What can my wife, 34, do about her racing heart?

Q MY WIFE has been experiencing frequent heart palpitations. The GP has 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.

A SUPRAVENTRICULAR tachycardia is when you feel like your heart is suddenly racing. But rest assured it is quite common — affecting around one in 400 people — and it’s very rare for it to be life-threatening.

It occurs because of a problem with the electrical conduction system of the heart that makes it 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 to correct the abnormal rhythm and are effective, safe drugs — but like all medicine, can have sideeffects, and at her age your wife may be reluctant to take them.

She may want to consider avoiding stimulants that could affect her heart rate — including caffeine (which means tea, coffee or too much chocolate), alcohol and any tobacco.

In your longer letter you say your wife is dealing with considerable stress. It’s hard to be certain whether this is a factor, but regular relaxation may help. At this point it’s best to avoid rigorous exercise which can sometimes actually trigger SVT.

And there are things to try when her heart does race.

One is to dip her face into a basin of cold water; this stimulates the vagus nerve, a major nerve that runs from the base of the head to the abdomen, which has a role in a number of functions including the heart rate. Doing this can successfully terminate an attack of SVT. A gulp or two of ice-cold water may have the same effect.

You also mention she is keeping a record of these episodes. This will prove useful if her GP refers her to a cardiologist.

Q SEVEN years ago I was diagnosed with skin cancer (a 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 eventually it disappeared. It recently reappeared — I used the cream and it went away again. I worry it may return.

Cynthia Tipples, Penarth, Wales.

A BASAL cell carcinoma (BCC) is the most common skin cancer — estimated to affect up to 10 per cent of us at some point.

Although this type of cancer is relatively unlikely to spread elsewhere in the body, it is locally invasive and aggressive. Untreated, it can burrow deeply, damaging underlying tissues.

Once you’ve been diagnosed with a BCC, you will need checkups (perhaps every one to two years), paying particular attention to all sunshine-exposed areas of the body.

The good news is the right 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 noninvasive and avoids scarring. Other possible treatments are radiotherapy, curettage (scraping off the cancer) under local anaesthetic, and cryotherapy (freezing).

If none of these is thought suitable, the lesion can be removed surgically (involving a deeper excision) under local anaesthetic.

But it’s clear that topical treatment has not worked for you, which suggests your BCC needs to be surgically removed.

This will leave a scar but your BCC will be permanently gone. I’d ask for a referral to a surgical dermatologist for this.