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Finally a diagnosis but what does it mean? (Read 3426 times)
beadbabe
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Finally a diagnosis but what does it mean?
Feb 12th, 2007, 5:32am
 
Hi there
Finally got the results of a 24 hour holter monitor I have had the doctor on the phone telling me that I have both narrow complex tachycardia and ventricular ectopics, as well as some other acronyms that I don't remember. I am really concerned as to why this has happened and what is causing them. Are these things separate faults with my heart or do/can they occur together.

RLR - are you there? As you seem to know a lot about these things. I am going out of my mind with worry now as I didn't think young people got heart probs especially if there is no family history of it.

The GP is recommending atenlol while I wait to see the cardiologist but I have read that that can bring on dangerous heart rythms if you have ventricular ectopics so should I take it?

Please help - I have tried to work out what is wrong with myself for too long because doctors won't believe me and now I am in too deep with information that I don't understand. It's not like I ever wanted to study for a medical degree and specialise in cardiology Smiley
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RLR
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Re: Finally a diagnosis but what does it mean?
Reply #1 - Feb 12th, 2007, 2:32pm
 
Okay, first let's take a deep breath and relax. I don't know for the life of me why some physicians must go to great lengths to generate alarm and panic in their patients without any justification. It irritates me to no end, but some physicians operate in black and white. If it says it, you have it and with lawyers and barristers waiting like wolves to pounce, they feel compelled to say nothing for fear of reprisal. You're going to be fine and here's why:

It is sometimes useful to classify tachycardias as either narrow complex tachycardias (often referred to as supraventricular tachycardias) or wide complex tachycardias. "Narrow" and "wide" refer to the width of the QRS complex on the ECG. Narrow complex tachycardias tend to originate in the atria, while wide complex tachycardias tend to originate in the ventricles. Tachycardias can be further classified as either regular or irregular.

If I were to run an ECG on a patient with anxiety and a tendency toward white-coat hypertension and an elevated stress response to simply being at the doctor's office, I will invariably see tachycardia in the low 100 to 120 range and if they are experiencing ectopic beats as a consequence of Vagus nerve stimulation, the ECG computer can read it as narrow complex tachycardia, usually with atrial ectopics since it is narrow, but ventricular is also possible. The benign palpitations will further cause the computer to read it as "irregular."

I comment on the ECG computer's interpretation because what you describe sounds very much like it was read directly from the computer's interpretation as a differential diagnosis. I will tell you that much like my colleagues around the hospital here, we take great care in never allowing a computer to tell us what is wrong. The computer has absolutely no idea of patient parameters, but rather bases it's differential diagnosis on "algorithms" assigned to it as a failsafe for folks who don't have much formal training in cardiology. In fact, I could care less what the computer reads out because I base my decisions specifically on the ECG read-out itself and give no credence to the computer's interpretation whatsoever.

The bottom line is that in my opinion, I don't think there's a blessed thing wrong with your heart. I certainly think you were anxious when you got hooked up to the monitor and the computer has no way of knowing your relative status in that regard. It only knows what it reads. Since there are some problems associated with specific forms of tachycardia and associated arrhythmias, the computer pairs it with the appropriate algorithm and spits out the response. But that does not mean in any way that you actually have a dangerous combination taking place. My God, if I were to rely upon the interpretation of those silly computers, every patient coming through the door would be launched into the telemetry ward for 24-hour observation.

So mix yourself a drink, take a deep breath and don't let your mind, and the information you received, stir you into a panic. No need at all. My opinion? You're going to be just fine and your heart is as healthy as can be. You're obviously suffering from anxiety disorder with somatic features and this can go a long way to making it "appear" that you're ill. But you only have symptoms, not disease. WHEW!!!! What a relief!

Kick back and wait for your cardiologist to read things out for you. I'm sure he'll tell you things are fine.

Best regards and Good Health



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Best Regards and Good Health
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