Need some advice

[twinmaker]

Starting about a month ago, I've been having a lot of skipped beats or what feels like my heart stops for a beat and then I have another four beats and then what should be the fifth beat isn't there. I've especially noticed this while laying on my left side in bed at night. I have a tightness in my chest which makes it a little difficult to breathe. I know, I know...I should have called the doc by now but with the holidays and company, I was afraid of the dreaded hospital stay. I guess the other reason I haven't called is that I have a pacemaker/defibrillator which makes me feel a little more confident about my decision to wait to call. Has anybody else experienced this? I know I have a-fib and v-tach, hence the pacer/defibrillator. I've been through all the meds and finally had the A-V node ablation. I don't want to have to start through all the meds again, and I guess with being new to the area and with the new doc, it makes me even more reluctant to call. Any advice would be appreciated. LINDA

 

[geebee]

Linda,

You need to see the doctor which I am sure is what you have already figured out. Not to try to scare you (OK - maybe a little if it works and gets you to the doc) but these are similar symptoms I had when my valve was sticking due to scar tissue encroachment.

Please go have it checked.

 

[ALCapshaw2]

On the Less Severe Side, your symptoms sound a LOT like what I experienced when I was diagnosed with PAC's and / or PVC's (Premature Atrial Contractions & Premature Ventricular Contractions). You need an EKG to distinguish between them. Your cardiologist may suggest wearing a 24 hour Holter Monitor to capture 'events' in case you don't show any 'in the office'.

Both are generally considered to be benign unless they happen every or every other heartbeat continuously. Beta Blockers are usually prescribed and can sometimes tame them even at very low doses in some people.

You may also want to think about possible triggers. The usual list of culprits include nicotine, caffeine (coffee, cokes, CHOCOLATE, etc), stress and others I've forgotten. I believe Bob H wrote a 'Tutorial' on PAC's and PVC's some time ago. Do a SEARCH to find LOTS of discussion on the subject.

Bottom Line: Go get it checked out. It's NO WHERE near as invasive as the other things you've already had done!

'AL Capshaw'

 

[Marguerite53]

Come on, Linda! It's time to start building a relationship with a new doctor! Isn't it great that you can go in and kind of interview him/her instead of feeling like it's an emergency and you have to take the first doctor on your list? And think how educated and informed you already are. It'll be a piece of cake. Now just pick up that phone!!

Wishing you the best. Marguerite

 

[twinmaker]

I will definitely call first thing tomorrow. I'm a little lightheaded and dizzy tonight which I hadn't been in the past. I guess it's my body's way of nudging me to do something about this. Thanks for all the advice. LINDA

 

[Ross]

Nudge, Nudge, Nudge.

 

[tobagotwo]

While you're there, have them double-check if your pacemaker is one of the ones with a battery issue. You don't want to be depending on it when the Energizer Bunny stops beating the drum.

Best wishes,

 

[Nan]

Glad you are calling your doctor. That is definitely the thing to do!

Now, I don't know about your pacemaker/defibrillator, but my pacemaker has the capability of recording out of the ordinary events in the heart, like a-fib, etc.

So perhaps it would be worth while asking your doc if yours does so, and could they take a look at it's recent history for you. It's like wearing a holter monitor all the time! But with lot less hassle.

Good luck and feel better soon.

 

[twinmaker]

Nan, Yes, mine can also record things so I will ask about that. Hopefully, my defibrillator doesn't have a battery problem. After one year, my defib. was recalled because of that, and I had another defib implanted. That was almost two years ago. Hopefully, the battery will continue to work for a few more years! LINDA

 

[marky]

So did you see your doctor??? what did he/she say?

 

[twinmaker]

Well, I called the doctor's office and left a message for the nurse to call. They called within the hour, and I explained all the symptoms. The nurse asked a lot of questions and told me that I should have gone to the ER last night. Anyway, I asked what they wanted me to do now, and he said he would talk with some others (?) in the office and would call me back. That was three hours ago. My heart is out of whack right now. So here I sit. Not sure what to think or do. LINDA

 

[ALCapshaw2]

Can you get to your Cardiologist's (or ANY Doctor's) Office BEFORE the close of business TODAY? If so, do so, so that someone can take an EKG while your heart beat is "out of whack". BEST to have someone else drive you.

'AL Capshaw'

 

[Marguerite53]

Boy, you just don't sound like yourself at all. Funny how we can tell even without seeing you face to face. I sure hope you are able to get someone to look at you pretty darn soon! Just checking in....almost 4:30pm your time.

Al makes a good point. Good luck! Marguerite

 

[geebee]

Linda,

Thinking about you and hope you are doing okay.

 

[ALCapshaw2]

Linda,

Did you manage to have an EKG taken this afternoon?

If not, about the ONLY place you can get one after-hours is at an ER (or a local walk-in Clinic IF you have one that stays open late).

I can tell you what I have done when I have arrhythmias at night. There ARE SOME RISKS, but I've been to the ER WAY TOO MANY TIMES and pretty well know what kinds of things may pop up. On several different occasions, I've gone into A-Fib. Each time it resolved back to Normal Sinus Rhythm after about 3 hours REGARDLESS of what was done (in hospital, in ER, STAY AT HOME).

MY decision was to Notify the Cardiologist on Call and "make a deal". I explained my history, that I am on Coumadin (protects against clots that may result from A-Fib) and that I want to just "ride it out at home". The Doc's usually add "Go to the ER or see your Doc if it doesn't clear by morning. SO FAR, they have always cleared within a few hours.

MY reasoning went like this. MOST arrhythmias are considered to be benign. There are one or two VERY DANGEROUS types, but I figured that if I had one of those, I would have already expired. Since I was already on Coumadin, I was already protected from clots, and one of the standard treatments for A-Fib is to put the patient on Coumadin.

Obviously there is some RISK in this approach. In the end, everyone must find their own Balance between going to the ER and waiting it out based on how well they know their body and how it reacts to 'triggers'.

I encourage anyone who does NOT know what kinds of arrhythmias they are prone to experience to be EVALUATED ASAP, even if it means a trip to the ER in the middle of the night.

'AL Capshaw'

I have NO formal medical training, just many years of living with heart diseases. I also have a stethoscope to listen to my heartbeat and a blood pressure instrument.

 

[twinmaker]

Thanks for all the suggestions and concerns. I finally called the doctor's office back right after I posted this afternoon. Had to leave another message for the nurse. He called back around 5:00 and said, "can you come in tomorrow morning at 10:45?" He said they wanted to interrogate my defibrillator/pacemaker and to do an EKG and depending on what those showed, they would go from there. My main concern is why this is happening. I felt that if it was my v-tach acting up and it was bad, then the defib. would go off. It hasn't. I'm 100% dependent on my pacemaker and my rate is nice and steady around 70. I guess now I'm wondering if there is some problem with my 25 year old St. Jude mitral valve. The arrhythmia has been going on all day. Hopefully, it will be happening when I go in. If not, then I'm sure I'm headed for an event recorder. I've had those a lot. I'm sure if I have to wear one, I'll be able to capture something within a day or so. This arrhythmia has been happening more and more over the past month. Al, I know exactly what you mean about making a decision to stay home and not rush to the ER right away. I've done that and 9 times out of 10, they'd admit me and let my cardio deal with it during regular hours. I know I have some serious problems with the ventricular tachycardia, but that's what the defribrillator is for. Since I've been dealing with this for the past month, I'm deciding not to go to the ER tonight and just wait until the morning. I know I should have taken care of this sooner, but it wasn't this bad a month ago. Thank you all again for you thoughts and concerns...I will let you know what happens when I get home tomorrow. LINDA

 

[ALCapshaw2]

There is a condition called "Pannus Ingrowth" where tissue growth can inhibit the motion of the mechanical valve leaflets. You may also want to suggest an ECHO to look for this possibility.

Please let us know what your Cardiologist finds.

'AL Capshaw'

 

[twinmaker]

Thanks for the info Al. I'm going to google that condition and will also say something about that to the doc. The more information I'm armed with, the better. I'll let you know what I find out. LINDA

 

[twinmaker]

Ok...here's the scoop. The EKG showed some atrial fib although it was difficult to read because of me being 100% pacemaker dependent, but it was seen, at least this is what the nurse said. They interrogated my defibrillator, and it showed that I had a ventricular tachycardia on Jan. 5 at 10:40 that last 5 seconds with a heart rate of 200. Since it was nonsustained, my defibrillator didn't fire...thank goodness. Of course, I didn't even feel this high rate. Anyway, there is only one wire from my defibrillator into my heart, and it's of course in the ventricle. So we can't tell from the interrogation what is going on in the atrium. They say all this is coming from my atrium. Because of having the A-V node ablation, I'm not supposed to be feeling any of the arrhythmias. The tech who interrogated my defib. said that sometimes the heart finds different areas to start sending signals or symptoms of the a-fib. I don't see how that is possible with the A-V node gone, but what do I really know. Anyway, my electrophysiologist wasn't in, but they did call him, and he now wants me to wear a holter monitor. I get it next Friday. The nurse said to go home, relax, and if things became uncomfortable for me to go to the ER this weekend and not to drive myself. DUH! He said, "call an ambulance, and they'll come get you." Of course, my husband is here, so that won't be necessary. He also said it was unlikely that this had anything to do with my St. Jude valve. So that's where things stand for now. My doc was coming in this afternoon and they said he would be given the results of what was done today. LINDA

 

[ALCapshaw2]

Thanks for the update Linda.

I'm glad that you got checked out.

Keep after your Cardio and Electrophysiologist until you get some 'understandable' answers! This may still require some more tests I suspect.

Hope all goes well in the mean time.

'AL Capshaw'