MOO112 said:Good Afternoon,
I had the echocardiogram on the 8th of August, and the doctor said
essentially,
everything was normal. But he added that there was some "slight"
leakage in a couple of the valves (didn't say what valves), and not to
worry since he sees that in about 90% of the echos he reviews. He was
going to let it go at that, but prescribed a 24 hour Holter Monitor
when I reminded him that the reason for the echo in the first place
was the heartbeat salvos I occasionally experience. The results of
that test will be in sometime next week.
As usual, along with the various posts I have read, the heart was on
good behavior during the 24 hours I had the monitor on. If it had been
on 24 hours earlier, it would have captured an episode of skipped
beats and thumps that dragged on for 45 minutes or so. I didn't feel
any salvos, but it was hard to gauge since I was active during that
interval. I have no idea what could have triggered that. If stress can
trigger arrhythmias, then it's possible that the unscheduled deadline
that I faced at work for the last hour that day could have been the
trigger. However, this deadline didn't bring on much mental stress at
all, so I would hardly label this significant stress in my book. I
work in an upstairs office adjacent to the mechanics garage, and
sometimes the office will temporarily smell of diesel or some other
fumes. For about an hour that afternoon, I got the diesel.
If the Holter had been on 72 hours later, it would have been a bonanza
of abnormal beats. Sunday night, shortly after I laid down to go to
sleep, the skipped beat party started. It lasted on and off for about
2 hours, until I finally fell asleep. I did have a cup of coffee
around 3 that afternoon (went to bed at 10:30 pm), which has been
known to keep me from falling asleep many, many hours later. For
what's it worth, this time there was also semi-foul air to deal with.
I had cooked a salmon fillet in the oven, and the smell (cooked fish
and a small amount of smoke, not enough to see but enough to irritate
the eyes) permeated the air. And as far as the coffee goes, usually I
can drink as much as I want (never over 2 cups) without palps.
The next morning, about an hour after I got up, I had what felt like a
salvo of around 5 to 7 beats. I'm not sure of the number, because they
were hard to feel.
Oddly enough, it happened about 10 seconds after my first sip of
coffee. There's no way caffeine can cause a reaction that quick, the
stuff had barely begun to enter the stomach.
So, like so many others, I'm on the hunt for the villain causing the
arrhythmias.
The doctor said ventricular tachycardia is found mainly in patients
with heart disease, which I already gathered from reading numerous web
articles. The Holter will more than likely come back negative for VT,
and it will probably be up to me to get the blood tests, further
monitoring, and possibly another echo as well as an EP study.
If these occasional 1 to 3 second salvos are not VT, then I can live
with them. The skips, palps, and salvos are not causing any of the
classic distress symptoms (pain, syncope, etc.), so if the cause can't
be found, I'd rather live with them than be put on medication. I jog
and do light weight training, and the thought of a sedentary lifestyle
is not pleasent. Impotence, yea, there's another delightful side
effect. I'm just generalizing, so I'm probably not right on the money
with the outcome of all of this.
In parting, I will pose a short list of questions to anyone who might
have some insight:
1) What is the significance of lying on one's back and triggering
arrhythmias?
No clinical significance.
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2) Is non-sustained VT more likely to be perceived or not perceived? I
ask this because, during normal beats with normal blood pressure, I
cannot feel the beats. If blood pressure is lowered in VT, it is
logical to deduct that a non-sustained salvo would also not be
perceived. Since I'm not a doctor, I'm probably wrong on this one.
Compared to other ectopy? Would feel the same.
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3)If I do have non-sustained VT, what is the likelihood of ending up
with an ICD?
Zero based on your history.
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If it's idiopathic, how is that likelihood affected?
Not.
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4)What was the diagnosis for anyone who had these short salvos like
the one's I experience now and then?
Depends on what is seen on the holter.
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5)Any thoughts on magnesium, potassium, and calcium supplements?
Magnesium and potassium suppress ectopy while calcium does not.
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6)Any thoughts on fish oil supplements?
Can suppress ectopy.
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I sure hope these episodes are diet or some other controllable aspect
of lifestyle related. But whatever the outcome, this is life and I
have to play the hand I'm dealt, so be it. It could always be worse.
Have a great day,
Moo
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/