normal echocardiogram, and a cardiac MRI was performed. The MRI revealed very mild dilation of the left and right ventricles, but the cardiologist reviewed studies and concluded that mine is not dilated and falls within the normal range for my age. I had another normal echocardiogram just yesterday, which showed no ventricular dilation, normal wall thickness, normal size, and normal function with an ejection fraction (EF) of 66 percent. The only finding on the echocardiogram was a mild tri-leaflet aortic valve with normal cusp excursion and no regurgitation.

I also noticed that every time I am stressed or anxious, the T waves in leads III and aVF on my ECG flip. Since my previous echocardiogram did not mention any sclerosis of the aortic valve, I am wondering if this condition has always been present. Given my NSVT episode, does this put me at risk of sudden cardiac death (SCD)? Additionally, is it possible 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, I have not experienced it again, although my Holter monitor showed infrequent premature atrial, junctional ectopics, and ventricular trigeminy, including one episode of trigeminy associated with emotional stress during a three-day Holter monitor period. The total number of ectopic beats in a 24-hour period was less than 30. I am a 31-year-old male who does not smoke.

Please advise.

Hello doctor,

Thank you for the reply.

So, should I not be concerned about the sclerosis of the aortic valve? Given the clear CT angiogram, it seems very unlikely that this is related to heart disease of the arteries, especially since the CT angiogram was only 11 months ago. The NSVT episode occurred six months back, and the latest echocardiogram showing the aortic valve sclerosis was done yesterday. In your opinion, should my arteries still be considered clear? Is the CT angiogram still valid?