Bradycardia & Tachycardia - is it possible to have both?
Since the last time I asked a question, I have seen three cardiologist and am now currently seeing the attending cardiologist at OHSU. This is the story: I have a history (at least a year) of Sinus Bradycardia, with an average resting heart rate around 46. They say I am not a candidat for a pacemaker until I begin passing out. My current Cardiologist ordered records from the last cardiologist, but didn't get them, so they ran a quick ekg, here is the information:
VENTRICULAR RATE 56
ATRIAL RATE 56
P-R INTERVAL 164
QRS DURATION 78
QTC 421 -
P AXIS 50 - degrees
R AXIS 3 - degrees
T AXIS 27 - degrees
EKG DIAGNOSIS Sinus bradycardia; Possible Left atrial enlargement; Left ventricular hypertrophy
So, today I was asked to go in for a Nuclear Stress Test - NON-Treadmill, here are the results:
They used Dipyridamole Infusion - 50 mg over 4 minutes
Reason for testing: Detection of Myocardial Ischemia ( RO/CAD)
VENTRICULAR RATE 44 bpm
P-R INTERVAL 170 - ms
QRS DURATION 88 - ms
QT 466 - ms
QTC 398 - ms
P AXIS 57 - degrees
R AXIS 44 - degrees
T AXIS 60 - degrees
EKG DIAGNOSIS Sinus bradycardia
At completion of the 4 minutes:
VENTRICULAR RATE 104 - BPM
P-R INTERVAL 192 - ms
QRS DURATION 82 - ms
QT 344 - ms
QTC 452 - ms
P AXIS 57 - degrees
R AXIS 44 - degrees
T AXIS 45 - degrees
EKG DIAGNOSIS Sinus Tachycardia
Possible Left atrial enlargement
Low Voltage QRS
Non Specific ST abnormality
Predicted Maximum heart rate for my age is 163 and Predicted 85% for my age is 137. My max was 110 bpm. This was 67% of predicted heart rate.
During this test I reported a headache at 1 min quickly followed up with chest pressure/pain and then at 4 minutes I had an overwhelming sense and broke into tears. At 5 minutes they administered the aminophyline - 75 mg.
So, I can't figure out how you can have bradycardia and tachycardia at the same time...is that weird? What exactly does all of this mean? Does it explain why I am so exhausted all of the time. Why I reported inconsistantly with the holter monitor? Any one have any ideas on this???? Anything you can help me to understand would be helpful. Thanks!~
Well I have a natural genetic bradycardia rhythm and I also have a SVT which is a tachycardia condition. My heart rate can go from 44 beats per minute to 229 beats per minute in the matter of 1 heartbeat. I've never heard of tachy-brady syndrome but I think what I have is different.
I would say in answer to your question though - yes someone can have both.
I think if you had anything to really worry about they would have said something to you in response to your stress test. Usually good doctors will take a little time for you to ask questions when conferring with you about test results. You seem a little anxious about the results still though so I would sggest another appointment to talk it over with him/her.
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