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In the photo, the carotid artery (red) runs up the neck between the Adam’s apple and the internal jugular vein (blue). This is good to know when you need to do the carotid maneuver. (See the post.)byYou’re in the middle of a disaster or on a long hike, and suddenly you feel a little faint. Or maybe you feel butterflies in your chest.You check your pulse, and it’s going really fast. Since your pulse is an extension of your heart, that means you have a really fast heart rate also.
What do you do?Until you can get medical help:1. Sit down if you can.2.
Check your pulse rate. (See the below.) If it’s going at a speed of 100–110, and it’s at a regular rate (maybe a few skips) you could be just overtired or nervous. Sit or lie there for a few minutes and try to relax. Dehydration, fever, and anemia can cause the heart to beat fast like this also.But If the heart rate is closer to 150 or higher, you’re probably in what we call supraventricular tachycardia (SVT). In SVT, your heart’s electrical system, which controls the heart rate, gets out of kilter. (See the insert about the electrical system below.) This can result in two things.First, when the rate’s that fast, the heart can’t efficiently empty the blood from its chambers. Second, those chambers’ pumping rhythms can get out of sync.
(Normally your atria pump blood to your ventricles, which pump it out milliseconds later. You can hear that when you listen through a stethoscope. Tadump, tadump. That system can get out of whack in SVT.) The Heart’s Electrical SystemNormally the heart rate is triggered at the “sinus,” or “sinoatrial,” node (1). The impulse then travels through the heart, syncing the beats of the four chambers (atria and ventricles). The sinus node knows when to speed up or slow down the rate if it thinks the body needs more or less blood to furnish its needs.Sometimes, for various reasons, the “supraventricular node” (2) can take over.
It will trigger the heart to beat around 150 times per minute (supraventricular tachycardia—SVT). This is an abnormal rate and always too fast.Occasionally, the left ventricle (7) can take over the rate at around 300 beats per minute (ventricular tachycardia—VT). That rate is unsustainable for life. If VT happens, you can try a hard thump with your fist to the middle of the chest, or hope the vagal maneuvers work. Neither method works very often, and if you can’t make it to a medical facility quickly, you’re likely not to survive.(Ignore the other numbers in the picture for our purposes.)Any of this is a big stress on the heart.
Your blood pressure may drop because your heart isn’t pumping blood out as efficiently. If you have underlying heart disease you could have a heart attack.Causes for SVT include thyroid disease, prescription medications, smoking, anxiety, recreational drugs, and a condition called Wolff-Parkinson-White syndrome (a slight electrical system abnormality you’re born with). Often, though, the cause remains unknown.Get The Survival Doctor’s interactive guidebooks. They do an anxious heart good.3. If you think it’s SVT, get your heart rate down.Until you can get medical help there are a few things you can try to kick it back into a normal, safer, more-efficient rate. All of these stimulate your vagus nerve (which has direct connections to your heart) and help control the rhythm.
After each “vagal maneuver,” check the pulse to see if your heart rate has slowed.a. Valsalva maneuver.Hold your breath and bear down in a strain (like if you’re constipated and straining to have a bowel movement). Do this for five seconds, then breathe.
This changes the pressure in your chest and therefore in the big blood vessels in it. That fools your body into thinking your heart should slow down. If the pulse hasn’t slowed, try again. Another way to do the Valsalva maneuver is to stick a finger in your throat and gag yourself.b. Carotid maneuver.Find your carotid pulse (see top photo) just below your jaw.
The vagus nerve runs next to it. Massage very firmly for five seconds. Warning: In rare cases this could knock off a piece of a blood clot lodged in this area and cause a stroke. Don’t do this in elderly people or anyone with a history of a stroke.c.
Ice-water facial.A little odd, I know, but if you have cold water (preferably ice water,) dip your face in it a few seconds. This stimulates your vagus nerve to slow your heart by causing what’s known as the. It’s the same reflex that helps some people survive for a long time under cold water by slowing the body’s metabolism down.Whether or not one of these things works, or your heart rate converts back to normal on its own, get checked by a doc as soon as you can.
SVT can also be prevented with prescriptions medicines.Has anyone ever experienced a fast heart rate? What did you or the medical personnel do? How was it treated, or did it just go away? This is where you find the radial pulse. Always use two fingers to feel for a pulse.
It helps you make sure you’re not mistaking your own pulse in your finger for someone else’s. Check Your NormalGo ahead and check your pulse now.
Yes, right now. If you know where to find it and what a normal pulse feels like, it’s going to be lot easier to check it when it’s abnormal. See the photos (right and top) to locate two of the most common areas.Notice the regular rhythm, speed, and force of your normal pulse. If you have a watch, count the rate for ten seconds and multiply times six for the heart rate per minute. Or check the rate for fifteen seconds and multiply times four.
The normal rate is 60–100 beats per minute. Some athletes may have slower normal rates because their heart pumps blood so efficiently.Then check your pulse without counting to get a feel of what a normal rate is so that if you don’t have a watch when you need it, you can discern when it’s beating way too fast.One trick of estimating the rate is to take it to the beat of the song (or ). Both tunes are at 100 beats per minute.(Subscribe to updates below.)Carotid artery photo by Shannan Muskopf on. Illustration of the heart’s electrical system by J. Heuser, based on an illustration by Patrick J. Lynch, illustrator, and C. Carl Jaffe, MD, cardiologist, Yale University Center for Advanced Instructional Media.
The illustration (only) is licensed under the Creative Commons. James Hubbard is the best-selling author of five books, including his latest, The Survival Doctor's Complete Handbook.
His expertise and down-to-earth style have made him one of the foremost survival medicine experts in the country. Through books; lectures; an online training course; and his popular website, TheSurvivalDoctor.com, Dr. Hubbard shares information about how to deal with medical problems when getting expert care is impossible. His evidence-based tips are a combination of modern medicine, makeshift treatments and Grandma’s home remedies.
Hubbard, This was excellent! As an “old” CV nurse (I have a Master’s in CV nursing from UAB and more than 40 years experience), I found your explanations to be easily understood for the lay person and excellent options when there are no medicines immediately available. I still remember the chest thump we used in the 70’s which frequently converted even V Fib before we could get the defibrillator in the room. I would offer one comment about carotid massage. In my personal experience, patients may feel lightheaded or dizzy during or after carotid massage. In the early 70’s I had several episodes of tachycardia in the 180-250 range which prompted a referral by my doctor to UAB (in those days there was no interventional cardiology being practiced in my city).
While there, being allegedly monitored, I had such an episode. Apparently the monitor techs were not watching, but I knew I was in trouble when I felt the palpitations and was severely orthopneic. Interestingly, when I called the nurse, she kept trying to get me to lie flat and kept telling me (without checking the pulse herself) that I couldn’t be having tachycardia because the monitor tech had not called her.
I, of course, had checked my rate and knew. Finally, I just did a valsalva maneuver and, although it took me three tries, I stopped the tachycardia. The point of the story is that it may take several tries at the valsalva to break the tachycardia. (Mine was later diagnosed as Paroxysmal Atrial Tachycardia, which we now usually call SVT, secondary to MVP with dysautonomia. My thyroid functions then were all normal, but about 8 years later, I experienced more tachycardic episodes and was found to have Graves Disease as the culprit.) Again, thank you for helping folks find options to “treatment” for times when a doctor is not available. Yes, I have experienced SVT several times in the past.
The first time I was in the first trimester of pregnancy. It is very scary, but I was told it is not life threatening. I was treated 4 times in the E.R. With an injection of adenacard (sp). It help almost instantly, but left me with a very strange feeling during the transition back to normal rhythm. This experience occurred several times during this pregnancy, which was my 8th child.
The next pregnancy 2 1/2 yrs. Later the SVT did not occur at all.One maneuver I have found to work as well or better than the ones you mentioned here, is to lie on my side and slowly roll to my back and then the other side. After about 2-5 times of rolling over, my heart returns to its regular pattern and rate. Thanks for the article, unfortunately I can identify with everything you said, and it is very accurate.
I had been sitting in my bed reading, then laid down to go to sleep. When I did, my heart started racing, then beating irregularly. My husband was out of town and we live a ways from the hospital, so I just sat back up and prayed. Went to sleep sitting up. The next morning my mother-in-law, who is a retired nurse, took my pulse and thought I should go to the ER. When I got there, they rushed me right in, tested for all kinds of things, tried everything to even it out, then finally resorted to putting me under anesthesia and using the paddles to shock my heart back to normal. Had a heart cath a few days later, and everything was okay and they said my heart was healthy and strong.
Never could figure out what caused the problem. I am on 3 meds (2 routine; 1 PRN) for SVT, and I am horrified at the thought of this happening without me being able to get to the ER for what is usually 12mg of ADO. I have personally used all of these tactics with some success, but as an RN (18 years), I definitely agree with Laura that you’ve spelled these out wonderfully, and that they can and do work well. I’ve also had patients tell me that they’ve put their wrists in ice water and it has helped.
(This hasn’t worked for me, but I wonder if mine is particularly stubborn.) I very much appreciate your articles and thank you so much for taking the time and effort to share your knowledge with the rest of us. Peace of mind is a priceless commodity, and you dole it out freely.
I have had SVTs since childhood. In my teen years they were considered moments of anxiety or panic even though I did not look or feel panicked. As an adult I was treated for depression and anxiety with medication and it NEVER took care of those episodes of fast heart rate. After about 11 years of treatment.I went to the ER one night and asked for something to slow my heart rate down because I could not sleep due to the “anxiety attack” that was causing it. The nurse said I did not look panicked.I told her I did not feel panicked. As a matter of fact, I stopped to set my VCR before heading out to the hospital. Turns out it was definitely an SVT.
My heart rate was 243bpm.:( I wound up with a cardio ablation a few months later but I still have the episodes of fast heart rate. The ablation did not help. I used to take medication for it but that really did not help and it was jam pack full of side effects. I now take Co enzyme Q10 daily and a few other supplements. What bothers me most is not the mistake that was made in diagnosis but after my family physician found out about this problem after the ER.she tried to get me to continue on “head meds” even though they made me feel awful and depressed and they never kept those episodes of fast heart rate from coming back.
Those meds really effected my behaviour and mood in a way that made me nonfunctional and in a downward spiral. I am now happier (in a normal sort of way) than I had been in years. I knew about the Valsalva maneuver but had never heard about the other two techniques. Thanks for mentioning them. I actually had a doc in Belgium tell me to press as hard as I could on my eyeballs to see if that would stop an SVT. Then he prescribed a “nerve pill”.;) haha.
I am 41 and experienced svt 2 years back and since then doctors have put me on antidepressants drugs, but episodes of fast heart rate keep coming back. Due to these drugs I feel dizzy and without any emotional state sort of mood all the time and it sucks to be like that.It seems that you have come out of this, should I let go of antidepressant drugs and start something else what do you suggest? I know the mentioned maneuver techniques but they work for a little while. I have completely cut down on caffinated drinks as they seem to trigger SVT.
I get more than enough sleep. I had experienced tachycardia (heart rate approx.
220) every 5 or 6 months for about 5 years. None of the techniques mentioned worked for me. Paramedic-administered adenosine (first time it happened) and hospital-administered adenosine (for a later episode) stopped it in seconds but without medical insurance (the hospital billed me $7500 for the ER visit) I decided during later episodes to just sit down, mentally relax, breath deeply and “wait it out”. After around 90 minutes my heart rate seems to spontaneously convert back to normal.
This has happened numerous times over several years. During one episode I tried eating some calcium-based antacid tablets. Although not immediate, they did seem to help my heart rate return to normal after about ten minutes.
It has now been perhaps two years since the last episode. My current “solution” seems to be a) getting enough sleep, and b) avoiding too much caffeine.
I think that my body metabolizes caffeine slowly. A lot of the attacks occurred on the day AFTER I had overindulged in caffeine. In addition, getting enough sleep seems to help my heart get enough rest to perform in a stable fashion. I feel pretty confident that I may have seen the last of the tachycardia.
I’m now 65 years old. My thanks to everyone for sharing their experiences.
We’ve all been there: A website refuses to load, returning a generic “website is not available” or “URL was not found on this server” error instead. Or a website hangs, never loading all the way. Or maybe you’ve been frustrated when trying to access a local application server, leaving you wondering what the problem might be. The question then becomes whether the issue is with the computer, the network, the site that you can’t reach, or with your internet service provider.Troubleshooting connection issues and server down issuesMany variables can cause network issues, often making finding the root cause of problems difficult. But there’s good news: You can use many free network troubleshooting tools to help you identify where the problem is, and what your next steps should be.
Whether you’re a home user with just a couple of devices or an IT professional who manages hundreds of PCs, you can benefit from the following tools:1) Website Down Check: How to see if a website is down or responding slowlyTools like the can help you quickly figure out if any webpage is currently experiencing problems or if the problem is likely with your network. Simply enter the URL to see if everyone else is unable to access the site, or if the problem only affects you.If you want to dig deeper to discover how quickly web servers are responding, the site Isitdownrightnow.com monitors the current status of popular websites such as Outlook.com, Gmail.com, Dropbox.com, YouTube, Facebook, and more. If a site you want to reach isn’t already being tracked by the tool, you can also enter a custom URL to view it’s status. Users can also report website problems they’re experiencing with websites, so you can get better insights into what’s going on with your favorite services.2) Ping: a tool that checks if a server, website, or device is “alive” and respondingPing is a simple, widely-used software utility that checks if you can reach a website or networked device (whether that’s a PC, smartphone, server, or Wi-Fi enabled coffee pot) and measures how long it takes to get a response. Because computer networks are not 100 percent reliable and data delivery isn’t always guaranteed, ping also measures how many data packets get lost on the journey to and back from the device you want to contact. If any of this sounds familiar, it’s because ping is used by sites like “Is it Down Right Now?” and by advanced network monitoring software (which we’ll talk about in a later section) to get data to display in their dashboards.Windows and Linux both come with the ping utility — no application download necessary. To use the tool, simply open a command window then type “ping” followed by the computer name, IP address, or website URL you want to reach (for example “ping google.com”).
Because the application runs on your computer, ping can also be used to check the availability of devices on your local network, which is one major advantage it has over sites such as “Is it down right now?”. Fun fact: The ping tool was named after the sound sonar makes because they both work by sending out a signal, then listening for an echo reply.3) Traceroute: a tool that can help you pinpoint where a connection is brokenThe appropriately named traceroute utility helps you trace and map the route data packets take when they travel from point A to point B. Traceroute is available as a command line utility on most major operating systems (Windows, OSX, Linux). If the tool runs successfully, this commands returns an ordered list of the routers your data passed through on the way to its final destination.If you’re experiencing connectivity issues, the tool can help you locate where in the chain there’s a a problem, and you can debug further from there. While a text-based version of the tool is available on both Linux and Windows (tracert), graphical versions of the tool, such as, can provide more reliable results, visually map out the path packets take, and continuously monitor changes in a route over time.4) Network monitoring software: keep an eye on all your critical devices, websites, and servicesA server can go down for many reasons.
Maybe a physical machine loses power, or perhaps the operating system or network card experiences an issue — many variables can cause a failure. If you’re an IT professional that needs to look after many servers and websites, you have a lot to keep track of.Manually checking dozens of devices and servers constantly is tedious (and the stuff of migraines). If one fails, you might not know until someone frantically bangs on your door. A network monitoring solution provides real-time insights for all of your servers, whether they’re located in-house or you access them through the internet, and can alert you at the first sign of trouble.Network monitoring software can also automate “ping checks” to see if a server, VoIP phone, security camera, or any other device is online and responding. Additionally, your network monitoring tool can display the status of your local and external devices in a customizable dashboard.Additionally, network monitoring software like Spiceworks Monitor utilizes protocols like SNMP, SSH, and WMI to measure (among other things), server CPU, disk, and memory usage, network switch bandwidth utilization, and the performance of individual applications.
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