Blackout whilst running

[RunMartin]

Not a good weekend. Last week I had a virus\cold and two weeks ago I ran a hilly marathon which I found very hard work. On Saturday I started a Parkrun (3 mile run) and I knew from the start that the virus was still active as breathing was wheezy. After a mile I felt a little unwell so I pulled over to the grass and the next thing I knew I was waking up on the grass. It looks like a had a blackout for a few seconds. I felt OK immediately I came round with no dizziness and walked back to the start. I just put it down to the virus. The next morning someone persuaded me to go to hospital (Accident and Emergency) to get it checked out.

They did several tests and one blood test (Tropoin test) showed a very slight abnormal level - it was 50 when the upper limit is usually 30. I was told this could be normal but they needed to another test in 6 hours. This came back similar (54) so they discharged me. If it was different they said it would have probably have been a small heart attack. The doctor also said this level can get up to 1000 with someone with a big heart attack

When I got home I looked up what the Tropoin test entails and it would seem that it is usually done in the first 24 hours. I did tell the doctors originally when I arrived at hospital that the event happened the previous day but I was moved around several times and saw different people and I did not see anyone writing anything down. Therefore so I am not sure if the message that it was more than 24 hours ago was lost during the day.

I have not had a heart attack before (I have a mechanical aortic valve) so I am not really sure if this test was valid.

Does anyone have any experience of this test.
I went back to the hospital today but they said may notes were in transition (not written up yet) so I am not sure what to do. If the two readings were different they were going to keep me in hospital to see the cardiologist. I am not sure what to do now. Has anyone got any ideas?

Note I have not had a heart attack before (I have a mechanical aortic valve) and I am based in the UK

Thanks

Martin

 

[Paleowoman]

Hi Martin - I have no experience of any of this but I am in the UK. Are you under a cardiologist for follow up with your valve you could ask to see ? Or can you see your GP and ask him/her for advice, maybe get a (urgent) referral to a cardiologist ? Hope you feel better soon.

 

[pellicle]

Hi

sounds very disturbing. I've not got much to add except it does to my un-medical ear sound like a small heart attack. I'd be chasing up that possibility if I was you. There may be some coronary artery congestion happening (without knowing much about your medical profile).

They did several tests and one blood test (Tropoin test) showed a very slight abnormal level - it was 50 when the upper limit is usually 30. I was told this could be normal but they needed to another test in 6 hours. This came back similar (54) so they discharged me. If it was different they said it would have probably have been a small heart attack. The doctor also said this level can get up to 1000 with someone with a big heart attack

I looked it up too (not being familiar with it) and found:
https://en.wikipedia.org/wiki/Troponin#Detection

Troponin elevation following cardiac cell necrosis starts within 2–3 hours, peaks in approx. 24 hours, and persists for 1–2 weeks.

so it would seem that within 2 days you'd still have sufficient levels that if it was "a big one" you would still see that. Like most tests we can also reverse plot the known decay rates and suggest possible ranges of levels back then. (you'll be interested to note they do the same with alcohol in tests)

So it suggests to me that something minor happened but that should spur you on to make investigations so that it doesn't become something major, so see your doctor and discuss these findings ... I'd call it a bit like a "foreshock" before a major quake. Unlike tectonics we can do something about blocked arteries (which cause oxygen to be in short supply to cardiac muscle, causing death of those cells ... which was what was test looked for).

 

[RunMartin]

I will be having a 24 hour monitor done in the next few weeks as a result of the blackout. This was after the doctors ruled out a heart attack. .I am hoping this will pick something up. I do seem to get a lot of ectopic beats and was wondering whether this could be the cause of the problem. They were present on the day of my blackout but not present when I had my ECG.

 

[cldlhd]

I'm not familiar with this test but I would imagine repeating the it after a few weeks would give a clearer picture. I'm not prone to lecturing or even advising other adults as I've usually found when it"s most needed it's most resented but I wouldn't engage in a run when I knew I was sick. Even elite athletes give their workouts a break when they're fighting an illness.

 

[Agian]

I had a 'trivial' heart attack and the Tropinin got up to 900. I was told that some people can have a normal Troponin that is higher.
Let us know how it goes Martin.

 

[almost_hectic]

Is it really that difficult to see a cardiologist in the UK?

 

[Paleowoman]

Is it really that difficult to see a cardiologist in the UK?

Unfortunately it can be, not just cardiologists but any hospital specialist.

 

[valdab]

Well about 8 years ago (before I knew I had a bicuspid aortic valve) I started suffering with soreness and jabbing pains around my chest. I, too, am in the UK; I called the NHS hotline and after listening to my symptoms, they suggested if it was no better in the morning I should go to the doctor. The soreness remained so off I went. They sent me to A&E to be on the safe side. At A&E all the tests came back clear apart from a slightly elevated Trop T.

They kept me in overnight - I had all manner of scans (still nobody found my BAV) and was discharged the next day. They didn't really seem to know what the issue was but suggested mild pericarditis (?).

As luck would have it, about six months later, I accompanied my husband when he saw his cardiologist for a check up following an ablation for atrial fibrillation. I had had a full check up with the same man a couple of years previously when I had turned 50 (still no discovery of BAV). After he had finished chatting with my husband, I mentioned in passing the hospital episode and elevated Trop T. He suggested they run a few tests and (finally and thankfully) they found my BAV. He was at a loss to explain the elevated Trop T however and suggested myocarditis.

About a year later I got shingles (virtually no rash) and it was only about six months later when I got it again that I recalled the pain was similar to that which I had experienced in my chest. I also uncovered a paper (which of course I now cannot find) which suggested that shingles could cause elevated Troponin

Nobody I have spoken to since seems interested in my theory but I thought my experience might interest you.

 

[RunMartin]

I have just been back to A&E and told them about my concerns. I had a good talk to an experienced doctor about the timeline of the events including when the tests were carried and what I felt like before and after the blackout. I had another ECG which showed no problems. The doctor was happy just to follow up the 24 hour Holter monitor which will probably be in a few weeks. I feel a lot happier now and thank you for all your support it is much appreciated.

Martin

 

[almost_hectic]

Unfortunately it can be, not just cardiologists but any hospital specialist.

WOW, thats kinda scary. I assume if its that difficult just to see a specialist its probably next to impossible to choose to get a second opinion. Getting a second cardiologists opinion is what saved my life.

 

[Paleowoman]

WOW, thats kinda scary. I assume if its that difficult just to see a specialist its probably next to impossible to choose to get a second opinion. Getting a second cardiologists opinion is what saved my life.

Patients here are entitled to ask for a second opinion, but I would think that might lengthen the process somewhat. I didn't mention that it's pretty difficult to get to see a GP too these days. For example, over the past few months at my GP surgery, which is fairly typical, it has begun to take three to four weeks to get to see a GP, and if you have an urgent need to see a doctor then you can have an on the day appointment - if you're lucky - but to only see a "nurse practitioner". Very scary - means patients frequently have to go to A&E (ER) or a walk in centre which are not that satisfactory considering they don't have the patient's medical notes etc. That's why I asked Martin if he was still under his cardiologist, then life might be easier for him to see a cardiologist, but luckily he was able to see an experienced doctor at A&E.

 

[honeybunny]

Scary indeed. Do keep us posted.

 

[Agian]

I copped a lecture about 'doctor-shopping' earlier this week, because I've sought a number of cardiology opinions.

 

[cldlhd]

I copped a lecture about 'doctor-shopping' earlier this week, because I've sought a number of cardiology opinions.

Your doc accused you of that?

 

[pellicle]

I copped a lecture about 'doctor-shopping' earlier this week, because I've sought a number of cardiology opinions.

Classy, very classy.