PSVT during exercise--very frustrating!

hi,

i am a 27 yo f with no family history of heart disease. i am essentially healthy although i was told as a child i had an "innocent" heart murmur. i could stand to lose about 10 lbs but i have never been grossly overweight or had any health issues associated with being overweight. in an attempt to lose said 10 lbs, i have been visiting the gym on frequent occasions throughout the week. i even signed myself up for "bootcamp" during the month of july. while i was attending bootcamp, i began to have shortness of breath when i ran. then, i developed pain that started in the center of my chest and veered right about halfway down. i went to see my doctor and one chest x ray (showing mild scoliosis...bonus, i guess?), a spirometry and an ekg later i walked out of the office with an inhaler and a diagnosis of pleurisy. after searching the internet over, i realized that my symptoms did not fit this diagnosis (and neither did his prescribed treatment for that matter...). i think my doctor was working off the information that i had spent a couple weeks in thailand a few months prior and came back with a nagging dry cough that did not clear up for about 2 months. armed with this and negative tests, he simply threw a wastebasket diagnosis at me and sent me on my way.

fast forward to early october...in an effort to progress in my running, i began pushing myself pretty hard on the treadmills. i would warm up doing a jog for 10 mins, followed by a one minute sprint. then i would go on about my weights routine then return to the treadmills for cardio. i can only run for about 10 minutes before i am completely winded and beet red in the face. even after a month of boot camp (extremely intense training), and consistent cardio workouts since, i simply can not progress beyond that wall. after my alotted 10 minutes on the treadmills, where i just kept pushing myself day after day thinking eventually my body will get better at this, i would go to the bikes and finish my cardio there. while i am on the bikes i am able to continuously monitor my heart rate. once i get on the bikes, my heart rate is usually pretty high from my treadmill run, like 160's. one day, out of nowhere i began having episodes of a heart rate over 200bpm. i thought it was an error because of my pedaling causing a vibration or something intefering with the reading. i stopped and took my pulse and it was indeed quite high. this happened 3 times on this particular day.

i happened to have a doctors appointment already scheduled so when i got there i made sure to mention these episodes to him. he scheduled me for a holter monitor but did not place any exercise restrictions on me. he also repeated my EKG which showed sinus bradycardia and sinus arrhythmia--in other words a completely normal and appropriate ekg for someone my age. i work as a telemetry tech, so after i had these episodes i went to work and hooked myself up to a monitor for my 12 hour shift. it also showed sinus bradycardia and arrhythmia. in fact, while sitting my heartrate was usually in the 40's and in the 50's while standing. i had not a single pvc, pac, or episode of svt while i monitored myself. but i also was not exercising. i am having the holter put on this coming monday and i will be heading to the gym to hopefully reproduce on the monitor what has been going on for some time now.

i am just wondering what my options are if the monitor does show psvt while i am exercising. clearly, this out of control heart rate is contributing to my inability to progress in endurance. just tonight i was on the bikes and again had episodes of psvt while on the bike. on my 10 minute warm-up on the treadmill, of which i only spent 7 minutes actually jogging and did no sprint at the end my heart rate was already 170. and i am not even pushing hard anymore due to these heart rate issues--i jog at 4mph. its just really frustrating to me to not be able to run or even ride a bike with my friends without being completely winded. starting in january, a bike will be a common mode of transportation for me, so i really need to figure out how i can be physically active without ending up short of breath or even worse, passing out from my heart rate being out of control. tonight my heart rate lingered a little too long at 188 while on the bikes which definitely reaffirms for me my need to have the holter monitor done. could my "innocent" heart murmur not be so innocent after all? is there anything i can do besides give up exercising to control this? what do you think will be the doctors recommendation after the holter? ablation? medications (yuck)? nothing?

Dear AuntieSocial

That was a long post so I am going to hit the high spots ok :)

Rules of using work out equipment at the gym, you have shortness of breath or chest pain, you stop the activity and rest.  If you feel ok, you can push yourself a little harder but never when you are having symptoms.

You posted "sinus arrhythmia" your EKG showed a sinus arrythmia, what was it?

Sinus arrhythmia is the variation in the spontaneous rate of the sinus node, resulting in variation of heart rate. Is this what your EKG showed.

If the Holter Monitor captures a SVT and you have sx I.E.  your heartrate is 200 BPM please stop the exercise.

As far as treatment many people with SVT are controlled by meds alone.  My best advice, stay in contact with your physician or find a good cardiologist.

Take care.

Kitt