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Hi there! So I recently had an echo and a 48 hour holter monitor. I was told today that my echo was normal but that it was taking awhile to analyze my monitor results. My question is, is it possible to have a normal echo but still have something show up on the holter (such as an arrhythmia)? Thanks for any input :-)

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Hi. Yes. An echo is just a picture of what your heart is doing for a very small period of time (a minute or so.) If your heart rhythm is affected by activity, posture, stress, etc., it is more likely to be caught on a Holter because it is tracking the rhythm over a much longer period of time and during various circumstances. Also, keep in mind that it still only shows what happened for those two days. I have clean echos and my Holter didn't show anything either, but, two tilt table tests definitely show I have POTS. Feel better.

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An echo is done primarily for the purpose of checking the structure and integrity of your heart. It will alert them to any valve issues, congenital defects, and gives a good estimate of your ejection fraction (how much blood your heart is able to pump out). A holter monitor is looking at the electrical signals your heart is putting out--your rhythm. The holter monitor is what will show tachycardia and any other arrhythmias. As was already mentioned, it is better to wear one for a while (get a month long one if possible).

Many people with dysautonomia have normal echo's but abnormal ECG's. Some people with dysautonomia are also found to have MVP, which would be seen in an echo. They are really both useful and necessary tests.

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An echocardiogram is a sort of a picture of your heart - measures sizes of chambers, ejection fractions, wall thicknesses, valves, it pretty much gives a detailed pic regarding the structure of your heart. A holter monitor is like a 48 hour electrocardiogram - it monitors the electrical activity of your heart. This is how doctors can figure out any abnormalities in the heart rhythm/rate - arrhythmias. Some arrhythmias are nothing to be worried about - for example I've been told I have sinus tachycardia. That means that my heart rate was higher than "normal" when the test was performed, but otherwise everything is fine. Also my Holter showed some minor ectopic beats (sort of out of sinc beats) which again are normal in most people.

I've had a 24 h Holter, as well as a loop monitor that I wore for a month (similar to a holter, only it records when you want it to record - like during episodes of tachycardia, or chest pain you should press a button, and the monitor records an electrocardiogram for that particular "event"), I also had 2 echocardiograms (5 months apart) and they all came back perfectly normal, except for isolated episodes of sinus tachycardia.

I hope this helps.

Alex

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