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AV heart block - How worried should I be?
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AV heart block - How worried should I be?

I'm visiting over here from my regular gig on the MS forum.

I had a chemical stress test last week.  It was ordered after I reported to my PCP that I was having a reoccurring feelings of fullness in my chest and becoming out of breath easily.  When I would check my BP and heart rate during these episodes the HR was always in the low 50s.

The test showed that I was repeatedly cycling in and out of second degree AV block with a 2:1 ratio.  They gave me aminophylline twice but that didn't do much to help.  After 30" they went ahead and took the follow up scan.  They hooked me up to a Holter monitor before I left.  

I saw a cardiologist today.  He said the scans showed no blockage or ischemic areas.  The problem is all electrical.  He ordered an echocardiogram.  I told him that I am getting more symptomatic by the day but since I'm not fainting, he didn't seem overly concerned and made a f/u appointment for one month (says he'll call about the test results).

I'm to the point that I experience chest pressure, my heart pounding a slow rate in my chest, shortness of breath and a draining of all strength many times a day.  Sometimes these things are present in varying degrees for hours at a time.

How worried should I be?  Do I need to look for a cardiologist who hears me better than this one?  I understand that heart block can be present without symptoms and not require treatment.  When it seems to be progressing isn't it time for action of some kind?

Since MS damages the central nervous system and the vagus nerve is part of the CNS, I'm wondering if there is any possible connection.

I was getting scared.  Now I'm frustrated too.  Thanks for any information or suggestions you can give.
Mary
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OK, I get it.  Nobody cares but me.
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We do care but we don't always have the answers. I understand your frustration. I posted something on the lupus board and no one answered for a couple of days. Truth was they weren't familiar with what I had asked.

As you found out there are different degrees of heart block. Generally second degree block is not treated unless the patient is symptomatic. You are having some problems so the doc is going to follow up. In some cases the block can be caused by medications. I assume you discussed all that with the doctor. In some forms of AV block, it will resolve on its own. If the symptoms are severe, they may do a temporary pacemaker.

You should ask what type of AV block you have (Type 2 Wenckebach or Mobitz 1 or Mobitz 2). I'm happy to hear you have no areas of ischemia, no signs of CAD. But you do need some answers.

You may want to see an EP (electrophysiologist), a cardiologist who specializes in the heart's electrical problems. You may also try posting your question on the heart rhythm board if you haven't already. The folks there know more about this type of problem. Hope to see you there.
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