Re: curious tachycardia

Posted By CCF CARDIO MD - DLB on November 13, 1998 at 09:49:13:

In Reply to: curious tachycardia posted by george on November 11, 1998 at 10:21:11:






I am experiencing a form of tachycardia that my physician doesn't recognize, and I would appreciate any help you can give.
I am 75 years of age,with hypertension and diabetes II both of some 20 years standing, and the early stages of Parkinsons'. The hypertension is trubborn, but the doctor keeps the systolic averaging 140 and the diastolic at 65 with quite a bit of medication: lanoxin, cardura, normodyne, lasix with potassium supplement, and lotensin. The diabtetes is under good control with the glycolated hemoglobin most of the time in the normal range, with 26 to 32 units of novolin 70-30 per day. I take sinemet for the Parkinsons' twice daily.
The tachycardia I am experiencing several time a weeek has very specific symptoms. My resting pulse rate is 60 and the pulse quite strong as masured with the finger on the artery just forward of the ear The incident starts with a disturbance in the chest, heart area. This is not a pain: just an awareness that the heart is not beating normally. It is followed by some lightheadness, by a rise in the pulse to about 100, ans by a substantial weakning of the pulse. These symptons remain for the remainder of the attack.
I can stop the attacks immediately with a carotid massage, but my doctor has warned me against using the method on the chance that plaque might be dislodged from the carotid and go to the brain causing a stroke. The Valsava maneuver will also stop it , but not as effectively as the massage. With no action taken, the attack may run for several minutes with the pulse then going back to normal.
There is reason to believe that these attacks come during periods of rest and not during mild exercise such as walking.
Can you identify these symptoms? Thank you for your help.
                                                                                          George
                                                                                     George
Dear George
You are clearly experiencing some form of tachycardia. I could guess as to the specific type, but what you really need to do is make an appointment to see a cardiologist. As a first step, you need an EKG and a Holter monitor (portable EKG). You should also have blood work taken to make sure that electrolytes such as potassium are normal. Thyroid function should be checked. I am curious, who told you to do the carotid sinus massage or Valsalva in the first place? I would stick with the Valsalva for the time being.
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