EKG Findings

[shon21]

I am 22 years old male 190 lbs 5’ 10”.  When I was 12 I was diagnosed with LGL syndrome.  Well, about a month and a half ago I was taking some diet pills “adipex” I took them for 4 days. On the 5th day when I quit I had an arrhythmia which scared me so the next day I go to pri-med, they performed an EKG said I had RBBB and gave me xanax for stress.  Well I was still not convinced so, come Monday I went to see my doctor and he performed an EKG it was normal.  He said it is just stress but,  will send you to the heart doctor to be sure.  So I go and see the heart doc he checks me out says I am fine says that he wants to give me an event monitor and states that I do not have LGL I have PSVT or SVT.  So I was fine for a while and the got a bad headache and a stabbing chest pain and went to the ER they performed a CT scan of my head, an EKG, and numerous blood tests and said I was fine. A few days after that I experienced a slight chest pain and what I think is shortness of breath and arm/neck pain.  I go too primed, they do an EKG and it reads sinus tachycardia no big deal fast heart.  Doctor gives me athenol. So come Monday I go to my regular doctor he gives me an EKG and it reads Right ventricular hypertrophy.  He says I am fine and might have GERD, and schedules me for a stress echocardiogram.  But, what scares me is one of the side affects of the diet pills was pulmonary hypertension and one of the indications of pulmonary hypertension is RVT “I think”.  Is it possible taking those pills for 4 days could cause pulmonary hypertension?  What is wrong help???

[CCF-M.D.-MJM]

Hi Shon,

I think there are two issues here.  To answer you question, no, I don't think  you will develop pulmonary hypertension from 4 days of diet pills.  Prolonged use is associated with pulm hypertension, but this is not your concern.  On the other hand, I would not use or prescribe diet pills either.  I have heard of more problems than benefits.  The answer is not and probably will not ever be found purely in pill form, although Rimonabant may someday be effective.  It uses an entirely different mechanism than previous weight loss drugs.  It blocks the receptor stimulated by marijuana to give people the munchies.....

http://www.med.monash.edu.au/bbns/units/bns3052/cannabishandout.pdf

Regarding the EKG and LGL, I posted a link below to describe LGL.  At this point I would see an eletrophysiologist.  Your EKG shows some changes, you've been told you have LGL, a similar pattern as RVH (right ventricular hypertrophy, which is what I think you meant by RVT) is seen sometimes with WPW, and anytime you have an intermittent right bundle on EKG, Brugada syndome, although rare, should be considered.  I think an EP doctor is the only equiped to answer these questions.


http://www.emedicine.com/med/byname/lown-ganong-levine-syndrome.htm

Hope this helps and good luck

[Paule]

Almost $50k diagnosing stress/anxiety.

Defensive medicine...

Doctors will keep testing until someone cries uncle and stops the madness.

[hankstar]

LGL syndrome is a somewhat outdated diagnosis from my understanding, AVNRT, AVRT, and WPW syndrome are the most common forms of SVTs. What used to be diagnosed as LGL is probably a noraml variant of some other SVT, mainly the ones mentiones above or even sinoatrial nodal reentrant tachycardia(SNRT), even anxiety sinus tachycardia.

I would tend to agree with paule that this is probably related to anxiety , probably because of the use of few diet pills over a short period, ECGs are famous for false positive diagnosis of LVH and RVH.

Good luck.

[mrbh]

While your symptoms are uncomfortable and upsetting, your other problem is strange, test happy doctors. What a nightmare!

Oh...knock off the diet pills. Not good if you have palps or other heart problems.

Take care and be well.

[dafan]

I dont know if you will read this thread or not but i just wanted to thank you for your expert knowledge in the area of pvc's . If you are a Cardio doctor I would love to know where you are so i can get some expert advice from you on this issue. Seems as tho all my tests came back normal that you can determine in some way that I really do have an underlying condition. I would love to hear about  your insight into this.Again, thank you for the most helpful comments.