Question about Non Sustained V-tach in someone with a possible BAV

[Roxx_yer_Soxx]

I was doing so well....I was getting my anxiety under control...then WHAM.... a few days ago, I started thinking about the first time I wore a Holter, it caught a 13 beat run of Non-sustained Vtach. (happened in my sleep at 3:00am...I didn't feel it)

At the time, I was having anxiety/panic issues, and had recently been put on Zoloft..... Cardio took me off Zoloft immediately.

Did a 2nd Holter..... a few PVC's.... but that's all
Did a 3rd Holter 3 months later..... A few PVC's...that's all

The cardio at this point was confident enough to blame the one episode on either my severe anxiety/depression/panic and/or the SSRI Zoloft.

So...At my request.... I had a Echo done..... and the results were:
Right Ventricle - Diastole 2.0
Inter ventricular septum 1.2
Left Ventricle end diastole 4.9
Left Ventricle posterior wall 0.7
Left Ventricle - End slope 1.2mm/sec
MV excursion 2.2
Aortic Root Diameter 3.4
Aortic Root Valve cusp sep 2.5
Left Atrial Dimension 2.5
Fractional shortening 37%
Aortic Valve Max Velocity 1.34 m/sec
Aortic Valve LVOT Velocity .78 m/sec
Mitral Valve E Velocity ,89m/sec
Mitral Valve A Velocity .66m/sec
Tricuspid Valve E Velocity .76m/sec
Tricuspid Valve A Velocity .41 m/sec
Pulmonic Valve .67m/sec

Findings: The left ventricle was normal in size and systolic function with a calculated overall ejection fraction of 66%. Left ventricle wall thickness and wall appeared grossly normal. The right ventricle appeared grossly normal in size and function as well. Both left and right atriums were normal in size. The mitral valve appeared grossly normal. Some views were suggestive of mild systolic prolapse of the anterior mitral valve leaflet. The aortic valve appeared congenially abnormal. It was difficult to distinguish between a congenially bicuspid aortic valve, or a deformed trileaflet with large right and left cornary cusps, and a very small noncoronary cusp. The aortic valve did not demonstrate eccentric closure by M-mode study. The tricuspid and pulmonic valves were not were visualized, but appeared grossly normal. There was no evidence of pericardial effusion. The vena cava and aortic arch were not well-visualized.

Color Flow Doppler- Color Flow Dopper demonstrated trace pulmonic insufficiency. Flow velocity across the aortic valve was normal. There was no evidence of aortic insufficiency. The mitral valve spectral Dopplar study was normal. There was no evidence of pulmonary hypertension.





My cardio wants a Echo done every year...but says there is nothing here that concerns him, and whether I have a BAV, or a malformed Tricuspid, he said it's functioning fine.

He says "any PVC's or short runs of NSVT that you may have are more annoying than anything....I see nothing here life threatening, or that needs treated at this time."

He says Non-Sustained Vtach is benign within a structurally normal heart without disease.

My question is: But does that describe me???

If I have a BAV..... even if working fine, with no stenosis or regurgitation..... wouldn't this technically mean I have heart disease?

And if so.... wouldn't that mean that my one run of NSVT could possible point to a more serious issue??

I am doing everything I can not to let this consume me like it did for 6 straight months.

Thanks for all your advice.

 

[tobagotwo]

Some thoughts...

Most people with a BAV go through life without ever knowing it. It can be a signal that other things are wrong, but it usually isn't. Yours was found basically by accident. My guess is that it would be just as good to have an echo every other year, because if it were to develop a problem, it would be years in the making. But that's between you and your doctor.

No, I wouldn't consider your fully functional, possibly BAV as heart disease. If there's nothing else structurally concerning to go with it, and it's not misbehaving (and it isn't), then it's like a chin dimple: some people have it, some don't. Unless there is heart damage from insuffciency or stenosis (and there isn't), like an enlarged (hypertrophic) ventricle, it wouldn't have an effect on your heart rhythm.

Note: the tech should look up the difference between congenial and congenital.

Best wishes,

 

[Bina]

I had occasional runs of SVT and/or benign palpitations that started 25 years ago, baseline echo was done.
It was many years before any symptoms developed, and then echo tests were done annually.

 

[debster913]

My cardio wants a Echo done every year...but says there is nothing here that concerns him, and whether I have a BAV, or a malformed Tricuspid, he said it's functioning fine.

He says "any PVC's or short runs of NSVT that you may have are more annoying than anything....I see nothing here life threatening, or that needs treated at this time."

He says Non-Sustained Vtach is benign within a structurally normal heart without disease.

My question is: But does that describe me???

If I have a BAV..... even if working fine, with no stenosis or regurgitation..... wouldn't this technically mean I have heart disease?

And if so.... wouldn't that mean that my one run of NSVT could possible point to a more serious issue??

I am doing everything I can not to let this consume me like it did for 6 straight months.

Thanks for all your advice.

While I don't have BAV (I had surgery to repair my mitral valve), I can understand your concern about the heart rhythm issues. For the most part, NSVT is not dangerous, because the run of V-Tach is not long enough (30 seconds or less) to cause your heart to go haywire. It's sustained VT that is dangerous. In my experience, I had NSVT most of my life; I even had an EP study in early 2006 to diagnose that my arrhythmia was indeed NSVT after my cardio had noted the arrhythmia during a 30-day stint with an event monitor. Later, though, I did develop slow-sustained VT as a result of my valve surgery (which was discovered during another EP study), and I had an ablation in December 2008. (I also recently developed A-Fib, also a result of the healing process post-op).

PVCs, also, are fairly harmless, as my cardio has also explained to me. My electrophysiologists ablated most of the PVCs during my ablation, and now I feel fewer PVCs. The only time they bother me is when I'm tired, stressed, or hopped up on caffeine.

If you still feel unsettled about your arrhythmia issues, you might want to consult with an electrophysiologist. In my case, my PVCs had gotten so out of control and unmanaged with even the best beta-blockers that my cardio referred me to an EP doctor; it was then, during my ablation for the PVCs that the doctors discovered the SSVT and got rid of that.

Hope this helps!

Best,
Debi (debster913)

 

[tcopel]

Just to ditto what Debi says about the possiblility of seeing a electophysiologist who specialize in arrhythmias. Similiar to your experiences and other above, I have frequent PVC's (sometimes bigeminy), occassional runs of SVT and a single episode of Torsades. I have been reassured by EPS that my heart structure is sound and that it is not life threatning, simply an annoying thing that I put up with daily. Still, it is unnerving at times and I understand you sensitivity to it. An EPS cardoilogist may help alliveate some concerns.

 

[Duff Man]

Interesting thread. I went from having a few PVCs a day to having zero PVCs and several short runs of v-tach a day. I think it's quite the coincidence that I too was on an antidepressant for an extended period of time when it started happening. I would rather have the PVCs back considering stuff like torsades can happen with v-tach. I wonder if I'll ever go back to just having PVCs.

PS, my cardiologist told me that it's no problem too. I think I disagree, since my uncle died of an arrhythmia at 50ish... but what am I going to do about it?