GENERAL ADVICE

HI, I STARTED MY NURSING COUSE THIS YEAR AND HAD TO UNDERGO A MEDICAL . DURING THE COURSE OF THIS MEDICAL THEY ASKED ME ABOUT THE BLACKOUTS THAT I HAVE SUFFERED FROM . I EXPLAINED THAT I FEEL DIZZY AND SOMETIMES BIT CONFUSED AND THAT SOMETMES IT FEELS AS THOUGH MY HEART IS RACING AND I FEEL BREATHLESS . I GET SLIGHT DISCOMFORTY ON THE LEFT HAND SIDE OF MY CHEST , AND SOMETIMES FEEL MY HEART SKIPS A BEAT . AND I GET A FLUTTERY FEELING IN MY CHEST THAT SOMETIMES CAN LAST FOR DAYS . SOME DAYS I PASS OUT WITH THESES FEELING WHEN I COME ROUND THEY SEEM TO IMPROVE AND I FEEL LETHARGIC THE REST OF THE DAY . IT DOES SEEM TO BECOMING MORE FREQUENT. I HAVE A UNDERACTIVE THYROID AND ASTHMA . HOWEVER THE BREATHLESNESS FEEL DIFFERENT TO THAT OF ASTHMA .  I HAD AN ECG THAT WAS NORMAL AS WAS THE BLOOD TESTS FOR MY TSH.LFT'S ECT. IT WAS NOTICED THAT I HAVE A MURMUR AND THE GP HAS DECIDED TO REFER ME TO CARDIOLOGY. IT SEEMS TO ME THOUGH THAT AS I BEEN SUFFERING FROM THIS FOR A WHILE IF ANYTHING WAS WRONG I WOULD HAVE KNOWN BY NOW AND REAALY I JUST WANT TO KNOW WHAT YOU THINK . I AM 5FT 6 INC 12ST WEIGHT AND 24 YEAR OLD FEMALE. THEIR IS HEART DISEASE ON BOTH SIDE FAMILY MY GRANDPARENTS DIED HEART DISEASE AS DID GREAT GRAND PARENTS AND MY MOTHER HAS A MURMUR AND MISSING BEATS AND EPILEPSY .

[Michael J. McWilliams, M.D.]

I think seeing a cardiologist is the right thing to do so that you have the reassurance that nothing is seriously wrong.  Your cardiologist will probably do a history and physical, EKG, echocardiogram, and much less likely a stress test.  Some physicians will also order a tilt table test so that they can put a name on what is happening.  In all likelihood your cardiac studies will be normal.  The symptoms you describe are common and hopefully I won't get myself in trouble with the nursing community but these are very common symptoms that nurses have.  The three most common cause for the symptoms you describe are inappropriate sinus tachycardia (IST)  90% of these patients are nurses, paramedics, nurses aids, etc, and the vast majority are female.  The other options are neurocardiogenic syncope and postural orthostatic tachycardia syndrome (POTS).  A 24 hour holter and a tilt table test will answer the question.  I usually on do the 24 hour holter and not the tilt.  The holter will show the average heart rate over 24 hours, with IST it is usually higher than normal (>90 beats a minute average, usually much higher).  The tilt is only done if the diagnosis is still in questions.

The key is knowing your symptoms and knowing when you need to sit down.  Typical triggers are sleep deprivation, fatigue, caffeine, tea and stress.  Individuals may have different triggers.

I hope this answers your questions.  Good luck with nursing school.

[LISAANNE1983]

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