Sinus tachycardia and premature ventricular contractions...

Hi Everyone,

This pregnancy has been so different to the other two. I had terrible morning sickness (throwing up 5/6 times a day) which has now (thankfully resolved itself). Then I started having these "panic attacks" which were preceded by continuous sinus tachycardia (fast heart rate). I figured the panic was more of a physiological response to the tachycardia than a straightforward panic disorder. Now, after some ECG's I am told I am having occasional premature ventricular contractions (PVC's). After doing some reading it seems that this is not uncommon in pregnancy, and can be caused by an increase in progesterone and the subsequent changes to the cardiovascular system that happen to everyone in pregnancy. I have a holter monitor on at the moment, so hopefully that will pick up any major dramas.

I was just wondering if anyone else has experienced this in pregnancy? I am told it is likely to resolve itself after birth. It is terribly disturbing - it feels like my heart is going to jump out of my chest at times and skips beats and flutters and does all kinds of weird things. If anyone has had this before, how was it treated? Did you take beta-blocker medication? I'm not keen on taking anything in pregnancy, but this condition is pretty scary!

Cheers,
Juliette

Geez Jules you have had a tough time this pregnancy. I hope someone posts that has had it before and can give you some advice.......xoxo

Hey Twinkle!! Haven't seen you 'round these parts for ages! Thanks for your reply. I ended up at the ER again last night...they did an ECG again and found this erratic heart rhythm again (it's always great when they nurse says "oh it is erratic isn't it?" NO KIDDING!!!!!). They are still telling me it's all okay (doesn't feel okay!!!). They say it's not uncommon in pregnancy, but I have never heard of it, and it doesn't seem that anyone on BB has experienced it either! Total wierdness...

i have an irregular heartbeat but they never told me what i can do to help it

hope u get answers soon

Thanks for letting me know I'm not alone murraysmum. It is such a disturbing feeling. They were talking about possibly treating it with beta-blocker medication - but I'm really not keen because of possible effects on bub. I think I'd rather learn to live with it (as long as it isn't life-threatening)... Has yours just started in pregnancy too? I read somewhere that high levels of progesterone are thought to play a part... I hope you are well :)

Hi Juliette, I suffer from SVT - Supraventricular Tachycardia. (have for 12 years now)

Usually I can deal with it -as my cardiologist has taught me some manouvers to stop it, or reduce it usually it only happens once a month or so. But since being pregnant and moving well into the second trimester, mine was happening every night/day.

I quickly saw my cardiologist we discussed beta blockers (which I have never had) and surgery (which I have always wanted - but he never let me have it :shakehead: ) and have had a holter monitor fitted for 24 hrs and an echocardiogram.

The risks as far as I know are

fainting
sweating
claminess
tiredness
dizzy

The worst things

severe low blood pressure - this affects the fetus, lack of oxygen and nutrients to the baby. Especially when it is ongoing not just sporadic.

IMO - I don't want medication - all meds that I can find are C & D category. None of which are safe for bubs, even in low doses

Surgery - as much as I have wanted it for years and he decides he wants to do it now, I dont want either. Its too risky - as I will be under fluroscope (x-ray) for 25min to 3hrs again not good for bubs.

My OB - is sitting on the fence, and has said to me in all his years of practice he has never had a patient under go surgery whilst pregnant for this condition. In the end its my decision, but quite politely said when we are doing your C-section I would like your cardiologist number incase you have an "attack" whilst on the bed ;) - in other words don't do it.

As much as I can trust my cardiologist, I also worry that the cowboy/guinea pig rule applies in my situation. I am pregnant with this and he wants to operate, he could only tell me of ONE case where he has operated on a pregnant lady. ONE. Therefore I would be somewhat of an experiment. Something I am not willing to risk, considering my bubs was ICSI/IVF.

I don't have a review with him till Tuesday, but my mind is made up - and I would rather have extensive monitoring, rather than be sliced and diced or fed a pile of drugs to "help".

Hi Juliette, I also suffer from SVT, and have done for 16 years now. It goit much worse during my pregnancies- i was hospitalised once with each of them and given drugs to slow the heart rate, but the runs of plapitations I was having came at least once a day.

Some tips i find helpful are to make sure you are very hydrated, especially druing the hot weather, make sure you are taking supplements to keep your iron levels up (aneamia and dehydration both trigger SVT) and be careful doing anything that will change your blood pressure suddenly- bending down or standing up quickly, getting out of a hot bath into cool air, etc, etc. I choose not totake meds for my conditon because the side effects are quite yucky and really mess with me, but I'm hoping to have surgery this year.

Hope that helps. It is quite a scary thing, and not many people know a lot about it :hug:

Krikit, it is tough knowing what to do when pregnant. Like you, I'm not willing to do anything that might put bub at risk. I don't think I'm a candidate for surgery (it's a new condition this pregnancy, and I am hoping it will resolve once bub is born), but the betablocker medications don't sound particularly safe either. I can totally understand why you're not keen on surgery (particularly with x-ray) while pregnant. My doctor seems to think that the anxiety I get when I get a run of PVC's is more of a problem than the PVC's themselves, so I am going to work on trying to implement a bit of cognitive behaviour therapy (telling myself it's not a heart attack!) and try to relax and take it easy. I got myself a cleaner at home to take off some of the pressure (I work full time too). I guess I'll just keep up the communication with all my various caregivers during pregnancy, and hope that monitoring is all that will be needed. I'm sorry you're going through this too, and I hope your cardiologist will respect your decision...

Thank you Lolli. It helps to know I'm not alone with this. Thanks for the tips re: hydration, supplements, and watching the postural hypotension etc. I have heard that the beta blockers aren't particularly nice to take even when you're not pregnant. My doctor said they can make you emotionally flat, and can sometimes even cause a worsening of symptoms. I hope your surgery goes well this year. It would be great if you could be rid of these scary episodes... I'm keeping my fingers crossed that mine will magically resolve once I've had ths baby! If not, then I guess I'll have to consider the surgery option too...

Just out of interest...does anyone know how to distinguish one of these so-called 'benign' episodes from a more dangerous cardiac event? I still totally freak out about it when it happpens...but I don't want to hassle my Dr or the emergency room unneccessarily... How do we know when we need medical help and when we don't?

Juliette, I found I had the same problem with the anxiety and pyschosomatic nature of it all, when my SVT first started getting bad, about 10 years ago, when I was 18. I still get it every now and then- if something happens that gives me an adrelenine rush, I'll think the plapitations have started, and I'll panic, which makes verything worse, and it takes me a couple of minutes to realise I'm ok. I found the way for me to defferientate the two is to lay down, or sit with my head between my legs, and breath into a brown paper bag (I have one in my nappy bags at all times, JIC), to decrease the oxygen rush and calm me down. Only do that for a few seconds- you'll know almost straight away which it is. if it is the plapitations, your breathing will slow down, you'll stop feeling paniced, but your heartrate will still be up, it won't come down as the rest of your anxiety sympotns do. If that all makes sense :D

have they taught you the ways to try and stop it yourself- holding yoru nose and breathing out, bearing down, dunking your head in cold water, that kind of thing?

Hi there dont stress, I too had this along with high BP but managed without meds. I too am also an RN and have recently started in CCU (coronary care unit) and we only start to worry if there is a run of PVC"s about 8 or so in a row, its actually very common and remember your heart is working over time at the moment, it feels funny I know but if it were anything serious the doc would know if you have a copy of your ECG id be more than happy to offer a second opinion and show my reg.

Thanks Lolli, the doctor at the ER told me about the holding my breath trick, he also said that drinking icy cold water can help too. I might try your brown paper bag idea too. I feel as if this thing has turned me into a complete hypochondriac!

Thanks Lydia too. I don't think I've had 8 in a row or more. I think mine usually come in between normal beats...but my heart is beating so fast it feels like it's happening one after the other. I wish I had a copy of an ECG...but they're all on my file at the hospital and GP. I suppose I could ask them for a copy? I'd like to learn more about the condition...knowledge is power and all that! Thanks for the reassurance.

Hi Gang,

Interesting post.
Some things to help you all.

Firstly, please don't breathe in a brown paper bag. It is actually dangerous and can drop you oxygen levels as you are re breathing carbon dioxide. You can pass out.

Secondly, it is important to only try those techniques to alter your heart rate suggested by your own health professional or specialist. Following the guidelines of another can be dangerous to the point of fatal. If you require these interventions they will be taught to you.

From my reading, 50% of women will have some sort of arrhythmia during pregnancy.
Most rhythm controlling drugs are safe during the second and third trimesters however none are proven safe during the first trimester. Some of the rhythm drug are actually used to control rhythm in foetus's so they must be ok for you! Some are used for maternal high blood pressure. Beta Blockers for example are for this and have a good effect on this and abnormal rhythms in pregnancy.

Abnormal Heart Beats


Again please don't follow any of the recommended techniques without consulting your treating professional.

Many thing influence the heart rhythm during pregnancy including the extra blood volume, hormones and emotions.

Panic attacks and anxiety episodes do release adrenaline. This makes you feel all light and jumpy and sends your hear rate; then you panic about the whole event and a spiral begins. The exacerbates the sensations and possibly the rhythms experienced. Stress of a constant nature can throw plenty of adrenaline into your system leaving you with regular extra beats which are harmless but unsettling.

How to differentiate between benign and dangerous?

Any sensation associated with pain in your chest arms or neck/jaw. Palpitations dizziness or lightheadedness, nausea, disturbances of vision or a change in your conscious state (observed that is!) then call an ambulance. Look if you are worried, call us. We'd rather find nothing to worry about than you not to call us and end up crook.

Many can still be attributed to anxiety and we are pretty good at coaching you out of it. If there is an emergency with your heart rhythm then we'll deal with that too.

Thanks Stretcher Bearer. I really appreciate the time you took to reply to my thread, and the reassurance. I'm going to see the psychiatrist on Friday to hopefully get some help with getting this anxiety under control to try and break the positive feedback loop between these alarming physical symptoms and the panic attacks/anxiety. I just want to stop feeling so jumpy and on edge all the time!

Hi there Juliette,

Not sure if you are still reading this thread, but thought I would post a reply as I seem to be having a similar experience to you. I am not pregnant, but had my second bub 10 weeks ago. One week ago I suddenly started noticing my heart was skipping beats fairly frequently. They became worse over a few days so of course I panicked and ended up in Emergency. The ECG noted PVCs as well. Yesterday I had an echo and a halter monitor fitted - I get the results next week. Mine seem to get worse when sitting and lying down - going to bed is horrendous - all I want to do is sleep, but the constant flip flopping of my heart makes it impossible. I'm a bit of a basket case!! The anxiety it causes is amazing. I have done a fair amount of reading (the heart rhythm forum on medhelp is helpful) and in an otherwise healthy heart, it seems to be a benign condition that you just have to live with - I'm desperately hoping mine goes away when my hormones settle down but I'm aware that it may now be with me for life. Crazy - one day you are perfectly fine and the next it feels like your whole world has been turned upside down!!
Anyhoo, just wanted you to know you are not alone! I hope everything settles down for you after your bub is born - the added anxiety is SO not welcome!

Take care.

Thanks Merjo. I'm sorry you're suffering too. It is so disconcerting when your heart isn't behaving as it's supposed to! Mine is worse when I'm at rest too...although it is especially bad if I've had a fairly active day, and then sit down. I know that I've overdone it when I come home and get heaps and heaps of skipped beats. I've read that this is common and a good sign that it isn't something more serious. Congrats on your 10 week old! I am starting to get really clucky now (just as well hey?!). I hope your PVCs settle down soon. I am keeping my fingers crossed that it'll go away once bub is here, but ya never know. Anyhow...feel free to post/vent/touch base if you need it. It can be reassuring to talk to someone who understands what it's like.