Your heart rhythm

Palpitations, arrhythmias

PACs

Question: 

I have been having an occasional irregular heartbeat in the past, it started in march.  I have occasional pac's, they seem to come on during times of high stress or extreme physical exertion.  I am a firefighter/paramedic and I notice them mostly when I work a house fire but at times they come during my training.  I have no pain with them.
I have seen a cardiologist and had an echo and 12 lead done.  The echo cardiogram came back normal according the the cardiologist.  my 12 lead says that I had an anterior septal infarct (old).  
My cardiologist says that I have nothing to worry about and that pac's happen to some people for no reason.  I guess i just feel uneasy about these since they kind of started out of the blue and they come so infrequently.
Do I have anything to worry about with these, could they be a sign of something else?

Hi Antonio,
Have these PACs been confirmed? As a paramedic you must know that extra heart beats in somebody with an otherwise normal heart are harmless. Things to check:

PVCs and Low Heart Rate

Question: 

I am 66 years old.  Took 88mg synthroid for many years, a new specialist gave.25 mg and since then . . It seems my problems started, achy bones, hair falling out, . .and most especially PVC's. Along with them my heart rate is between 38-40.  I am 66 year old female, in rather good health, I have Asthma and only take Ventolin,and Flo-vent when absolutely necessary, sometimes I don't need it for many months. . .and I do have several muscle and bone disorders, but I am concerned about the low heart rate. I had this happen last year, ( PVC's and low heart rate start out of the blue) I went through all the stress, and other tests, and get EKG's every year. . . I have never been placed on meds forthis.  My normal heart rate is between 55-60  and my blood pressure is usually textbook at 120/80  today it is around 119/70 with 38 pulse.  I feel fine, but also have anxiety feelings.  These are caused because I feel the PVC's about one every 5 beats, then every 9 beats, then none, then every 2 beats. . .It's enough to drive one crazy, being aware of these.  I worry because, if my resting heart beat is at 38, what is it when I am asleep????
Please help if you can figure what is going on.
Thank you. . .
JJ

Hi JJ,
Your bradycardia and PVCs definitely need to be checked out. One of the (many) causes of bradycardia include a problem with your thyroid, and you need to make sure you are still getting the right amount of synthtroid.

Extreme fatigue after ablation

Question: 

I had an ablation on 5-25-12 . I had a complication with a small perforation and pleural effusion. I was in ICU for 4 days. I am home now and have a lot of lightheaded ness when sitting upin bed or rolling over. I also feel my heart speed up. I am extremely, extremely tired. I sleep a lot during the day and cannot do any housework, etc. I called my dr which is 2 hrs away just for reassurance and was told the dr sees his patient's 3-4 months following procedure and gave me a 4 month follow up appt.  Are these symptoms normal and any need for concern? The ablation was not completed so I don' t know what was done. Thanks for any advice.

Hi Lynn,

Various cardiac procedures can be complicated by a perforation and/or  leakage of blood into the space around your heart  that causes all sorts of dangerous symptoms. They include:

Heart block during pregnancy

Question: 

Dear dr, im a 30 year old 8 month pregnant woman. Last year may 2011 my cardiologist said that I had a rbbb and a lpfb. I may require a pacemaker for this and very terrified. Today I had 3 ekgs and it all said normal ekg. My doctor was shocked that the rbbb and lpfb was not seen. Could it be possible That I no longer have rbbb and lpfb?or is it malfunctioning because im 8 months pregnant?thank you so much. Martha

Hi Martha,
You either have a heart block or not. Your first step ought to be to find out whether that first EKG was correct or in error. If true, a Left bundle branch block during pregnancy may be a sign of imminent heart failure, "peripartum cardiomyopathy (heart malfunctioning)". It could be a serious problem and you should have it confirmed or denied by a cardiologist.
Hope this helps,

Dr T

SVT

Question: 

Hey I'm 17 and was diagnosed with SVT about 2 months ago. I'm not on medication because I chose to have an ablation done but during the surgery they couldn't induce the tachycardia, so it was a pointless surgery. The procedure was done on May 14th and I've been feeling much worse. I'm dizzy and light headed all day long, as well as short of breath. My heart rate has been at least 120 and over pretty much constantly and I don't have much energy at all. I don't know if this has anything to do with the procedure or not but my next cardiologist appointment isn't until August 13th, so do you have any idea what might be going on?

Hi Kailie,
Your symptoms are consistent with an inadequate pumping action of your heart as can happen with supraventricular tachycardia (SVT). I assume the August appointment is with the ablation cardiologist, who may not be the same as the one who is supposed to treat you NOW!
Read this also:
http://www.cardiachealth.org/ca-blog/svt-15-yr-old

heart defibulator shock

Question: 

i am followed by a person that checks it regularly....... but they fail to explain the questions i have...... (1)  everytime they put the megneti on to check the machine i start coughing.... like i am sensitive  to it is this normal............ (2)   the shock i have ..... feels like the old pain machine.... where you press to hard it feels like a drill went through the body......is this the way most people feel when they get a shock.

Hi George,
I don't know why you should start coughing with the magnet. The shock can be very powerful; one of my patients described it as being kicked by a horse! Just remember your defibrillator only fires when a dangerous heart rhythm occurs that would threaten your life.
Hope this helps,
Dr T
 

AFIB and ablation

Question: 

My 36 yr old son developed AFIB a few yrs ago, his cardiologist prescribed a take as needed medication, I do not know the name, but he never prescribed a blood thinner, each passing year the AFIB progressively worsened, this past year my son was placed on several different daily meds (Not all at once but different as in months in btween a new med change) but never a blood thinner, fast forward to this coming June, 2012. My son is going to have a Cardiac/Heart/Catheter/Ablation, I dont know the difference between the names if any.
he is now on Coumadin and his levels are all over the place. under 2, then over 7, etc.
Could you shed some light on what ablation can do for AFIB, also I am interested in aftercare, especially lifting, as I want to help him with his "chores' such as lawn mowing and trash removal.   I do not want him doing these 2 things especially, he will have a 2 week period off from work, so hopefully that will help, he works in  the construction field, he has been forewarned to be careful about cutting himself, also he was told he will be on coumadin for months afterwards , but not for a extended/forever period of time. My elderly Mom had AFIB and was always on a blood thinner, from the 1st DX right up to her death.
I am so confused . I hope I made some kind of sense and you can find my question among this babble.
Thank you kindly.
Jen aka "worried mother"

Hi Jennifer,

New onset Atrial fibrillation

Question: 

Last week I went to my primary doctor because I had not been able to sleep for more than 4 hours a night for months.  He diagnosed me with atrial fibrillation after performing an EKG and referred me to a cardiologist. I am a 40 year old male / nonsmoker. The EKG says ventricular rate 75 bpm atrial rate 234 bpm duration 92ms QT 399ms R axis 45 degrees T axis 42 degrees Atrial fibrillation with controlled ventricular response Poor R wave progression. The cardiologist can't see me for 2 weeks. My heart feels like it is going to beat out of my chest (which is basically how I have felt for months).  He prescribed enteric coated aspirin 325 mg. and performed blood work which all came back normal. Does the ekg indicate that I should go to the hospital Er immediately or should I be okay to wait (of course, barring anything that I would "think" is a heart attack or stroke). Also, does the Poor R wave progression mean that I have probably had a previously "unknown" heart attack? And is there anything else that jumps out at you on the EKG? CC me a copy of my answer.

Hi Joe,

A soccer player collapsing during a Premier League Match

Question: 

Hi,
As you may or may not know a footballer in the UK collapsed on the pitch and is lucky to be alive.This of course worries me drastically been a 23 year old lad who does regularly participate in sport it also brings back memories of when i was getting regular palpitations a few years back but didn't do anything about it and haven't really suffered with them for sometime.Is it worth getting an echo and ecg as after reading certain sites it states that palpitations are linked to defects?
and can they also relate to lifestyle as it can be said im not the healthiest drinker or eater in the world.

Hi Shaun,
I do know about it, including the statement from a cardiologist afterwards that nothing abnormal was found. Until then I thought he had suffered a lethal arrhythmia and a Sudden Cardiac Death (SCD) episode, but that would have been excluded by the testing that must have been done.

An irregular heart beat with a history of SVT

Question: 

I am 22 with type 1 juvenille on-set diabetes (18yrs.) I also have hypo- thyroid. I had the cardiac ablation in 2008 for SVT. Was doing fine , for the last 4-5 months I have had rapid irregular heart beat constantly. It makes me nauseaus and dizzy. And on top of that for the last week I have been vomiting with diahrhhea!! Im really scared because I feel so weak. hat should I do?

Hi Sam,
Go see your doctors! Your history of an ablation for SVT in combination of a rapid irregular heart beat with nausea, vomiting, diarrhea  and dizziness is worrisome. You need to be checked out and have an EKG & blood work done to make sure your electrolytes are still OK. An ablation doesn't mean your SVT has been cured!

Hope this helps,
Dr T

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