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Admitted Overnight Sinus Tachycardia "Borderline?"
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Admitted Overnight Sinus Tachycardia "Borderline?"

Hi all, here is the background:

My girlfriend (22 years old) had been sick for a day or so prior to the hospialization, fever, sore throat, stuffy nose, etc.  She had been experiencing bouts of chest pain and back pain with vomitting (found out later that it was her gallbladder).  She made an appointment with her general doctor because she was hoping to get some antibiotics to feel better and she wanted to know what was causing the vomiting/chest pain/back pain.  The doctor ended up running an EKG and noticed that her heart rate was 140.  Other than her being sick symptoms, she had no chest pain, no chest discomfort, and wasn't short of breath.  The doctor convinced her to go to the hospital and admitted her overnight.  He told her he ordered an Echocardiogram and that it would be administered at the hospital.

Getting to the hospital, a hydrostatic blood pressure was done and noticed that it dropped a bit when she stood up.  She was placed on a heart monitor and given those leg pumps while she laid in bed and also ordered food.  She was given IV fluids and tylenol.  The cardiologist was ordered and we were told they were consulting with Electrophysiology.  A second EKG was done at the hospital when we first met the cardiologist.  Upon completion of the EKG, the cardiologist told us that everything was fine and that she just had sinus tachycardia.  He said that they would still do the Echocardiogram just be be sure, but that there probably would be no problems.

She continued receiving IV fluids, had the echo performed, an x-ray and did a urine test.  She also had several blood tests performed (I have never seen so much blood drawn!) including tests for Crohns (which she had been diagnosed with a young age and later to find out she doesn't have it!), cardiac enzymes, BNP, CBC, etc along with several blood cultures.  She saw a GI doctor who told her that they didn't want to do any tests until all her heart issues had been resolved, and her general doctor again.  Later on in the night the nurse came in and told her that her Magnesium was low and gave her an IV, from which she sweated profusely and was uncomfortable.

In the morning the cardiologist came in and told her that even though he hadn't looked at the echocardiogram, he knew that it had came back normal and that no further consults with them were necessary.  Her heart rate had dropped to around 110.  They wanted to do a stool test, but my girlfriend, who did have a bowel movement, did not want to give them a sample because at this point she just wanted to go home and didn't want a delay.  The general doctor came back in and told us that we could go home and that she was on the "borderline" and that he thought it was better to admit than to be sorry.

I guess my question would be what was the "borderline" he was indicating?  Do you think the overnight admission was necessary or do you think it was an overreaction on the general doctors part?  I guess I ask this question because the cardiologists seemed to be so unconcerned with the situation.  Also, it seemed that we had no advanced warning of was going to be done and for what reasons, tests were just ordered.  

Just for other information, she at a later date consulted GI and had a colonoscopy and EGD performed along with blood tests to diagnose for Crohns (the GI doctor was skeptical that she had it since she had gone 9 years without medication and had no symptoms).  All came back normal and the GI doctor rescinded the Crohns diagnosis.  He proceed to treat for GERD, and after many months of little improvement, but not much, we went back to the general doctor again (wait for GI doctor was too long) and asked that he check for gallbladder problems.  He didn't believe the gallbladder was causing the problems, but ordered an ultrasound anyway.  It came back positive for gallstones and he referred us to a general surgeon (he was wanting us to get a HIDA scan too, but we thought it was unnecessary).  After performing the surgery, she had been symptom free ever since.  It took about 10 months after her inital hospitalization to get the correct diagnosis.

Thanks for your help!
-Heart219
3 Comments Post a Comment
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1100598_tn?1377890199
To answer your question. The EKG machine will give its interpretation of the results by saying "Normal, Borderline, or Abnormal". So when they said Borderline, that is what they meant. But it is up to the Cardiologist to interpret all the tests. They probably admitted her because her magnesium (an important electrolyte for the heart to work properly) was low.

Its good to hear she is doing well. :)
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Avatar_n_tn
Hi whisperwolf,

Thanks for your clarification.  I had been wondering what "borderline" had meant ever since she had been to the hospital.  My question now would be do you think they performed the EKG incorrectly at the doctor's office since the cardiologist was so quick so say everything was normal at the hospital?  Or do you think it was because the rate was so fast?

In regards to the admission, the general doctor did the admission, not the cardiologist.  The general doctor based the admission on the borderline ekg and the 140 rate alone, blood tests weren't performed until a couple of hours after she had been admitted so they didn't know her magneisum was low until later on.  She was admitted around 1:00pm and they didn't hang the Magneisum IV until around 11;00pm.  I'm not sure how low her Magnesium was, but she wasn't showing any signs or symptoms.  All I know is she said that she should have told them to stop the IV because she was sweating so bad lol.

Thanks again for your help,
heart219
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1100598_tn?1377890199
Yes, I would reckon they admitted her because of the Tachycardia so they could find out the cause. She can always ask for copies of her medical records to answer any more questions she might have.
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