2nd Opinion

I'm 45yr female,no high blood pressure,no high cholesterol. Father died suddenly at 47(no autopsy-presumed to be heart attack).Both mother and father are from Italy. About a month ago, I started having chest pressure/shortness of breath. Went to ER.EKG,Chest xray all good. No blood clots.Sent home and advised to have nuclear stress test the next a.m. Was on the treadmill not even 1 minute when they had me slowly get off. My EKG was going totally erratic.Sent me back to ER.Cardio's asst said I had a life threatening rhythm. Nurse said we shock people in that type of rhythm. They did an emergency cath.No blockage.Sent home the next day on calcium blockers and told to go back to cardio in 5 days for retest on treadmill. Failed again.Referred to an EP and for an MRI.Put on 50mg of atenolol and off calcium blockers.MRI negative.EP did echo(negative),treadmill still showed extra beats so upped dosage to 75mg. Been on event monitor for almost 3 weeks and I'm having frequent palpitations(EP said just had me wear one to see if I could feel them).Guess I passed that.He upped dosage to 100mg. He tells me what happened was I have a heart tissue in the right ventricle area go haywire.He said these things just happen, albeit perhaps not frequently.He said I could have an ablation if the palpitations really bother me.In the meantime, I've become an avid reader of this website and tried to find some comments that would ease my mind. I've read about ARVD and pushed the EP to do a signal averaged EKG.He said he would.I'm going for a 2nd opinion.Does this haywire tissue make sense?can i relax

[Cleveland Clinic]

oakroom,

ARVD is a difficult diagnosis to make. Im assuming you had ventricular tachycardia. Given your family history of sudden death and your arrythmia, I definitely would seek evaluation at a tertiary referral center for further evaluation of your arrythmia.  

It is impossible to determine the right next step or guide you without full review of all of your data, but I hope this is a start.

good luck

[oakroom]

Thank you. My 2nd opinion will be with Dr. Leon (EP) at Emory Hospital in Atlanta whose specialty is in ARVD. That qualify as a tertiary referral center?

[Cleveland Clinic]

Yes certainly.  Please update us after your visit.

[Stelladallas]

If I were you, I would run for that second opinion.  For years it was believed I had hypertrophic cardiomypathy.  I was asymptomtic for yrs. then I started with runs of AF and frequent hospitalizations.  Since I live in a small town, the cardiologists came from the city and I saw several.  Well, to my luck, one of them finally said I had to choose just one because it was hard for him to review the case and I wasn't getting anywhere.  I had already had an ablation and that didn't work.  After he told me that it was genetic and that I should have my family checked, I could not accept this because none of my family had the history they talked about.  With his blessing I went to the Mayo Clinic and they did extensive testing and said, no, it was not mypathy, but diastolic dysfunction and that I was having sick sinus syndrome.  My meds were changed and I was still having either a fast rate or very slow rate.  When it went down to the 30's they inserted a dual chamber pacemaker.  Wow!  I love it because I feel great and my heart does not feel wishy washy and am walking 2 miles a day.  Run for the second opinion.

[oakroom]

I went for my 2nd opinion this morning and he was pretty net and direct. Even with the negative tests, there are still factors I have that could indicate ARVD. The only way to be sure was to have a right ventricular angioplasty and the biopsy. I've agreed to do that and we're doing it Tues.Feb 8th. This past Monday, I woke up to put my 3yr old son in bed and as I walked back I felt my rhythm going nuts and I couldn't catch my breath. Called 911 and they told me I was having pvc's with vtach. My pressure was 140/90. After a few hours I was sent home but this was the first time I had NSVT that wasn't exercise induced and it was frightening. I have to know what is going on.I was starting to get light-headed Monday and thought I was going to pass out. The biopsy will be done by Dr. Smith who does about 100 of these/year. I'm ok with the procedures. But Doc, would sure be nice to know that you think these 2 procedures are worth the risk? I think the consensus of the opinions is something serious is going on, but they still don't know for sure what without these additional invasive steps.