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Scary episodes again (Read 3296 times)
Natalia
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Scary episodes again
Sep 14th, 2009, 1:12pm
 
Hi all, RLR,

I am sure I have proabably mentioned this before and have seen other people writing about very similar sensations....
But in just over a week I have experienced 3 occurances of this scary episode, 2 of them taking place since Friday and I don;t remember ever having it so often. It usually happened every now and then, about once a month or less.

I experienced this at least twice since staring betablockers in december last year ( I was on 200 mg matoprolol tartrate).

A few weeks ago I had to have  my Betablockers dose reduced to 50 mg twice a day and it seemed to control the PVCs the same as it did on a higher dose.
About a week and a half ago, I got very upset by smth my son did ( he is going through a difficult stage at the moment - not listening, etc) I didn;t have the mental energy to shout at him or tell him off, I just felt like all the energy had been drained, so i went upstairs and just cried, and couldn;t stop. I don;t usually cry very often at all and I was a bit surprised by my reaction this time. After about 15 min a skipped beat, then another, and another, they were at the same intervals, and only stopped when i took a few deep breaths and ran downstairs.
A few days later I got another run of them, this time while just walking with a friend, a deep breath seemed to help again.
The most unpleasant and pronounced episide happened just under an hour ago and prompted me to write this post. I had just eaten a small amount, and was sitting on the sofa stressed out bu the kids fighting and a little bent over the laptop, when one ectopic (which felt like a PVC -  radiating through the lungs and chest type) somewhat triggered a subsequesnt run of slightly different ones, more fluttering in nature, and on top of that  at the same time my heart made a "trrrrrrr" sound, as if hit by an electric shock or as if it was a wooden brick flipping very fast and hard inside a container. I am sorry for such a lengthy post, but these things are hard to describe accurately....
I am trying to look for possible triggers but so far nothing comes to mind. I have had some trouble with my gastritis lately and wondering if this might be one of the triggers. I have also had back pain (from lifting my daughter and chest pain from her accidently kicking me in the ribs repeatedly while sleeping - she's been a bit under the weather lately and sleeping with me). My ribs are quite tender to the touch in places but i can't see how it would coause the ectopics to increase. I am a bit sleep-deprived at the moment and could easily fall asleep at any given moment of the day if allowed.
RLR, are these "runs" of tachycardia", or flutter or whatever they are also caused by the Vagus nerve? Or does the fact that a single ectopic caused by the vagus nerve triggers this run mean there is something more sinister going on with the heart itself?
Are deep breaths just a coincidence or is there a connection or reason why they seem to stop the ongoing fluttering?
This latest episode today really scared me...... Sad
could this have been VT or accelerated idioventricular rhythm ?
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« Last Edit: Sep 14th, 2009, 2:52pm by Natalia »  

I'm not tense, I'm just very very alert
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RLR
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Re: Scary episodes again
Reply #1 - Sep 15th, 2009, 10:24am
 
Accelerated Idioventricular Rhythm??? My Gosh, you're reading way too much!!!

This type of presentation is seen most commonly on reperfusion following acute myocardial infarct, or heart attack. I can assure you that it's not the case where you're concerned and you can get into deep trouble by seeking out medical information based upon your perception of the symptoms and formulating a layperson's rationale.

I find it to be no surprise at all that you have searched high and low for a possible trigger but are unable to discover it. Virtually all persons with anxiety disorder exclaim that stress such as that being described in this instance has no bearning on the issue, together with the fact that they don't "feel" anxious so therefore it has no bearing either.

Emotional strain, sleep deprivation and GI dyspepsia or discomfort can all produce benign palpitations of extreme variation. Simply because they are experienced in a different form, does not make them something sinister at all.

As for any effect by your lungs, I'm constrained to point out that this is part of the information that I share repeatedly on the forum. The vagus nerve innervates the lungs as well as the heart. Changes in tidal respiration alter heart rate. Intentional deep inspiration can break the pattern of vagus nerve stimulation in many instances because it overrides involuntary activity by the vagus nerve.

There's nothing physically wrong with your heart and you're in no danger of experiencing any type of cardiac event as a consequence of the palpitations.  

You'll be just fine. I see absolutely nothing of your description that would suggest anything pathological is at work. Take a deep breath and relax. Incidentally, gastritis is a very particular clinical disorder and I doubt you are actually suffering from it. It's important when speaking with medical professionals to describe what you feel or what you're experiencing rather than what you have, if you see what I mean.  

Best regards and Good Health
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Natalia
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Re: Scary episodes again
Reply #2 - Sep 15th, 2009, 11:29am
 
RLR,
Thank you for such a prompt reply.
I know I have been reading too much Sad

The run of PVCs which I have described in the first post feels like a run of ectopics triggered by a single PVC, and I mostly got it while slouching or bending down. I have only just began to deal with the single PVCs and was even thinking of reducing the betablockers further, but last night's episode was a real set back.
You have reassured me once again. I have coe to the point where I am prepared to wear reveal just to find out what this irregular runs actually are Sad.

Another thing is, we were thinking of having another baby, but I am not terrified that the pregancny might make those "runs" and the PVCs worse, although it was only my daughter's birth that brought them on again.
I had 2 boys before (one of the stillborn) and had hardly any to none PVCs during pr and after birth.

Do I understand correctly that even runs of ectopics and flopping are still considered benign and do not pose any threat? I do feel a bit light headed when they happen but I think fear has a major part to play in the lightheadedness.
Does the fact that they terminate with a deep breath or two suggest their Vagal nature?

As for Gastritis, i was diagnosed with it as a child and once again 3 years ago after a gastroscopy. Antral gastritis with no presence of helicobacter is the official diagnosis.

Thank you again for your help and reassurance!
Natalia
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Re: Scary episodes again
Reply #3 - Sep 15th, 2009, 5:09pm
 
Okay, if you'll re-read your reply to me you will observe that you have a stronger belief in your own diagnosis than that of the medical community and seem bound and determined to prove yourself correct in your presumptions.

When I speak conclusively, you respond with "yes, but you're not listening to me. I'm speaking about palpitations that go flop-flop instead of flip-flop and then ones that are actually created from others that start out like the benign ones. Now surely that constitutes disease and not just palpitations. Are you certain that you understand? Yes, I know that palpitations are benign, but this is different I tell you. These are not your average palpitations. This is not normal and every single time I submit to diagnostic tests, they are unable to locate the underlying cause."

I illustrate this medical parable in the hopes that you'll recognize that you are exceeding the boundaries of practicality in efforts to stem your anxiety. Regardless of the extent to which I pronounce the condition benign, you are compelled to respond "you mean even these? Even ones like this? How can that be possible?"

Now you can head for the nearest healthcare clinic and have them strap on a holter for a full year if you care to and despite the recorded data, it will only confirm what has existed all along; there is nothing wrong with your heart in any way, shape or form. Absolutely nothing.

I'm reminded of a young nurse who came under my direction from time to time in the emergency department of a university hospital system. She was but 4 months post-graduate from the nursing school with an associates degree. I took note because she was uncommonly confident in her abilities and to that extent, she indeed performed her duties without incident.

There was, however, a different facet to her character that soon became a very significant issue. She felt that her confidence as a nurse and the relative ease with which she carried out her responsibilities extended beyond her skill set and well into the realm of that associated with a medical doctor. Rumors began to surface within the nursing circles that she was challenging the various diagnoses rendered to patients by the physician group. In each instance, she based her reasoning upon what she had read and been taught.

Likewise, in each instance, her own perspectives were inaccurate as a result of limited training and experience. The nursing supervisor worked closely with her on a daily basis to try and bring her enthusiasm and confidence within the boundaries of her actual abilities. Despite all the encouragement available from her supervisor and peers, she persisted.  

As it happens, she elected to openly challenge a physician while in the patient's room with the family present as well. That physician was me.

She proceeded to very pointedly inform me of my error in assessing the patient. I politely handed her the patient's chart and asked her to please review the medical history, patient symptoms and objective analysis, followed by the diagnosis she alternatively felt was more accurate. She actually made it through the cursory phase quite well and I even commended her before the patient and his family.

When she reached the point of objective-based findings, however, she quickly spiralled downward because that depth of training and experience was well beyond her skills set. When I helped her navigate through the findings and their correlation to the patient's underlying problem, she stood in disbelief almost as if the information contradicted her own impressions. I elected not to divulge the incident to her superiors.

Once the patient was discharged, I had the nursing supervisor place her under my direction for the next 10 days, during which time she was free to challenge any diagnosis made with the caveat that it be done in the appropriate setting and under the proper circumstances.

Time and again, she relied upon her skills set to reach conclusions in the absence of the insight which gravitated just out of awareness. In each case, I revealed irrefutable evidence to countermand her inaccuracies to the extent that her confidence began to wane. Over the next several days, she began demonstrating signs of apprehension and lack of confidence in her actual abilities and slowly began losing faith in her assessment skills, even her skills as a nurse.

Just at the point where I thought she might lose her confidence altogether, I took her aside and spoke candidly with her. I explained that the outright complexity of medical science and medical practice can very often appear deceptively simplistic. I further cited that it is human nature to make sense of it all by deploying cause and effect rationale but that such perspectives, despite the overwhelming sensation that theyfeel right, are most often grossly inaccurate.

I closed our session by enouraging her to take her time in establishing her skills and that there was no substitute for experience. I saw her nearly ten years later as she stood counseling a young nurse. She looked up and saw me walking past and pointed to the young nurse and smiled. She exclaimed "it's me ten years ago!" By the way, she had gone back to medical school and became an emergency room physician.

There's nothing wrong with your heart, Natalia. I know this not based on mere opinion, but rather on many years of training and experience.

You'll be fine.

Best regards and Good Health
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« Last Edit: Sep 16th, 2009, 3:33pm by RLR »  

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Natalia
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Re: Scary episodes again
Reply #4 - Sep 16th, 2009, 2:24pm
 
RLR, you are so right. I know exactly what you are saying.

The story about the nurse is very interesting.
I am feeling much better now after your replies.
Thank you so much for your patience and understanding.
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I'm not tense, I'm just very very alert
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