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tazechip
tazechip, MD
Category: Cardiology
Satisfied Customers: 26824
Experience:  Yeard of experience in Critical Care Medicine
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I had a bit of a scare yesterday: I went to my daughters school

Customer Question

I had a bit of a scare yesterday: I went to my daughter's school teacher meeting, it was a fairly warm and stuffy room, and half-way through I suddenly felt light-headed (I quickly took a sip of cold water) and my mouth felt "numb" inside, I just put it down to the stuffiness, but I then got severe palpitations that lasted about 10 minutes.
Now a little background information: for several years my health has been declining - I have been feeling increasingly tired, generally unwell, with lots of other "unexplained" symptoms like aches and pains in various parts of my body, muscle weakness, muscle twitches (from occasional to several times a minute), dizziness, feeling faint, sudden loss of energy (i.e half way through an activity I would have to stop and sit down or lay down), trembling/shaking (inside my body and out), palpitations and many others. I used to be very fit and active before so this was a shocking change. Also every-day tasks became a problem - even a short walk, a stressful situation or a long chat with a friend would cause my symptoms to worsen (I am currently pretty much house-bound because of the weakness). For a long time this was blamed on "anxiety" (which indeed I developed, but as the RESULT of my ill health, and it is now a very rare occurance) and I tried different treatments but I became highly sensitive to medication (and also other substances, i.e. coffee, alcohol - which I never really drank anyway but now cannot even take a small quantity). Finally last year I was diagnosed with ME/CFS which actually (unfortunately) explains my symptoms. I have also been trying to keep a note of when the symptoms occur. The palpitations that I "normally" have are during periods of worsening of the ME and also after several nights with little sleep, also during my menstrual cycle. They usually come a few times a day and consist of about 1-3 "thumps". A year and a half ago (prior to my ME diagnosis) I had an ECG, 5-day tape & heart ultrasound - all ok, just showed some ectopic beats); I also had tachycardia (120+ bpm) as a side effect of one of the meds; also recently I had 2 episodes of (I can't remember the proper term the GP used) very fast heart rate along with feeling extremely faint for a few minutes in the night - this only lasted a few minutes and only happened 2 times.
However the episode yesterday was very different from my usual palpitations, in that it lasted about 10 minutes of continuous irregular thumping and it made me feel very unwell - weak, sick and dizzy. I tried to put it down to the stuffiness of the room/having to deal with a couple more "stressful" situations (a long telephone conversation and the need to go out and drive to school). I guess what I would like to know is whether it could just be a reaction to yesterday's "events", or should I get checked up? Having visited my GP many times over a year prior to the diagnosis, I would rather not "waste" their time unnecessarily. I have learnt to accept that the different "unexplained" symptoms are due to the ME and I don't "worry" about them anymore, but I guess I don't know where to draw the line - to blame everything on the ME or seek further medical help?
Submitted: 3 years ago.
Category: Cardiology
Expert:  Shantal-Mod replied 3 years ago.
Hello,

I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.

I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.

Thank you!

Shantal
Customer: replied 3 years ago.

I am ok to wait but am a little disappointed because this is the third time this has happened in about 6 months, and I am paying monthly for this service...and I am not asking terribly difficult questions so I so not know what the problem is?

Expert:  Shantal-Mod replied 3 years ago.
Hello,

Thank you for your patience, we will continue to look for a Professional to assist you.

Thank you,

Shantal
Expert:  Shantal-Mod replied 3 years ago.
Hello,

I apologize as we have not yet been able to find a Professional to assist you. Do
you wish for me to continue to search for someone to assist you or would you
like for us to close your question at this time?

Thank you for your patience,

Shantal
Customer: replied 3 years ago.

I am a little surprised as your status always says "Cardiologists are online" - if they have been online since I posted the question, why can they not answer? I am growing increasingly disappointed with this service. As I pay monthly for this service to have access to advice at any time, I expect to get a reply. So I will continue to wait for an actual reply, please do not send me another message saying you couldn't find an expert. I look forward to hearing from you soon.

Expert:  Shantal-Mod replied 3 years ago.

Hello,

We will continue to look for a Professional to assist you.

 

Thank you for your patience,

Shantal

Expert:  tazechip replied 3 years ago.
Hi--sorry for your wait. Just one question here--can you more fully describe the irregularity you felt in your heartbeat?
Customer: replied 3 years ago.

Mostly feeling of a missed beat (a longer gap between beats) followed by one or more "thumps", followed by "pauses" and thumps etc. with a few relly fast beats in between. It started off with the missed beats and thumps for around 10 minutes, then for about 10 minutes just fast beats with an odd missed beat and a thump, and after that it calmed down I haven't had any major "episodes" other than maybe the odd missed beat a couple of times over the last few days (which is fairly "normal" for me). Hope that helps.

Expert:  tazechip replied 3 years ago.
Thanks--was there any chest pain when this happened?
Customer: replied 3 years ago.

No, no pain. Just feeling faint and light-headed and out of breath.

Expert:  tazechip replied 3 years ago.
OK. This sounds different from what you had before and I'm concerned about it. While it could have been an episode of premature atrial contractions with perhaps a run of paroxysmal atrial tachycardia, the missed beats might have been premature ventricular contractions and the racing pulse would then have been ventricular tachycardia which is a much more dangerous arrhythmia. You definitely need to have this addressed right away with an EKG, echocardiogram, and another Holter monitor. I obviously can't tell you exactly what the arrhythmia was, but to be on the safe side it needs immediate evaluation
Customer: replied 3 years ago.

Thank you for your reply. I have to say I am more worried now, as I've tried to put it down to the "usual". I wish you could have answered sooner, when I originally posted this question, as now we're into the weekend and the GP surgery is closed. In your opinion would it be ok for me to wait until Monday or should I seek advice sooner? Also, what could this type of arrhythmia cause?

Expert:  tazechip replied 3 years ago.
Sorry but I came on just as soon as I was notified of your question. I think it will be OK to wait until Monday but if this happens again before then you really should seek immediate medical attention. Paroxysmal atrial tachycardia is not a dangerous arrhythmia, but ventricular tachycardia can deteriorate into ventricular fibrillation which of course would most likely be fatal unless CPR were established and defibrillation attempted.
tazechip, MD
Category: Cardiology
Satisfied Customers: 26824
Experience: Yeard of experience in Critical Care Medicine
tazechip and other Cardiology Specialists are ready to help you
Customer: replied 3 years ago.

I'm sorry to bother you again, just a quick question, should this happen again, while I wait for assistance, is there anything I can do to help myself? I've heard that for atrial fibrillation (which I think is the term the GP used for my night time flutters) you can squat or hold your breath to put pressure on the heart so it can re-set itself, and I also read that coughing can help - are any of these true and would they make a difference?

Expert:  tazechip replied 3 years ago.
No bother at all. I don't think this is afib. If it were paroxysmal atrial tachycardia maneuvers like a Valsalva maneuver--straining and holding the breath--or carotid massage, rubbing over the carotid pulse in the neck--can potentially break the arrhythmia. So you could try one or both of those.
Customer: replied 3 years ago.

Thank you very very much. I've read up a little about all the medical terms you have used as I was not familiar with them, and I still have some further questions (I will pay for this further advice as for a new question!).


When I mentioned there were period of fast heart beat, I do not think they went over 100bpm, they felt more like raised pulse due to worry/stress - my pulse was not as fast as during the "flutters" in the past - if that makes a difference. But the "thumps" were definitely different, in that I'd never had more than 3 consecutive thumps in a row, and this lasted a long time.


My further question is what could cause my heart to have behaved in such a manner, and what would be the possible treatment? Also, if this was (so far - and let's hope it stays this way!) a one-off occurrence, would an ECG show anything? I realise these are all questions I can ask my GP on Monday, but feeling slightly anxious about it right now, I would like to ask you, as you seem to have a more extensive knowledge. Once again thank you so much for your help.

Expert:  tazechip replied 3 years ago.
My pleasure, and we can continue for as long as you'd like. It's possible that these were just premature beats without the tachycardia--the rapid pulse. As for the cause, it can be electrolyte imbalance and a few PVC's a minute are not necessarily dangerous. The ECG might be normal unless the irregular beats occurred while it were being done. As for treatment, often a beta blocker drug is given if it isn't an electrolyte imbalance

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