Just received this letter from the cardiologist.
I’m very confused.
Are they saying that 46 episodes of tachycardia in 30 hours is normal and should not give me any symptoms?
Feeling very dejected and not listened to right now.
Luckily I have a fantastic GP who keeps pushing for me, but I feel like the cardiologist is brushing me off. 😞
No, they are not saying it's normal, they are saying that there where no cardiac dysrhythmias seen during them, the last statement sums it up "However her symptoms may well not be cardiac in origin".
It doesn't seem to me that he/she is 'brushing' you off, they are saying they will organise an ECG for reassurance!
If it is not heart related then your GP will need to reassess.
Thank you. I’m just confused as all my symptoms correlate with tachycardia according to the nhs website. Palpitations
Lightheaded
Chest pain
Nausea
So surely it’s the tachycardia causing my symptoms which is cardiac in origin?
I am not a medic, but I would say that it depends on what is causing the tachycardia, if it isn't the heart that is causing it, then the cardiologist is probably not the best person to investigate further.
Hence why i said the GP would need to reassess the best course of action.
Oh I see, so they are saying the tachycardia may not be caused by a cardiac issue.Thank you. I misunderstood it that they were saying my symptoms were not related to tachycardia.
Always good to get a second pair of eyes to read these things!
Thanks
For your own peace of mind, I would suggest that you call your GP and ask for a telephone consult to discuss the results, they can confirm exactly what is meant.
There are lots of reasons Which can account for your fast heartbeat.Some are cardiac in origin like atrial fibrillation where there are irregular electrical impulses in the upper chambers of the heart leading to erratic fast heartbeat.
Tachycardia can also be caused by things outside the heart. Like overactive thyroid .
I think the cardiologist is suggesting that the cause may be outside of the heart
Thank you. Bloods were all normal range
The word tachycardia literally just means a heart rate above 100bpm, it doesn’t imply that there’s anything wrong in and of itself, because there are times when we would expect someone to be tachycardic. Sinus tachycardia is generally that ‘normal’ tachycardia: when we do something that should elevate the heart rate, and where there’s no abnormality in the electrical signals from the heart at the same time (arrhythmia) then this would be considered appropriate sinus tachycardia. This list isn’t exhaustive, but things that would be expected to elevate the heart rate are movement and physical activity, emotional state (fear, stress, intense joy), chemical stimulants like caffeine, nicotine, and some medications (antihistamines, asthma inhalers, and a few others). It would be entirely possible for someone to have 46 bouts of normal, appropriate sinus tachycardia in their day, depending on what they were doing and what was going on around them. You can also have inappropriate sinus tachycardia, though, where the heart rate elevates beyond what one would expect, either for no reason at all, or as an exaggerated response to something that should elevate it, but there’s no underlying arrhythmia. However, getting diagnosed with this when you have an average hr of less than 100bpm is extremely difficult, despite the fact that it’s medically accepted that you can still have IST with an average in the 80s or 90s if the issue is an exaggerated response. My resting hr is high 50s, and I drop to the 30s over night, but literally lifting my hand and scratching my head bumps it 30 beats. Getting up and walking across the room I hit 120. Exercising, I easily exceed my maximum ‘safe’ hr to hit 180 bpm, and that’s in spite of taking medication to lower my heart rate as the result of also having an underlying arrhythmia. Those kinds of rapid, overly high and unnecessary elevations would be typical of someone with IST. I’m not saying that’s what’s happening with you, just trying to offer some information on sinus tachycardia more generally.
I read the letter to mean that they’re going to do the echo for the sake of completeness, but that they believe the symptoms around your tachycardia, and perhaps the tachycardia itself, are not cardiac in origin - it could be being triggered by something else potentially physiological unrelated to your heart as others have suggested. Whilst I hate the anxiety excuse, particularly when I have experience of things being inappropriately dismissed using it, it is also worth saying that the human mind is extraordinary, and stress and anxiety can cause a spectacular array of genuinely physical manifestations, including what you’re experiencing. But in any event, the holter picked up nothing cardiac to explain your symptoms.
Thank you, I guess I’m just fed up with feeling so unwell and frustrated that there doesn’t seem to be a simple answer. Beta blockers are helping somewhat, but not entirely. Bloods were all considered normal range.
I’ve learnt over the last 15 years that what we actually know and understand about the human body, truly understand, is very little. Those scant ectopic beats on your holter? For some people, like myself, when frequent they’re the trigger for specific forms of arrhythmia, and although we know enough about them to determine when they’re a problem in and of themselves (usually if you’re having several thousand a day or runs of ventricular ectopics), we don’t actually know how or why they happen. Because they’re not generally a problem, even when they trigger arrhythmia for a person, very little research goes into understanding them, or coming up with a reliable treatment for them for those who don’t meet the criteria for the one really good treatment option available. Even if someone is diagnosed with IST, the treatment is generally beta blockers, in part because we just don’t understand what causes that, either. I take a calcium channel blocker as an alternative to beta blockers, because beta blockers are also the first line for trying to limit ectopics, and still have the same degree of reactive/inappropriate tachycardia as I do without taking it.
Having had lots of medical problems myself, and a daughter with complex needs who always does things her own way medically, I completely appreciate how frustrating and disheartening it all is. I hope you eventually get an answer, but unfortunately there are times where - due to an absence of human knowledge of how the body works - as long as we can be confident there’s no serious issue being missed, we do sometimes have to accept that the medics don’t know.
I would ask for a tilt table test to check for postural tachycardia syndrome. The PoTS UK website has a lot of very good information and a page you can print out and give to your GP. They also have a list of consultants/hospitals which diagnose and look after PoTS patients.
24 hour holter and Echo results advice 
Please Help, Results CT scan
Holter monitor referral. H
ECG after Holter monitor
