PSVT

[PCP]

three weeks ago I was working and within a week I experienced two episodes of PSVT. The first time I working on a transfer car and we had just finished driving and I got out of the ambulance and I felt light headed, sick, and a little confused, along with some chest comfort. We had a nurse with us and he noticed I rubbed my chest and asked if I was okay. Of course I said yes. I finished transferring the patient from our cot to the other ambulance crews cot. Mean while still feeling light headed and sick with chest discomfort. I should add as well that I have something called Transposition of the the Great Arteries. Any ways I stood at the back of our ambulance and was hanging onto the back door when the nurse said get in and I will hook you up to my heart monitor. I handed my partner the keys and said you can dirve, not mentioning that I was not feeling well.

I sat in the sit at the head end of the cot while he hooked up the leads and when he finished he turned on his machine and it with in seconds he told me to lay down on the cot and told my partner to drive code 3 to the hospital which was 1/2 an hour away. It turned out my heart rate was 284 beats a minute. He started line and took my BP which of course was high for me I believe it was 150/90 something.

while in route I shifted and my heart rate dropped back to 137 and then slowly whent down to 110 and stayed there. I was released from the hospital within hours and was told to stop drinking coffee and working so much and to start eating better. They also mentioned that I need to reduce the amount of stress in my life. I was cleared to go back to work a within four days and again the following weekend after doing a cardiac arrest call an hour or so later I felt my heart racing again. So put on the pulse OX and it read 240 and that episode lasted about 5 minutes. Just as we reached the hospital I could feel my heart was not pounding and I felt fine.

Same thing told to take time off and to rest. I have an appointment with my cardioligist who I see every two years in a few weeks.

I did some research but could not find much to tell me what causes PSVT and what if anything I can do to prevent this from happening again.

My quesiton is what typically causes PSVT?

I know you can't give me any advice but any information about PSVT would be appreciated.

Thanks.

[tniuqs]

Do you mean TGV Transposition of Great Vessels or TGA ?

Did you have any surgeries as a Child ?

Do you have any Murmurs and what grade ? and quieter is worse (more volume) than louder and any regurgitation or gallop ?

Has your cardiologist ever said anything about WPW thats Wolfe Parkinsons White ?

That's an "extra" conductive pathway ? many WPW require either medications or abligation surgery ... see link.

http://www.mayoclinic.com/health/wolff-parkinson-white-syndrome/DS00923/DSECTION=treatments-and-drugs

Any other PMHX your missing ? Are you on ANY prescribed meds or taking OTC for something ?

Yup NO Caffeine at all, stay away from any soda/ pop, chocolate and any "Power Drinks" .

Don't use a Pulse Ox to check pulse rate when you are in warp drive ... use a cardiac monitor 3 lead is fine to get an accurate rate.

Who ever cleared back to work is a fool / tool, and doesn't BCAS do a in depth physical before hiring ?

You should not be working on a truck till the cardiologist gets a handle on this ... most seriously contact your CUPE rep too.

cheers

sorry for short note I have very limited Internet out here in the toolies.

[PCP]

Squint,

I have TGA and had surgery at 6 months old. The Dr. put in a baffel between my chambers rather than switching the arteries back. The procedure I had is called " Post Mustard procedure " I am on no medications and never have been. That might change when I go and see my cardiologist in two weeks.

My cardiologist has never said anything about WPW. I do have murmurs, but not sure what grade? I don't drink pop, energy drinks, chocolate, but do dirnk one or two cups of coffee a day which is very had for me to give up, as I have 21 month old twins at home and plus working shift work. I am working on it and hope to not be drinking coffee by next week!

I had to use the pulse Ox to check my heart rate due to not have 12 lead monitor available at our ambulance station as we don't have ALS. I have never had a problem in past until that week and have not had any other episodes since. When I look back now on both times it happened I had not eaten much that day and had 3 large coffees!!

I did do a in depth physical before hiring and no proplems came about. I am starting at a new station this month and I am not scheduled to start until after I have seen my cardiologist. I am working at the mine site still, just can't afford to be taking a month off work before seeing my dr. in Vancouver.

Hope all is well with squint and that your summer is going well

[fiznat]

Hey PCP,

Generally it is a bad idea to solicit medical advice on a forum like this. The people here do know a thing or two, but the person you really need to be talking to is your cardiologist. My understanding is that tachycardias have lots of different etiologies- from accessory electrical pathways, to mechanical strains, to neurological problems, to chemicals. All of these problems have different courses and different treatments. Get this taken care of by a physician ASAP, and listen to the advice you've already received. There is no way you should be still going to work and exerting yourself on codes. Next time you might not be so lucky!

[PCP]

Thanks for your comments fiznat and I after my night shift tonight at the mine site which usually is quiet I am scheduled for holidays which at this time I am going to see my Cardiologist and getting this taken care of. I have done some research on PSVT and the things you mentioned that causes tachycardia was also mentioned in the books I have read. Not saying that any of those reasons is why I expereienced those two episodes but I am working on changing my life style!

Thank you for taking the time to post your comments. I plan on taking it easy with my family over the next few weeks and I am looking forward to resolving this problem I experienced.