Pulsating Neck Pulse...?

Hi Doctor,

When I was 19 years old, I had 3 'black outs'; the third one required CPR to revive me.  I spent a month in hospital, where I under went numerous cardiac investigations.  My Cardiologist considered inserting a Pacemaker, but after discussing my case history with his collegues, he concluded not to taking my age into consideration.  Wolf Parkinson White Syndrom (syndrome) was also suspected, but wasn't officially confirmed.  He prescribed 'Inderal' to treat the severe arrythmia I was experiencing and said that if I have another heart block, that a pacemaker would have to be inserted.  I attended annual reviews for 2 years after that, but then ceased to attend them (due to youthful innocence/ignorance).  

Intermittingly, I've since experienced dizziness and heart palpitations but never told anyone (for fear it would result in a Pacemaker being inserted which I considered for 'an old persons problem' and not mine).  I've just turned 33 years old.  Late last summer I experienced particularly severe palpitations and two episodes of dizziness (where I felt I was on the verge of a 'black-out' but didn't as I laid down and waited for my heart to 'calm' down).  Since then, I experienced night sweats for a period of 6 weeks, cronic (chronic) heart palpitations, throbbing pulse in my neck (which is very visual), permenant tiredness and breathlessness with little exersion.  I attended my General Physician, who instantly referred me to hospital for a full medical assessment.  During which a heart trace was carried out, which diagnosed me with A. Fib.  On the basis of which, I had a 24 hour Holter Monitor fitted.  I await the results from same.  My Mum had a Mitral Valve replacement and wonder if there's a risk I too have a problematic heart valve from the symptoms I've experienced, or do you think if the heart problems I'm experiencing now are related to the heart problems I've had before (i.e. heart block ?WWP).  Is it possible my symptoms could be isolated to the previous cardiac problems I've had and could be retified with heart meds or a Cardioversion, or do you think it's all related to my previous history.  Can you please shed any light as to what my over-all symptoms may be clinical indicators of.  I'd really appreciate your opinion regarding the above, while I anxiously await results of my Holter Monitor.  

Thank you so much for the time you've taken to read my query and enormous thank you in anticipation.

D

[Brooke_38]

Hello...

Your history of arrhythmia does sound a bit perplexing. I am surprised that with the initial arrest requiring CPR, that you were not taken in for an electrophysiology study to determine what exactly was causing the conduction problem.

Given your latest problem of Atrial Fib confirmed by EKG, it's difficult to say how this relates to your past history of arrhythmia because you mention in your post about "suspicion" of WPW but not actually confirmed.

Are you now currently in Atrial Fib? What medications were prescribed for this? Are you also taking some type of anticoagulant like coumadin or at least a daily aspirin? This is very important in helping reduce the risk of stroke from the clots that can form from afib.

Some have success with restoring sinus rhythm by chemical conversion with drugs. If this fails to convert you to sinus than they may suggest an electrical cardioversion. I've been through both, and to be honest I have no memory of it. When the drugs failed to convert me from afib to NSR, I was completely sedated and shocked with 100Joules and awoke in a sinus rhythm. The only reminder of the procedure was a little redness where the elecrticity was delivered.

Once this is resolved I think that you should inquire about an EP Study to once and for all get an official diagnosis. I'm sure that you will feel much better getting to the core of what is causing all your problems.

My best to you as you get this resolved... Please keep us updated:)

[Jerry_NJ]

My AFib may be due in part to a leaky Mirtral Valve.  I also believe these problems can be inherited, genetic.  My Mitral Valve was repaired by surgery in November of 2007.

A echo-cardiogram can determine the condition of the Mitral Valve as well as all other physical conditions of the heart.  This test is none intrusive and done without any discomfort and very little time (about 10 minutes best I can remember).

[Denise2009]

Hi, thank you so much for your response.  I'm currently very much in A. Fib (to the point of having it as I type this response!).  The frequency of the heart-pounding, neck thobbing sensations is increasing.  It's VERY uncomfortable, but what's more, it increasingly unnerving.  To answer your question, no I haven't been prescribed ANY medication, and I'm not taking any other medication.  The Doctor in the hospital merely arranged for me to wear a 24 hour ECG Holter Monitor the following week (i.e. last Wednesday through to Thursday afternoon).  The result of which I will be getting next Wednesday.  

Regarding the Heart Block which resulted in all vitals fading and then ceasing, which required CPR, I did have numerous tests done while I was in hospital.  These included 24hr and 48hr holter monitoring, numerous ECG's, Echograms, Stress tests and I also had an EEG carried out (as a form of Epilepsy called Absent Seasures which had to be ruled out and later was ruled out). Tachicardia was evident in all exams carried out.  The results of the stress test indicated that after doing the stress test, my heart 'skipped beats' when I rested after exercising on the thread mill.  As I said, the overall opinion was to insert a Pacemaker, but this was postponed with annual assessments recommended.  I am familiar with Cardioversions, and I'm aware of their successful outcome.  I guess my biggest fear is that my A. Fib. is as a result of a malfunctioning valve.  I live in hope (but fear the worst with human nature being what is!).  I'll keep you posted.  

Many thanks again for your response.  Till next time, take care,

D