Arrhythmia

My 28 year old daughter has been told that she has a heart murmur and first and second degree heart block.  She started having blackouts and the consultant described it as an ectopic heart beat that sends her heart into an irregular rhythm and causes her to become lightheaded and sometimes blackout.  The consultant did say that this wasn't anything to worry about and the more you worry the more the blackouts will occur.  She had a 24 hour holter monitor, stress test, and an echo.  They said that the 24 hour tape showed first and second degree heart block, the stress test was normal and the echo was almost normal but nothing to worry about.  She hasn't been started on any medication but I have known people get pace makers fit for the same problem.  There was talk of doing electrophysiology to see if they could set off the arrhythmia but have now decided just to leave things and to go straight back if she blacks out.  She gets occasional pains in her chest and the centre of her back as well.

My concern is that her dad has had several heart attacks in his 30's and I had a daughter who died at 6 months with heart valve disease.  I am now wondering if there could be something wrong with the valves in her heart and if there are any other tests that could determine if it could be her  valves.  

My daughter always used to have high blood pressure of 140/100 which was never treat but since Christmas has low blood pressure of 110/52 I have been told that when your blood pressure changes this could indicate a problem with your heart as well.

[Cleveland Clinic]

The first and type I second degree heart block is of no concern in a young pt.  It seems that she probably has an SVT that could probably be treated with an ablation procedure, although I would need more info to be entirely sure.  The valves should be assessed with an echo and if there are no structural problems, that should be enough.  On the other hand if there are structurally abnormal valves a more aggressive echo called a TEE should be done, especially if the regular echo has questionable results.  Finally, I would not be concerned about the pressure.