If you’ve read my trail journals, you know I encountered a fairly scary health issue in 2022. I was on an 8-day hiking and climbing expedition in Wyoming’s Wind Driver Range. We’d summited the highest mountain in the state – Gannett Peak at 13,810′ – just a few days earlier and were on our way back to the trailhead. I’d enjoyed a wonderful morning of hiking before sitting down for lunch on some flat rocks. But when I got up to resume our afternoon’s miles, my heart started racing and I got very light-headed.
At first I thought this was one of those momentary head rushes you get if you stand up too quickly and your blood pressure drops. But then other symptoms began to appear too, and I began to wonder if I was having an allergic reaction to something around me. (A team of hikers with llamas had just passed our lunch spot. Could it be that? But who’s allergic to llamas?) Or maybe it was just a side effect of the high elevation.
None of these possible causes were the real culprit though.
As I tried to hike uphill for the next hour, I absolutely struggled. I wasn’t in any physical pain, but my heart was beating at a ridiculously fast pace nonstop. I had absolutely no energy at all, and I had to stop after every 10 steps to catch my breath. What’s more, my lips felt numb and tingly. I’d gone from my normal, strong hiking mode to feeling like I’d sprinted a marathon and I was utterly exhausted and weak.
None of my symptoms made any sense after my long lunch break. But they symptoms never subsided. When I struggled my way into camp a few hours later, my heart rate was racing at a ridiculous 160 beats per minute (max heart rate as 48 year old woman is roughly 172 bpm).
After 10 minutes of sitting down with my pack off, my heart rate dropped slightly. But it was still 140 bpm – or 80% my max heart rate. That is the heart rate you’d expect to see for someone who’s out doing a vigorous jog. Not someone laying flat on their back doing nothing. And my heart continued beating at that rapid rate for the next two hours, even though the only physical activity I was doing was breathing.
Then just as quickly as the episode began, it seemed to magically resolve. My heart rate dropped down to 88 bpm. This pace was still a little high compared to my normal resting heart rate of 55-65 bpm, but it was much closer to the realm of “normal.”
A repeat event
When this cardiac episode happened, I had no clue what was going on. It was so odd. Nothing seemed to have triggered it. At least not as far as I could tell. And nothing like this had happened to me before while I was out backpacking.
Except that it had.…
I didn’t put the signs together in that moment, but I’d had at least one prior event that I’d attributed to a different cause. About 10 months prior, something similar happened while I was hiking the Timberline Trail. My pulse started racing after a creek crossing, and then major fatigue and weakness came over me during the final 7 miles of my hike. No matter what I did – resting, eating protein, eating sugar, drinking water – nothing seemed to resolve the situation.
I was so exhausted during those few hours that I wondered if I would even make it back to the trailhead. I’d been hiking along just fine all morning, then I stopped to take a break near the creek and *BOOM* my heart was racing unnaturally and all my energy disappeared. It was the weirdest thing.
I still felt horrible when I arrived back at the trailhead, but I drove myself to a little burger shop and had a hot meal and some super salty French fries – and then I suddenly had my energy back. Consequently, I chalked this weird episode up to hunger or maybe hyponatremia, which occurs when your sodium and electrolyte levels get too low. There was nothing to worry about.
Back Home
About one week after my heart arrhythmia on my Wyoming trek, I was back home in Oregon again. I’d just come back from the grocery store one afternoon when my sister called, and I began multi-tasking. I continued to talk to her while I carried several bags of heavy groceries in from the car, and my heart started racing.
Jeez, I thought to myself. How heavy had I packed those grocery bags to get my heart rate going like that? I continued unpacking my groceries and putting them away as I talked on the phone. But afterward, I had to sit down. My heart was really beating a mile a minute.
When our phone call ended, my heart was still racing out of control. And it continued to feel like it was beating right out of my chest for the next 45 minutes – even as I sat at the kitchen table doing nothing physical. That’s when I made a decision. I was going to the ER. I didn’t want to be an alarmist, but this just wasn’t normal.
When I told the ER nurse my symptoms, she immediately whisked me back to a screening room and hooked an EKG up to my chest. She probably thought I was having a heart attack right there in front of her.
But it turns out I wasn’t having a heart attack. As soon as the ER doctor saw my EKG results, he knew the culprit behind my symptoms. The reason my heart was currently beating at 156 bpm in the ER was due to supraventricular tachycardia (or SVT).
In laymen’s terms, the sinus node in my heart was misfiring and causing an electrical malfunction. Whenever this occurred, my heart would get into a weird feedback loop and start beating irregularly fast. SVT is not generally life-threatening, but frequent or prolonged episodes – like the ones I was having – could weaken my heart especially if had any other underlying conditions.
I’d later learn from the doctor that my SVT was a congenital issue. It was not a result of anything I’d done (or failed to do). And I’d probably had many of these episodes during my life, but they ended quickly and naturally.
We went over some non-invasive ways to help my heart resolve an SVT episode on it’s own – like roughly massaging my carotid artery in my neck or bearing down like having a bowel movement to impact the vagal nerve. In unusual cases where though, the medical staff has to use the paddles to electrically shock the patient and restart their normal heart rhythm- similar to what they do when a person’s heart stops entirely in the ER!
We wouldn’t have to utilize this most extreme treatment that day, because the vagal technique worked. But I did leave the ER that afternoon with a referral to my local cardiologist to discuss the next steps in my heart health.
TREATMENT
There are many different circumstances surrounding SVT patients, so there is no right or wrong way to treat the condition. Some people have brief arrhythmia episodes that only last a few seconds, while others could have prolonged episodes (like mine) that lasted for hours. Some folks have episodes that rarely occur, while others have SVT episodes with alarming regularity. And there are no specific triggers you can avoid.
After seeing my cardiologist, he provided me with the three most common treatment options:
- Do nothing at all;
- Use medication to control your heart rate; or
- Undergo a surgical procedure called a cardiac ablation
Based on how long my SVT episodes were lasting and where they seemed to be were occurring (in the backcountry, miles from medical assistance), I made the decision to go with the ablation procedure, and I scheduled it for early December 2022.
During this one-day procedure, I was lightly sedated, but still conscious, while the cardiologist inserted multiple catheters into the blood vessels in my groin and fed them to my heart. Then he used the electrodes to send my heart into an SVT episode so he could pinpoint the exact area causing the arrhythmia. Over the next few hours he would use both heat (radio frequency energy) and extreme cold (cryoablation) to ablate the abnormal heart tissue and prevent my heart’s electrical system from misfiring into a SVT episode.
All told, my procedure took about four hours in the OR, plus another four hours in the recovery room. And then I had about seven days of recovery at home. But it worked! I haven’t had an SVT episode since the ablation, and I didn’t have to worry about an lengthy arrhythmia during my climbs of Mt. Rainier (Washington’s highest peak) or Granite Peak (Montana’s high point) .
FINAL THOUGHTS
I’ve met other hikers who’ve also been diagnosed with SVT, and some of them have chosen to manage their episodes using the other methods. However, given my outdoor lifestyle and other personal factors, I’m 100% happy that I went with the surgical route.
My biggest regret in the entire process was that it took me so long to realize what was going on with my body. I have a tendency to ignore aches and pains. I’ll hike through blister agony and muscle soreness. And I always seemed to always write off my racing heartbeat to a tough climb or not being in peak physical shape.
In hindsight though, I was my own worst enemy. I really should have made an appointment with my doctor after my Timberline Trail incident. I shouldn’t have tried to self-diagnose the issue or ignore it. The consequences of the having an untreated heart condition in the backcountry could have resulted in a far worse outcome.
And so, despite being an introvert who doesn’t want to post many personal details on the internet, I’m sharing this cautionary tale. If you find yourself having similar symptoms, please contact your doctor and get their advice. Don’t ignore it or push it to the back burner. Your health is the most important thing you will pack for any future backpacking trip.
