11 November 2013

Supraventricular Tachycardia

Skipping Rope at La Granja by Joaquín Sorolla, 1907

When I was little and played games that involved a lot of running or jumping, I was always a little afraid that my heart would start to pound too hard. Most of the time when I would play these kinds of games, my heart would beat what I considered to be "normal fast"--the kind of fast heart rate that comes naturally from exercise, and gradually returns to normal with rest. But sometimes this "normal fast" heart beat would turn into something I called "hard fast" if I came down too hard after a jump or jerked to a sudden stop during a run. This heart rate was fast and pounding, and would continue just as strongly even if I stopped and rested. When it did stop, it stopped all of a sudden, like a switch had been turned off.

It didn't occur to me at the age of eight or so that what I was experiencing wasn't normal. Because of this, I never talked about my "hard fast" heart rate with anybody and simply came up with ways to deal with it on my own, like taking a deep breath and holding it for a moment. But when I was eleven years old, my mother talked with me and my sister about having mitral valve prolapse, a heart condition that can cause abnormal heart rhythms. After hearing about my mother's heart condition, I started to talk with her about my "hard fast" heart rate, and she made an appointment to see a specialist.

About six months and three different models of heart monitors later, I got a diagnosis of supraventricular tachycardia. I was born with abnormal electrical pathways in my heart that can cause sudden episodes of rapid heart rate, as fast as 270 beats per minute. My particular kind of SVT, AV nodal reentrant tachycardia, starts and stops suddenly and often begins with a drop in blood pressure that causes dizziness and visual blackouts.

My SVT is not dangerous, and over the years I've learned how to avoid episode triggers and manage episodes when they start. I've discovered that, in addition to certain kinds of movement, my episodes are triggered by caffeine, chocolate, licorice, ginger, heat, and the hiccups. I've also learned tricks to stimulate the vagus nerve, which returns my heart rate to normal. Holding a deep breath, which I hit upon accidentally as a child, is one such trick, but even better for me is a cold cloth on the back of my neck.

Still, having SVT does make things a little harder for me. I can't drive because my sudden episodes can cause visual blackouts that would be extremely dangerous to have while operating a vehicle. I can't pull all-nighters for college because the lack of sleep and the caffeine usually used to compensate for it are both triggers, and I have to muddle through colds with just Tylenol, vitamin C, and zinc lozenges because decongestants can trigger arrhythmias. But these are only inconveniences, and I'm happy that my heart problems are no worse than inconvenient!

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