Question: My wife regularly suffers from palpitations. The GP diagnosed supraventricular tachycardia (SVT) and prescribed beta blockers. But are there drug-free steps she can take instead? She’s only 34.
Mike Ruane, Scunthorpe, North Lincs.
Supraventricular tachycardia occurs because of a problem with the heart’s electrical conduction system
Dr. Martin Scurr replies: Supraventricular tachycardia is when you feel like your heart is suddenly racing. But rest assured that it is quite common (affecting around one in 400 people) and very rarely life-threatening.
It occurs because of a problem with the heart’s electrical conduction system, which causes it to suddenly beat faster and without warning.
Some people also experience light-headedness or fatigue. These episodes can last a few seconds or several hours.
Beta blockers can help correct the abnormal rhythm and are effective, safe medications, but, like all medications, they can have side effects, and your wife may be reluctant to take them.
She may want to consider avoiding stimulants that can affect her heart rate, including caffeine (meaning tea, coffee, or too much chocolate), alcohol, and tobacco.
In your longer letter you say that your wife is experiencing significant 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, which can sometimes even cause SVT.
And there are things you can try if her heart is racing.
One of these is to dip her face in a tub of cold water; this stimulates the vagus nerve, an important nerve that runs from the base of the head to the abdomen and plays a role in a number of functions, including heart rate. Doing this can successfully end an attack of SVT. A sip or two of ice-cold water can have the same effect.
You also mention that she keeps track of these episodes. This will prove helpful if her GP refers her to a cardiologist.
I’m afraid my skin cancer will come back for the third time
Question: Seven years ago I was diagnosed with skin cancer (basal cell carcinoma) on my right arm. It was scaly, bright pink, and measured one inch square.
I was prescribed a cream for it and it eventually disappeared. It recently reappeared – I used the cream and it disappeared again. I’m afraid it will come back.
Cynthia Tipples, Penarth, Wales.
Dr. Martin Scurr replies: Basal cell carcinoma (BCC) is the most common skin cancer; it is estimated to affect up to 10 percent of us at any given time.
Although this type of cancer is relatively unlikely to spread elsewhere in the body, it is locally invasive and aggressive. Left untreated, it can burrow deeply and damage underlying tissues.
Once you have been diagnosed with BCC, you will need check-ups (perhaps every one to two years), paying particular attention to all sun-exposed areas of the body.
The good news is that proper treatment, which depends on the BCC, should lead to a cure. The first-line treatment is a cream containing fluorouracil (a chemotherapy drug) or imiquimod (also used for warts).
This type of treatment is non-invasive and avoids scarring. Other possible treatments include radiotherapy, curettage (scraping away the cancer) under local anesthesia and cryotherapy (freezing).
If neither is considered appropriate, the lesion can be surgically removed (requiring a deeper excision) under local anesthesia.
But it is clear that topical treatment has not worked for you, indicating that your BCC will need to be surgically removed.
This will leave a scar, but your BCC will be gone for good. I would request a referral to a surgical dermatologist for this.
- Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk
- Dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context. If you have health problems, consult your own doctor.