Irregular heart beat...URGENT

Hi and thank you for this web page.
I am very concerned about my 18 year old son. For about 6 years now he has been having episodes where he feels as if his heart is shocking him. He says it just feels like a jolt. At first it only happened when he was really pushing himself while playing sports. Now it happens when he is just sitting in class or walking. He says sometimes if he wasn't sitting down when it happened, the "shock" would bring him to his knees. His heart rate will be irregular and his blood pressure goes up. Sometimes his heart rate is so low the nurse at school has a hard time finding it. He is on Toprol XL 50 and the doctor said when it happens just take another pill.
After these episodes he is so exhausted he sleeps anywhere from 2-6 hours and is exhausted the rest of the day. They seem to be happening more and more.
The doctor said we may never find out what it is, but he doubted he would die from it.
He has wore an event monitor, had a stress test, had an echocardiogram all with ok results. He did have a tilt table test which he passed out on.
My family is significant for heart problems. My mom died at 46, her brother at 40. I have 3 sisters 2 have had heart attacks  at ages 46 and 49 and I had a double by pass at age 48. My great niece died at 18 from what they said was an irregular heart beat and my niece that is 30 just had a heart attack, flat lined and was brought back and recieved 2 stents. High cholesterol rins in our family
I am begging someone to listen to me and give me some clues on what might be happening to my son.
He is very athletic not overweight at all and he is very confused and worried about what is happening to him.
Please help.
Thank you Jan

[Momto3]

My goodness Jan...that is quite a lot to deal with.  When our children are involved, the stakes rise about ten-fold.  What diagnosis was your son given with respect to the "events?"  Given the family history, I tend to agree with you -- I'd rather error on the safe side.  You are relatively close to the Cleveland Clinic; is there any chace you could get a consult at the CC?  The CC also offers an online "e-opinion."  There is a charge for the service, but sometimes it helps to get an opinion from the experts.  

How does your son's doctor explain the "shock?"  I get pvcs and other stuff, but I never feel shocked, just some flips, flops, tumblings, etc.  

Please try to post your question under the "Ask a Doctor" forum (above left).  They only accept 2 questions per day/site and it seems that the best time to try and post is between 7 - 9 a.m. (EST).  Have your quesiton ready and then if you get in, you'll can just paste it into the box.  

[jannyl2]

Thank you for your reply.
His diagnosis is syncope and tachycardia? (sry if the spelling is wrong)
I am so scared something is really wrong and no one is taking him serious since he is young and and active.
I will try and post it, but I have to be at work at 7:00 and don't get off until 3:30. I do not have internet access at work.
Thanks for your help though. I didn't think anyone would reply.
Jan

[Barbarella]

Did your son ever see a Cardiologist?  You mention his "doctor".  If he has not seen a Cardiologist I'd make an appointment, I think your son needs to see a Specialist.

[Momto3]

You're welcome.  I agree with Barbarella....take the ball into your own hands and schedule an appointment with a cardio (or get a referral if you need one).  If everything turns out fine, then it was worth the peace of mind.  If there is an underlying problem, you'll be right on top of it.

Oh, the forum also accepts questions on weekends.  I'll keep my fingers crossed that you can get your question in to the doctor on the rhythm forum.  He is really great at helping people out.

connie

[Momto3]

I just clicked on "post a question" to the doctor.  There is a $20 fee (I think because there have already been 2 questions today), but it might be worth the money.  The cardio on the rhythm board is really nice and he has been very helpful to a lot of posters.

[jannyl2]

Yes, my son has seen a cardiologist. He had him do the stress test to see if he could get his heart to go into one of the episodes, but of course my son felt fine that day.
I will continue to try and get my message posted.
Thank you for your interest and help with my son.
Jan

[dolfnlvr]

I agree with the others.  I would post the question to one of the forum docs.  Then I would go back to the cardiologist and keep at it until I had a good answer.  This is NOT a normal arhythmia, and your son's body is telling him something is wrong.  

My situation is much less imperative, but when I first started passing out as a teenager it took us 5 doctors and a situation where I passed out IN THE OFFICE in front of the doc before they took us seriously that it wasn't a "normal" fainting spell (my heart rate drops to 11 beats per min when I pass out).  Then suddenly it was a priority to figure it out and make sure I was okay.  So...be persistent and go wherever necessary to get to the bottom of this mess.

Good luck!!!

[jannyl2]

Thank so much for your input, What did the doctors decide was the problem with you? Did you ever have a "shocking" sensation that left you totally exhausted?
Jan

[dolfnlvr]

No...no shocks.  I have a variety of issues.  The passing out is from vasovagal syndrome.  I have an overreactive vagal nerve, basically when my adrenaline gets going, my "calm down" message gets over done.  It causes me to pass out and have my heart rate drop to as low as 11 beats per minute.  I've been on medication for it in the past, and they did recommend a pace maker at one time, but thankfully I haven't had to go that far.  To diagnose the issue I was put on a tilt table at a 45 degree angle. They let you stand there for awhile, and, if you have problems, then your blood will start to pool in your legs causing a drop in blood pressure.  The drop in BP will cause fainting/passing out.  If you don't pass out, they give you some meds that will help the process along...for me there was no need...I was out in 9 minutes flat.  Thankfully, my heart is in good shape, as are my arteries, so the effects are relatively benign.  But it does wipe you out.

I just know what it's like to know that something is "not right" and have doctors poo poo it like you are overreacting.  You almost feel like doing a dance in their face when something happens and all you want to say is "I told you so, I told you so."  Then you just want to get on with fixing it.  

Be persistent.  And ask the forum docs for advice.  Many of them can recommend nearby medical centers that have the best chance of helping your situation.  Just be sure to tell them where you are located.

Good luck.

[Artaud]

Hi,

In addition to being evaluated by a Cardiologist, I would consult a Neurologist for the Shock Feeling. I had suffered from Seizures for 19 years without a diagnosis being made. I would get the common feelings of Deja Vu, and I would experience lapses in memory pertaining only to names. I have had the events while operating automobiles, I was always aware of where I was going, always had seemingly normal reflexes during the seizure, but the Deja Vu and Memory Loss of names were the prominent features.

I started going to Pharmacy Technician Classes, a 6 month course that would have qualified me fill prescriptions and dose IV bags in hospitals (all under the direct supervision of a qualified Pharmacist, of course), and during the school I would have a similar feeling come over me, causing me to fling myself backward, sometimes against the wall (which I was sitting next to). The Instructor asked if I was OK, and usually pleasant with my Instructors, I barked "no, I'm not OK". So I went back to my Neurologist, who was a jerk, so I found another Neurologist.

The new Neurologist ordered a 24 Hour EEG. (not EKG). Do you have any idea what it is like to leave the hospital with 20 wires glued to your head? (I'm not sure if it was 20, but it felt like it ;-) Anyway, it was discovered that I was having seizures. I was prescribed Dilantin, and for the first time in 19 years, I was finally symptom free.

Do not assume the PVCs are the cause of the Shocking Feeling. Problems with the heart rhythm may be causing Seizures.  Or it may be that a Neurological Condition is causing the PVCs.

I read a report the other day of a man admitted to the hospital with Seizures that he would sometimes experience at night or the early morning. Conventional Seizure treatment failed, but for some reason the man was implanted with a Cardiac Event Monitor. It was discovered that he was periodically experiencing 35 second pauses in his heart beat.

Cover both aspects in the quest for your Son's health. I am especially concerned about the tiredness that occurs after the event, this is a hallmark of some seizures.

Best of Health to you and yours.

[PVC man]

I think you posted that he had an event monitor?...that's usually a long period of time during which your son can trigger the recorder and you can get IMMEDIATE feedback as to the naure of the arrythmia

If it were my son I would just want to make sure that the TYPE(s) of arrythmia was documented so that an effective diagnosis/prognosis can be made...have they "caught" irregularities for your son on event monitors?...if so...what type ARE they? ...that should dictate the decision as to prognosis and courses of action/therapy.

I know I was relieved when my PVCs were finally "caught" on a stress test...to me...I felt like I would drop dead from fear but Iwas assured afterwards that these were NOT dangerous episodes...

I agree with others that if the feelings are accompanied by fainting or dizziness that this is a cause for concern.  My  cardio has always told me that I should let him know ASAP if I fainted from an irregularity.  I am not bragging or anything but it is very weird... I can hace PVCs every five seconds and not feel the least bit dizzy (I just feel like jumping out of my skin.)

Also, I feel with your strong family history of some problems and some early deaths that the cardios need to be VERY COMPLETE in their evaluation and not just tell him to "take another Toprol."

It is always scary when our kids are sick...we all wish you the best and we're here to try and help...

[Happy2girls]

So sorry, this must be causing you tremendous stress.  Have you asked your cardiologist to refer you to an EP specialist?  Google "EP Study" and see if perhaps you think this type of specialist will be benefical to your son.  Good luck to you.

[Momto3]

I just wanted to follow up on Artaud's EEG post. When my son was about 7 months old, he had an EEG among many tests.  It definitely was very strange to see all those electrodes stuck to his head.  And, Artaud is right, there are a LOT of electrodes!  He had some hairdo after that test..LOL.  Fortunately, that test was negative for seizures.  

For a few months prior to the test, my son had been sleeping for inordinate amounts of time.  He rarely fussed over anything and was content to snooze.  At first, I thought he was just a very calm baby, but as time went on, I knew something wasn't right. For a couple months prior to the EEG, he suffered with several illnesses (ear infection, bronchitis, strep, pneumonia, eye infection) and had been treated, repeatedly, with antibiotics.  After about 30 visits/tests, I was exhausted and still searching for answers.  I insisted on allergy testing, including a test for penicillin.  Despite the doctor's belief that a penicillin was extremely unlikely, he agreed to the test. The doctors were nearly certain it was not a penicillin allergy, and they were wrong.  The doctor was so astounded with the results, he took my son down the hall to show his colleague. He said he had never seen a patient so young with such a severe reaction; he said we saved our son's life.  My son is in his 20's now and I can count on one hand the times he has been sick in the last 20 years (knock wood).  

Anyway, I know this isn't cardiac in nature, but I wanted to stress the importance of following through on your instincts.

Artaud, my EP is the same way about dizziness, fainting, shortness of breath. I was also very fortunatel.  Despite the frequent pvcs, I never had significant dizziness and never passed out.

[SwanSong]

I've that shocking to the heart you describe Janny. I am on two heart medications for atrial fibrillation caused by Perimyocarditis and Pericardial Effusion. When I first got on the medications I had a near syncope reaction to them several times and felt as though my heart was being shocked. I was exhausted after each episode and had to go lie down.

Your son isn't taking the medications I am on, but I wonder if his sinus node, the mechanism in the right atrium which sets the heart beat, has a problem. That's where my problem is because of inflammation in my heart and pericardium.

It took me 2 years of on and off symptoms and 8 months of constant symptoms and 11 visits to the ED at two hospitals to get a diagnosis and proper treatment for all my conditions.

[dolfnlvr]

Bumping this up, because SwanSong had a similar experience.  Want to make sure you saw that.

[jannyl2]

Hi, I am sorry it took me so long to get back to all of you. Thank you all for your input.
Yesterday my son had another episode at school. He was in class and felt his heart do the "shocking" thing again. The girl next to him asked him if he was OK and he said no. She alerted the teacher and he was excused to go to the office. He couldn't make it and was doubled over with pain and said he knew he was on the verge of passing out. Another student saw him and ran to get help. I got a call and said they had called the ambulance for him. They gave him 4 baby aspirins and 2 nitro pills before his pain went away. He was on oxygen and scared to death. This was by far the worse one ever. At the hospital they did a chest X-ray...normal, blood work...normal and an echocardiogram..normal. After 4 hours we were sent home again with, "Well, I really don't know what's going on, but I'm sure it's not life threatening. It could be in his head, it could be an electrical malfunction of some sort, or there were a few things that could maybe be Wolfe's Parkinson White Syndrome, but I doubt it. Return to normal activity and come back if you have problems. So, 4 hours later, a ride in the ambulance, and $100.00 before we walked out the door, I still have no answers.
I am trying to get a referral to a hospital in Louisville Ky. Keep us in your prayers and keep your fingers crossed we find an answer somewhere.  Thank you all. Janny

[Momto3]

Do not give up!  You know him better than anyone.  Great news on the good test results, but you still don't know what is causing the episodes.  When I read that he was given 4 baby aspirins and 2 nitro pills, my inclination is to think "heart."  I suppose it's hard to say if the nitro "worked."  I believe the doctors have told my dad, if the pain is NOT cardiac in nature, the nitro will NOT work. And, if it does work, it should work quickly.

Talk to your son's doctor about a referral to an EP. If it's "electrical" they should be able to help, With your family history, a positive tilt test and continuing episodes, I'd keep exploring.  I'm sure he is frustrated and will probably welcome any tests or appointments suggested.  Because his episodes are not all the time, you might be interested in a loop recorder.  It is implanted and in place (recording) at all times.

One last note, because it is "not life threatening" does not mean it is not "life altering."  Good luck with the referral.  You may way to visit the website for the Heart Rhythm Society and look to see which doctors are in your area.  Maybe you'll find one in Louisville that is a member.

[Barbarella]

We live in Louisville, and "Jewish Hospital" (Heart and Lung) is listed among the top 10 BEST hospitals throughout the U.S.  I've had tests done there and have seen a Cardiologist there,  I was very satisfied.  

Good luck to your son!

[jannyl2]

Thank you so much for your input. Trust me, I am not giving up. I know somewhere, someone has had these same symptoms and a Dr. somewhere knows what to do about it.
I will keep you all updated on our progress.
God bless, janny

[whatayear]

Hi I didnt read threw everything there was alot of stuff but has your son worn the 30 day monitor?
Its through lifewatch and its like a constant EKG it is through lifewatch and any cardiologist can order this it is sent right your house and you hit a button when he would have an attack its an event monitor. good luck!