Slow heart rate-please help

[jessy412]

Hello,
My wife is only 28 yrs old and is in excellent condition, she works out regularly.  A few months ago she began feeling pain in her chest, and feeling fatigued.  She was given numerous tests.  One of which she wore a belt around her chest for 24 hrs.  When she finally had her visit with a cardiologist he told her there were some times throughout the day her heart went down to 30bpm.  He told us on the back of the heart she had inflamation, probably from an infection.  He said he was giving her a steroid to reduce the inflamation.  It was his opinion that once the inflamation was gone the pressure on her heart would go away and things woulds go back to normal.  We asked what if they didnt.  He then said he would want a second opinion.  Then he stated if the heart did not go back we would need to look into a pacemaker!  I lost my mind.  Does this sound right, my 28 yr old, never smoking, runner of a wife needing a pacemaker???  Please, if anyone has any information let me know.  Is it common for inflamation to make your heart slow down?  Please help.

[Michael J. McWilliams, M.D.]

I understand your concerns.  It is probably worth a second opinion.  In the community, it is sometimes hard to know what to do.  Some of the best doctors that I have ever met practice in the community setting and if you get one of them, I certainly trust the opinion.  The problem is that I don't know who gave you that opinion.  It might be worth gathering your tests and rhythm strips and making appointment with an academic medical center.  I would set up an appointment with electrophysiology and cardiology and be available for a few days in case they want tests.

The situation you describe is not common -- that is why I think a second opinion will be helpful.  I agree that a pacemaker should be avoided unless absolutely necessary.

For my own education, please post after you have a better idea what is going on.  If you post the nearest large city I might be able to give you some names.

Good luck.

[jessy412]

Thank you for your input.  The place she went to is Suburban Cardiology. It's in Williamsville, NY 14221.  The drug she was given for the anti-inflamatory is called Methylprednisolone 4mg.   My wife does not seem too concerned in that she believes it is all going to workout.  I wasn't at the appointment so I was unable to see or hear the context in how the doctor was explaining his opinion  to her.  Just the fact that he mentioned the work pacemaker scares me to death.  As I wrote before, I can not believe a 28 yr old female with no heart history, who is very athletic, and who has no family history would need this.  I am even more skeptical that when asked what if the inflamation doesn't go down, and her heart rate doesn't go back up what do we do next, he stated he didn't know and would want a second opinion.  Being that this is the heart we are talking about I am terrified.

[Bromley]

Hi. Second opinions are routinely used as a way to reduce the liklihood that one person might make a critical mistake.  Having a doctor say that he would get one **IF** a situation had even the slightest chance of becoming critical would be reassuring to me for two reasons.  First, it tells me the situation is relatively not critical now.  Second, it says that the doctor is aware of the fact that all humans have limitations, and that he is ready to deal with this fact in the normal course of going about his business.

Sometimes the language a doctor uses can seem alarming.  It is my understanding that in the present state of medical technology, heart inflammation can be dealt with.  From your description, my concern would be the amount of time and effort it takes to get in to see your doctor for a follow up, or in the case that something new develops.  In particular, while you are following through on medical orders or waiting this out as necessary, as far as your frame of mind goes, it is important to be happy and positive so that you can remain alert and keep your wits about you.  Educating yourself and seeking out a qualified second opinion of your own might also help with some of this.


Regards.

[Michael J. McWilliams, M.D.]

did they use word pericarditis?

[degrassi]

did they mention friction rub or discuss antibiotics?

[jessy412]

Initially they used the word pericarditis, and explained it to us as a swelling of the fluid sac that surrounds the heart.  However, after more testing they said that the inflamation was particular to one area of her heart.  That this inflamation was putting pressure on her heart causing it slow down.  That is when the doctor stated it appeared there may have been some kind of infection which led to this inflamation.  That is when he prescribed the anti-inflamatory steroid which I listed above.  Degrassi, they told my wife the pain she was having in her chest was from a "friction rub"  Stating when the fluid surrounding the heart is inflammed, it causes pressure and friction which will result in a chest pain and also a feeling like a knot in the back.  (both of which she has)  She has been on the aforementioned steroid for three days now.  At first, it made her more tired and groggy.  However, she woke up this morning and felt great.  No pain when she inhaled and took a deep breath.  We are hoping this steroid is having a positive affect.  Thank you all for your continued information.  Please write with any more opinions.

[Bromley]

Hi. I am glad to hear about the improvement.  I still like the idea of a second opinion.  I cant say whether an e-opinion would be suitable for something like this, but some well respected institutions can make an appointment actually rather quickly.  For instance, I know that at one time it was possible to get an appointment at the Cleveland Clinic within one week.