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Q: My wife has been experiencing frequent palpitations. The primary care physician diagnosed supraventricular tachycardia (SVT) and prescribed beta-blockers. But are there drug-free measures she can take instead? She is only 34 years old.
Mike Ruane, Scunthorpe, North Lincs.
Supraventricular tachycardia occurs due to a problem with the heart’s electrical conduction system.
Dr Martin Scurr responds: Supraventricular tachycardia occurs when you feel your heart speed up suddenly. But rest assured, it is quite common (affecting approximately one in 400 people) and very rarely life-threatening.
It occurs due to a problem with the heart’s electrical conduction system that causes it to beat faster suddenly and without warning.
Some people also experience dizziness or fatigue. These episodes can last a few seconds or several hours.
Beta blockers can help correct the abnormal rhythm and are effective and safe medications, but like all medications, they can have side effects and your wife may be reluctant to take them.
You may want to consider avoiding stimulants that can affect your heart rate, including caffeine (meaning tea, coffee, or too much chocolate), alcohol, and tobacco.
In your longer letter you say that your wife is suffering considerable stress. It’s hard to be sure if this is a factor, but regular relaxation can help. At this point, it is best to avoid rigorous exercise that can sometimes trigger SVT.
And there are things you can try when your heart races.
One is to submerge your face in a bowl of cold water; This stimulates the vagus nerve, an important nerve that runs from the base of the head to the abdomen, which plays a role in a number of functions, including heart rate. Doing this can successfully end an SVT attack. A drink or two of ice water can have the same effect.
She also mentions that she keeps a record of these episodes. This will be helpful if her primary care doctor refers her to a cardiologist.
I’m afraid my skin cancer will come back for the third time.
Q: Seven years ago I was diagnosed with skin cancer (basal cell carcinoma) on my right arm. It was scaly, bright pink, and measured an inch square.
They prescribed me a cream and it eventually disappeared. It recently reappeared – I used the cream and it disappeared again. I’m worried she might come back.
Cynthia Tipples, Penarth, Wales.
Dr Martin Scurr responds: Basal cell carcinoma (BCC) is the most common skin cancer and is estimated to affect up to 10 percent of us at some point.
Although this type of cancer is relatively unlikely to spread to other parts of the body, it is locally invasive and aggressive. If left untreated, it can burrow deeply and damage underlying tissues.
Once you have been diagnosed with BCC, you will need checkups (perhaps every one to two years), paying special attention to all areas of the body exposed to the sun.
The good news is that proper treatment, which depends on the BCC, should lead to a cure. The first-line treatment is a cream with fluorouracil (a chemotherapy drug) or imiquimod (also used for warts).
This type of treatment is non-invasive and prevents scars. Other possible treatments include radiation therapy, curettage (scraping off the cancer) with local anesthesia, and cryotherapy (freezing).
If none of these are considered suitable, the lesion can be removed surgically (which involves a deeper excision) under local anesthesia.
But it is clear that topical treatment has not worked for you, suggesting that your BCC should be removed surgically.
This will leave a scar but your BCC will be gone permanently. For this I would request a referral to a surgical dermatologist.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk
- Dr. Scurr cannot correspond personally. Answers should be taken in a general context. Consult your family doctor if you have any health problem.
