Transient episodes of tachycardia

[island emt]

Just because you are a pigheaded Pt: You would get a full workup to include 12 lead, dual 16 ga IV's just in case, Full rainbow blood draw for the lab. A full hx of events any meds taken including vigra,cialis etc due to your advanced age and the fact you have been away from your poor wife. Then you would go to the local cardiac center for more labs and monitoring over a 24 -48 hour period.

Would look for strange foreign diseases, parasites and bacteria's since you have been out of the country for extended periods.

Like Kaisu said : STOP being a dickhead and get to the DR.

[Arctickat]

Do what I did one night. When we got our LP12s I took one home before putting it into service and strapped myself into every monitoring parameter it had before I went to sleep...then downloaded the data the next morning.

Worst sleep EVER!!!!

Got a spare LP12 laying around.

ERdoc has all the right answers, so the rest of us just get to poke fun at ya.

[DwayneEMTP]

You all or such dorks...

Before posting I'd made an appt with my PCP. But because of the posts I went to the urgent care at the local hospital. They weren't overly concerned, ran a 12 lead only...picture perfect...Doc said he was unconcerned given my recent/current/family history. My job doesn't really have insurance, (Kind of, you pay up front and then they consider it for payment later) so I think that he chose not to do more than he felt prudent. Doc diagnoses anxiety issues...that doesn't feel right to me, but neither does MI...And I can't really afford to persue a long course of action if it's only for peace of mind and not based on logical, realistic concerns...know what I mean?

The reason I didn't consider it emergent, right, wrong or indifferent, is that I'm completely asymptomatic at all other times, and no n/v, chest pain, headache, dizziness, sig diaphoresis during episodes. Zero family history of hypertension/stroke/cardiac issues, plus I workout 4 times per week minimum and maintain a HR of 140-160 for 60 to 90 mins without symptoms. Shouldn't a significant pathology show itself with exertion if they are going to present at rest?

Vitals today BP 126/76, P 56, SPO2 97% r/a, 12 lead of an unusually fit, horny 18 year old...

So, with those things being known, what might I be missing in the cardiac world that might cause such symptoms only three times (last time it started to ramp up, but then settled within 2-3 mins) in a couple of weeks and not at all during exertion?

So, though it would be nice to have all of the other things done...If for no other reason so as to avoid having any fart stomping done, not going to happen on my budget. Though, I certainly will persue it more aggressively should things seem to change at all..

[Arctickat]

WPW? V-Tach?

Holtor Monitor.

[Kaisu]

Did this happen while you were reclining? I'm inclined to think regurgitation.... edit... sorry - meant reflux. Stop eating all that fatty crap before bed.

edit PS Glad you are OK. Would really miss you..

PPS - about a third of cardiac patients have no symptoms of cardiac until the MI - when 50% of them die. thus our concern

Edited November 18, 2012 by Kaisu

[Arctickat]

Did this happen while you were reclining? I'm inclined to think regurgitation

Hey all,

So, twice during the last week I've had single instances of transient episodes of tachycardia that have awoke me during the night. They were about 5 days apart or so.

I dunno, but I tend to sleep in a prone position....I suppose Dwayne could hang upside down from the ceiling though.

Edited November 18, 2012 by Arctickat

[DwayneEMTP]

Would WPW be new onset at my age? Present at such a low rate?

I was sleeping, flat, on a bed, the first two times, peeing the third...

[Arctickat]

http://www.ncbi.nlm.nih.gov/pubmed/15575244

[ERDoc]

Pubmed reference FTW!!

[mobey]

Doc diagnoses anxiety issues...that doesn't feel right to me, but neither does MI...And I can't really afford to persue a long course of action if it's only for peace of mind and not based on logical, realistic concerns...know what I mean?

Nope! I don't know what you mean...

I would spare no expence on investigating a cardiac issue if you are concerned.

The reason I didn't consider it emergent, right, wrong or indifferent, is that I'm completely asymptomatic at all other times, and no n/v, chest pain, headache, dizziness, sig diaphoresis during episodes. Zero family history of hypertension/stroke/cardiac issues, plus I workout 4 times per week minimum and maintain a HR of 140-160 for 60 to 90 mins without symptoms. Shouldn't a significant pathology show itself with exertion if they are going to present at rest?

If it is exertional in nature, then yes!

If it is non-exertional in nature (accessory pathway, afib, valve issue etc) then no!

So, with those things being known, what might I be missing in the cardiac world that might cause such symptoms only three times (last time it started to ramp up, but then settled within 2-3 mins) in a couple of weeks and not at all during exertion?

To put it frankly (and a little smart-ass), Paraoxysmal Cardiac rythm disturbance of unknown etiology.

So, though it would be nice to have all of the other things done...If for no other reason so as to avoid having any fart stomping done, not going to happen on my budget. Though, I certainly will persue it more aggressively should things seem to change at all..

I highly suspect these tachycardias are going to be runs of bigeminal PVC's or PAC's, probably linked to dehydration (Poor water intake, high dose caffeine), combined with stimulants both intrinsic (anxiety, occasional adreniline shots) and extrinsic (smoking, pop, coffee, betelnut) stimulants.

But my 100% honest advice to you, is wear a frickin halter for 24hrs. I doubt the cost is too much considering these could be runs of v-tach!

Oh BTW: don't take this wrong.... but you are getting old.

Things like valve problems, athrosclerosis, aneurism, are real. Yes it would be early.... but still a consideration.

Edited November 18, 2012 by mobey