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Heart Disease (Expert Forum)
Arrhythmia/IST
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
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Arrhythmia/IST
by dande4, Nov 14, 2005 12:00AM
DR.,Thank you for your time.
39yrF w/3 children/on the go!. Recent echo/stress fine. Borderline MVP,trace mr./tr.(tests done yearly or every 2) Episodes of gradual increase/decrease of hr. Chills,teeth chatters. Recently was trying to switch from atenelol to toprol. While changing meds, hr at rest was 90's to 100 and when getting up/walking jumped to 130/140's. Took event monitor,showed sinus tachy.(thought maybe it was due to stopping atenelol and starting toprol) Went back to atenelol after 2 days. History of pac/pvc's. Episodes stated eariler are slow increase to peak then slow decrease. Event monitor placed and pressed during episode shows sinus tachy. Afterwards hr remains in 90's till adrenaline seems to subside.
In absence of structural problems,good echo/stress does this sound like IST? I can't figure the chills and teeth chatters except for adrenaline. Dysautonomia~is IST considered in that category. My cardio is leary to give IST diagnosis, says feels more anxiety/hyperadrenergic though I don't see myself as anxiety giving rise to my rate when I stand. Any reassurance?
Long term prognosis?
Can IST return to normal over time?
Would exercise help to reduce resting rate further even if meds.keep it in 70's/80's?
Would that possibly help to correct the tachy? Could this be POTS,no sig. b/p drop except little systolic 10pts or so.
Looking to get endocrine work/up done,though previous tsh etc., normal.
Thank you once again. Hope this post may help others.
39yrF w/3 children/on the go!. Recent echo/stress fine. Borderline MVP,trace mr./tr.(tests done yearly or every 2) Episodes of gradual increase/decrease of hr. Chills,teeth chatters. Recently was trying to switch from atenelol to toprol. While changing meds, hr at rest was 90's to 100 and when getting up/walking jumped to 130/140's. Took event monitor,showed sinus tachy.(thought maybe it was due to stopping atenelol and starting toprol) Went back to atenelol after 2 days. History of pac/pvc's. Episodes stated eariler are slow increase to peak then slow decrease. Event monitor placed and pressed during episode shows sinus tachy. Afterwards hr remains in 90's till adrenaline seems to subside.
In absence of structural problems,good echo/stress does this sound like IST? I can't figure the chills and teeth chatters except for adrenaline. Dysautonomia~is IST considered in that category. My cardio is leary to give IST diagnosis, says feels more anxiety/hyperadrenergic though I don't see myself as anxiety giving rise to my rate when I stand. Any reassurance?
Long term prognosis?
Can IST return to normal over time?
Would exercise help to reduce resting rate further even if meds.keep it in 70's/80's?
Would that possibly help to correct the tachy? Could this be POTS,no sig. b/p drop except little systolic 10pts or so.
Looking to get endocrine work/up done,though previous tsh etc., normal.
Thank you once again. Hope this post may help others.
Doctor's Answer
by Cleveland Clinic, Nov 14, 2005 12:00AM
, Nov 14, 2005 12:00AM
dande5,
Thanks for the post. IST is a difficult diagnosis to make as it is often difficult to explain the what is abnormal, especially if your heart rate lies on the high end of normal. I would definitely want to see an extended picture of what your heart rate does over the course of a day to more clearly see the trends over long periods of time.
The main concerns of IST is whether the elevated heart rate can cause long term damage to the heart. If you truly had high persistant rates I would be more concerned then if you have elevations with activity. It would also push me to treat you more aggressively. Overall, in all comers, IST has a fairly benign prognosis.
Certainbly conditioning, or lack therof can masquerade as IST. Physical conditioning wil be paramount for your health no matter what your underlying condition is. Better conditioning may also help with a small amount of rate control.
POTS and IST are probably linked and both represent a different subsets of autonomic dysfuction. I would recommend seeking a second opinion with a cardiologist who specializes in autonomic dysfucntion, such as at a syncope clinic before establishin this diagnosis and looking into other treatment options.
good luck
Thanks for the post. IST is a difficult diagnosis to make as it is often difficult to explain the what is abnormal, especially if your heart rate lies on the high end of normal. I would definitely want to see an extended picture of what your heart rate does over the course of a day to more clearly see the trends over long periods of time.
The main concerns of IST is whether the elevated heart rate can cause long term damage to the heart. If you truly had high persistant rates I would be more concerned then if you have elevations with activity. It would also push me to treat you more aggressively. Overall, in all comers, IST has a fairly benign prognosis.
Certainbly conditioning, or lack therof can masquerade as IST. Physical conditioning wil be paramount for your health no matter what your underlying condition is. Better conditioning may also help with a small amount of rate control.
POTS and IST are probably linked and both represent a different subsets of autonomic dysfuction. I would recommend seeking a second opinion with a cardiologist who specializes in autonomic dysfucntion, such as at a syncope clinic before establishin this diagnosis and looking into other treatment options.
good luck
I was at my pcp about another problem, but when I got off the exam table and literally walked 1 or 2 steps I was SOB. He came over and listened to my heart and couldn't believe it. He increased the ccb.
Unfort. I had to go back on the bb, because of another problem it was helping with. I wonder if anybody can ever get off of bb's? I didn't have a problem when I stopped the ccb before.
Class IC antiarrhythmics are strong sodium channel blockers. They also slow nerve impulses in the heart, but have little effect on repolarization. They may be used for supraventricular and some ventricular arrhythmias.
Flecainide (Tambocor®)
Propafenone (Rhythmol®)
Hope you're feeling better.
Following an ablation in 2004 for Wolf Parkinsons, I had fits of PVC's and PAC's, short runs of SVT and NSVT, and some IST. I had shortness of breath after light activities, and pain in my chest that both me and my doctor thought could be heart disease. I didn't know whether I would have an MI, eventually get bad VT's and die, end up with a Pacer, or be limited for the rest of my life in terms of physical activities that I would be unable to do.
After consulting my doctor, I started an exercise program and made diet modifications; both of these "initiatives" were adhered to faithfully everyday almost without fail. I am convinced that my present good health (all symptoms but for occassional blips have subsided, off of Beta Blockers) --- though an incredible blessing for sure --- owes a lot to exercise, and of course to some great medical care I received from my Doctors (and nurses).
Talk to your personal doc before doing it, but as the doc here suggests, get going on exercise. In my case, I just cant say enough about how much all of it helped.
Good luck. -B
or gaviscon had help him rid himself of some of these extra beats? I would like to hear from him again. Would be glad to hear from anyone who suffers from these nasty infractions and perhaps chat about them.
Thank you
Bromley, you changed your diet also? In what way? I have once again started to do my walking routine. I try to eat well, though I do like sweets. I am not overweight, probably a little underweight. I would like to get off this BB one day. Thanks for your input!
Ricky, I have pvc and pac. For several years. Sometimes worse than others. Definately stress, caffiene can aggravate, especially for me. Hang in there.
I am taking Toprol XL 25 mg everyday for IST and mild hypertension. Both problems are well-controlled by BB. I'm planning to travel to Asia next month. I'm worried about what the elevation (especially sudden increase) will do to my HR & BP as I would be basically up in the air for at least 16 hours. Any idea?
Thanks!
The bit about calories is a little easier for me to do when I engage in one of my favorite things to do: long distance running. But running is not for everyone.
Consider --- for this