RLR,
I'm new here and have been told this is a good place to come for knowledge and advice.   I'm 55 still having occasional menses, although not had one for a couple months.  I suspect I ovulated recently, but not sure.

I've had my first episode of SVT in 2005.  ONly had 2 more since and heart has seemed OK until the past few months.  I've had episodes for days of pounding, keeping me up at night.  One morning in Apr. ended up in the ER for it, then went into SVT while there.  Held my breath, it converted to NSR, no meds needed.  I'm currently on no meds at all.

Have been healthy until all of this plus being Dx with Hashimoto's Thyroiditis.  Haven't started on thyroid meds yet.

I seem to have good days and bad.  Last week I walked a brisk 2 miles each day, this past week my heart started beating faster and it seems weaker--84-90 bpm even at night.  BP normally is good but now goes up to 140/80 sometimes--high for me.

What is scaring me is that the past few days I sometimes can't even walk short distances without my HR increasing and pounding and getting SOB.  This happened yesterday just walking from my car to DS school.  I couldn't even climb the stairs there.  And I'm not overweight.

It happened again today.  Thought I felt fine this morning, got a lot done, but after lunch the heart things started and I seemed to get easily SOB again.  Then of course I panic which exacerbates things so had to take a xanax to calm down.

Several months ago I had an EKG, stress echo, cardiac enzymes with no problems detected.  And then ended up in the cardiologists office on an emergency basis one day because I bent over and when I stood up my heart did this sickening hard few thumps and then was irregular.  In a panic I called the cardio, she fit me in, did another EKG and it looked fine.  When I told her the story she laughed and said I had GERD.

Since then I've taken quite a few supplements to heal the Gerd, watched what and when I ate and it went away.  But  it almost seems to me that awhile after I eat is when the heart speeds up and then I get SOB when getting up from sitting or walking even short distances.  But I'm still not sure it's only when I eat larger meals.

I'm very concerned because I know that when we eat, blood gets shunted to the stomach and digestive system  to help digest food, thus if one has an arterial blockage then it could trigger a heart attack.

Also, I've seen a lot as an ER nurse, so understandably I'm scared.  This is a pre-existing condition for me and our insurance refuses to pay anything remotely connected to this.  Plus $5,000 deductible for me alone.  We are still trying to pay off doc and hospital bills from last year and desperately trying to save for retirement.  

The thought of an exploratory catheterization scares me, plus  the expense will bury us, but I'm scared that the other tests are not enough.

I am worried sick day and night, wondering if I'm going to drop dead.  If I had decent insurance I would have gone to the doc or hospital by now, but what if they just send me home and tell me I'm OK?  Yet I'm still having SOB on exertion.

What are your thoughts on this?  I am grateful for any guidance you can give me.

Cindy

I know how you feel! I have experienced similar symptoms. After I eat a big meal, my heart rate will almost always shoot up and I will feel SOB. I sometimes also get a headache. Sometimes this is more severe than other times. Eating less at a time makes me feel much better. I do not know why eating would cause such severe symptoms, but I would be surprised if you had a blockage. Hope RLR comes along soon to impart his wisdom!

Well hello Cindy and welcome to the forum. First of all, let's slow the pace of things down because it appears that your background and training as a professional nurse has placed you on sort of a runaway train with your fears.

Let's look at the facts. Realize that DOE is not universally associated with cardiac insufficiency. It's also important to understand that if conditions can warrant dyspnea, then other symptoms would begin to appear as well. As for the history of PSVT, I would wouldn't give it much more than a passing glance if I were reviewing your chart, especially in light of the dx of Hashimoto's and potential for GERD to be actively present, including the fact that your diagnostic tests are unremarkable for signs of overt cardiovascular disease. By contrast to your concerns, I'm afraid the cards are stacked high against the potential for this to be heart disease.

Experiencing fullness upon eating can be related to a number of problems and depending upon symptoms can represent reflux disease, cholesistitis, IBS and other causes. Based upon your description, I believe we're dealing with a GI issue rather than anything cardiovascular. A variant of reflux disease would certainly be high on the list based upon your symptoms.

The reason that you feel dyspnea is related to upward pressure on the diaphragm that can dramatically reduce your capacity to breathe deeply or obtain the characteristic inspirational breath. Shallow breathing and dysregulation of the sympathetic and parasympathetic drives can induce broad changes in heart rate from mild tachycardia to bradycardic circumstances that are often followed by pounding heart associated with increase of cardiac force.

It's important to watch your dietary habits for several reasons. As we age, the stomach generally produces less acid and in the presence of large meals, it can become quite a task for digestion to commence without unpleasant side-effects and discomfort. Try eating smaller meals throughout the day and do not drink liquids during the meal as much as possible and alternatively save them for afterwards. If certain foods produce indigestion, then steer clear but realize that in most cases, it's more about how you eat rather than what you eat.

People under stress can also perform something known as aerophagia, or the swallowing of copious amounts of air while eating and drinking beverages. This air can become trapped and produce a good deal of bloating.

People have also been trained to some extent to go for a brisk walk after eating with the notion that it aids in digestion. Well, yes and no.

Many people try an envision the process that the body undergoes when digestion ensues and the upregulation of blood supply to the GI tract. Blood flow is increased to the GI tract, but it doesn't equate with a distinct diversion of blood away from critical areas. It doesn't work like that. So your concern that it could somehow define cardiac insufficiency or result in the increased risk of a cardiac event has no basis in fact.

In the case of reflux symptoms, it's sometimes prudent to treat it symptomatically to determine if relief is experienced, particularly in light of the fact that your insurance may not present you with the best alternatives.

Here's an approach you can use to see if relief can be experienced, but I must also remind you that obtaining medical information via the internet in the absence of direct evaluation is much akin to trying to go to court without an attorney.

Do not eat large meals and augment small meals with a light snack in between if necessary. Do not eat any sooner than 2 hours before going to bed, do not eat or snack in bed as well. When eating, do so slowly and drink most beverages after the meal. Prilosec OTC, as you know, is available without a prescription and you can try taking 1 capsule approximately 1 hour before meals, but never afterward. In addition, a teaspoon of Maalox II or Maalox complete about 20 minutes or so after the meal would be alright for the first few days or so, but continued use can cause constipation or worsen the condition if it already exists. You should also stay away from caffeinated beverages, which also tend to be quite acidic in nature and since the idea is to reduce acidity for a period, then consuming such beverages is counterproductive.

Make certain that you are getting restful sleep as well, since this can have a direct effect on reflux disease and GI problems in general. If you anticipate exercising, do so before you eat and limit the activity until such time that your symptoms have abated.

It is my opinion that your symptoms are not related to any type of cardiovascular problem whatsoever. Your focus should be upon relieving the symptoms of reflux disease and GI discomfort in general. Following a few simple guidelines will bring relief and within about 10 days or so of adherence to the guidelines mentioned, you should begin to see a positive change.

Lastly, always remember that any treatment or decisions regarding your healthcare should be discussed with your primary care physician and you should never substitute information on the internet for direct evaluation by your doctor.

You'll be just fine. Your fears that this is a heart problem are entirely unfounded. Focus on the GI issues.

Best regards and Good Health

Well, I finally wentto the ER. Had another bad night of racing heart, waking
me up multiple times. Got DS ready for school and heart was racing,
getting short of breath.

I drove him to school and then went to the ER and sat in the parking
lot for about a half hour, crying and worrying about what was wrong
and all the expensive tests that would need to be done. I vacillated,
but I just knew I could not go back home and go through any more.

So I went in, fortunately it was all familiar, since I worked there
and it was good to see all the nurses and docs I worked with before.

Hooked me up to heart monitor, it show NSR--normal sinus rhythm. I
had taken .25 of xanax prior to going in because I didn't want to be a
babbling basket case upon arrival. Nevertheless, I was still quite
anxious and shakey. He listened to my lungs and I had an expiratory
wheeze, indicative of a mild asthma, which shocked me. I've never had
such a thing. He said both it and palps can be triggered by acid
reflux and hiatal hernia.

So I had a breathing treatment and 1 mg Ativan IV. I was scared the
breathing treatment would kick me into SVT since they do speed up the
pulse, but he gave me one that has less tendency to do that plus the
Ativan would counteract that.

Chest Xray normal. EKG normal. Blood work normal, except TSH was
4.17 ( up from 2.7 a couple of weeks ago). Also he said I had
Hypomagnesemia, it was only 1.7 (1.8-2.4). I don't understand that,
since I take some every day. Evidently it's not enough. Or the extra
potassium was creating a mag imbalance.

So I got 2 grams (2,000 mg.) of mag through the IV. Let me tell you,
I felt like a wet noodle after that and felt relaxed for the first
time in a couple of weeks.

Gave me a script for Protonix for reflux and an inhaler if I need it.

So that was how I spent my entire day. A lot of waiting. At least I
took a short nap there.

I need to get this reflux healed, although I've heard that many people
got rid of it just by going on thyroid meds. And I need to take small
doses of mag throughout the day so I don't get the diarrhea.

I'm tired.

Cindy