WPW Symptoms

[Imaz]

Hi,

I have been having symptoms of the WPW for a while now though have been looking for a diagnosis.  I have seen a cardio several times over the years but all results have came out to be normal.  I have done an echo, ecg, 24hr Holter and a 7days PARecorder, as well as a stress test({treadmill).

I am by no means a dr but do think my ecg tracing has been overlooked.  If I post my tracing here, would someone be able to help overlook the tracing to see if it has any link to WPW Syndrome.

Thanks

[littlegreenman1]

In asnwer to your question: no. We're not docs.

There are all kinds of SVT, WPW being a particular "brand."  Tom_h can probably say better, but I think WPW has a particular EKG form.

My particular SVT was not diagnosable via EKG.

Did you catch an episode on the Event recorder?

[Imaz]

Thanks for your reply - A few years ago, I was able to post and have answered from Dr's on this forum at a cost of $15 I think, but I can not longer find that option...

I had the Event recorder in 2010, but have all the tracings printed out to me recently upon request.  Infact, all tracings for all ekg were printed out to me upon request this week.

[tom_h]

As littlegreenman1 mentioned, WPW displays a marker even in normal sinus rhythm.  In NSR, ECG characteristics of WPW are a shorteded PR interval, a widened QRS complex, and a small "slur" or delta wave with upstroke of the QRS complex. Sometimes physicians may or may not detect it; it can be that subtle. WPW is in a family of SVT's referred to AVRT.  I was first thought to have WPW as my ECG looked (faintly) like it should.  But it turned out to be another kind of AVRT called Circus Motion Tachycardia, named for the tight looping ring of the accessory path.

I often see people refer to their "racing heart" as WPW, when in fact it could be any number of SVT's, Woll-Parkinson-White included.  The fact remains, when they hit, your heart races, and it's not fun at all.  Depending in the frequency of your SVT, and 30 day monitor is your best bet to capture an event.  Until I used one, my doctor pleaded with me to come to the ER during an event so it could be recorded.  I always converted it instead.  The 30 day monitor captured two SVT events, and I was on my way to a cure, as was littlegreenman1, and a large number of other forum members here both active now, or cured and gone on.  Good luck!

[tom_h]

Sorry for the misspelling above- It was suppose to be "Wolff-Parkinson-White"

[Imaz]

Thanks Tom.

In my NSR ECG tracing, "I think" I have those dips which are seen for WPW - According to all the WPW patient ECG traces I have seen on the web.  Again, I'am no Doctor, and I would be surprised if the Cardio who viewed my traces wouldnt be able to identify it? Unless I am wrong in my diagnosis?

It seems you had some kind of surgery among others on this forum to correct it?

[MichelleP_3811]

You will really need to get your svt captured for an official diagnosis.  It doesn't sound like your cardiologist saw wpw in your ekg but I have heard it can be hard to see.  How often do you feel your heart racing?  Do you get short of breath and feel faint?  If you know you will have enough symptoms within a months time you can get an event recorder from your cardiologist to hopefully capture an event.  Once captured you may be able to get an ablation to correct the accessory pathway svt if that is indeed your diagnosis.  If you truly suspect wpw you should continue to pursue this.  Good luck.  I hope you can get to the bottom of all this so you can get an action plan together.  

[Imaz]

How often do you feel your heart racing? every so often.  I can climb a level of stairs and be completely exhausted.  I can walk around and suddenly have a racing heart.

Do you get short of breath and feel faint?  Shortness of breath, YES.  Feel of faint, YES - Do I actually faint, NO.  

For me, this all started in 2007, after waking up one morning.  I have been to all kinds of blood tests, neurologist, ENT to be diagnosed with nothing.  I have also done cardiology tests as mentioned as well.

When I feel like faint, it is as if I am not getting oxygen to my head and struggle to breath through my nose/mouth.  

Dr's keep saying is probably anxiety etc, but it is not.  I know for a fact I panic because all these started to happen, rather than anxiety triggered it.  I no longer panic when an episode happens anymore, because I am use to it.  I know in minutes, I will be ok.

Yes, I have been rushed to ER many times over the years but to only the hospital tell me nothing is wrong with me, ECG is fine, blood work is normal and dismissed.

I have had MRI's and CT scans of my head which are fine.

All this came about together with some dizzy spells as well, and some days can be really off-feeling, disoriented.

I dont know...

[MichelleP_3811]

I rather think that wpw would have presented sooner but it does sound as though there is some sort of tachycardia going on.  I would suggest going to a cardiologist and asking for an event recorder.  You wear it for a month and when an episode starts you record it and send the information in over the phone.  This way the doctor will be able to see how it starts and what your heart is doing when you are in an episode because if you aren't in tachycardia when you are having a test no one will give you a diagnosis.  I know you said you had blood work done but have you had your thyroid checked?  Hyperthyroidism can cause a racing heart but do indeed go see a cardiologist to get an event recorder.  But for your peace of mind, if you have had the general tests to check the structure of your heart and those came back fine which is sounds like they did, rest assured what is going on will not cause you any undue harm.  You obviously want to keep on top of it and get it taken care of eventually but it is not likely you will succumb to sudden death if that helps ease your mind a bit.  But keep going back to the doctor or different doctors until you can get this addressed properly.  Sometimes it can take a little while to get it diagnosed but persistence pays off.  Good luck.

[grendslori]

I haven't read through all of these posts but having worked as an EKG tech and supervisor and having had a daughter who had multiple heart problems (including WPW) I can tell you that WPW is one of the EASIEST problems to diagnose on the EKG. The P-R interval is shorter than normal so it appears almost right on top of the Q-R-S complex (the main complex for the EKG). Because it is right on top of the QRS, the P does not look like an upside down U which is what it would normally look like. All of the areas on the EKG (P, PR, QRS, T and U waves should all start and stop on the baseline) There is a break about halfway down the right side of the upside down U which swings up onto the QRS. That 'upswing' is called the 'Delta Wave'. That wave represents a 'track' that doesn't belong there. All of your symptoms are brought on with exercise (climbing stairs, walking around ect). This is not a sign that you have WPW, it would be more of a sign of deconditioning or normal sinus tachycardia. WPW doesn't work the way you are describing. Ask your doctor to put an Event Monitor (sometimes called the King Of Hearts Monitor) to have to wear for 30 days. You push a button when you are feeling this way to capture the heart beating. There are other issues that can be causing your problems such as low blood sugar (get a 5 hour GTT done) and ear problems such as fluid behind the ear drums. Get your ears checked when all of this is going on. Take care    

[Imaz]

Hi,

Yes, thyroid blood work was checked, as well as celiac and pretty much every desease I could think off.  All this was looked into by a physician who also dismissed me.  The ONLY thing my GP found strange was my sugar levels, although they were in normal range, they were not consistent, one time they could be higher end of normal, and others it would be lower end of normal.  I have also done the 1 or 2hour GTT glutine sugar test which came out normal.

I have a blood pressure monitor at home which I check pretty often, as it has the pulse rate - On resting, my pulse can be as high in the 90's, and othertimes it can be high 60's.

Either I have been cursed or what, my GP's who I have switch between have also left the practice or retired...  It is like starting over again and again...

grendslori - Thanks for your info.  i believe here they call it the Patient Activate Recorder where you have two cables to attach and it only records on activation.  I had tried this in the 2010 for 7days, unfortunately with my luck, that 7 days didnt experience anything too unusual, but I still pressed the button when I felt a little odd.

I could have used it last night, when driving, I felt like I had no oxygen to my head and feeling of brain fog, like things around me were disconnected even though people were talking in the car!

[Imaz]

Not related, but the past month my upper right hand side abdomen have been a little discomforting...  I brang it up with the GP and they did some blood tests and ultra sound, all seem fine.  Told me to go on a glutine free diet, hasnt helped.  Having a lot of wind, but passing normal stools.  The whole stomach generally feels uncomfortable and frequently urinating.  Must be getting old with all this..

[MichelleP_3811]

I have to tell you during the worst of my heart symptoms I also had a lot of wind.  So much so it was obvious there was some issue but I wasn't really sure what to do about it.  There isn't much online.  Beyond my svt I had pvcs that got really bad after the svt was corrected.  So bad that it made me feel so sick that I wound up doing an inadvertent sort of fast for a couple days just eating a little fruit and granola and water.  And to my surprise after a couple of days I felt much better and the gas was virtually gone.  I did not really connect the gas with my stomach as well because my stomach felt fine and it didn't seem like I was burping more than one should but I think there was indeed build up of gas in my stomach as well that was causing me to have a lot of pvcs and get sinus tachycardia after I ate because the vagus nerve was being irritated.  I still get some pvcs after I eat but if I take antacids it helps calm them down even more to the point I get very few.  So I might go back to the doctor and ask about acid indigestion and see if they would think antacids might help you.  It may not clear up all your problems but it may help you feel good enough to be able to tolerate what is going on better.  Take care.

[Imaz]

Thanks for your reply, you have been very helpful.

Is there any link between gas, abdominal discomfort and the heart?

I'm kind of at a lost, my GP, 2nd opinion GP have all either retired, or have moved to a different City - meaning I need to start all over again.  Regarding my general GP(any Dr) I saw for my abdominal discomfort, she did say to go on a glutin free diet, but it has been very hard with choices of food...  

Do you feel fatigue? Get up in the morning and still feel tired and can still sleep...

I'm not sure if I can walk into a GP and request for a referral to get a 30 day patient activated recorder LOL, - Not only that, but I have never seen one on the referral forms, they have either been a holter monitor or a 7day patient activated recorder..

[grendslori]

You need to get that monitor for a 30 day period....7 days isn't long enough.

[MichelleP_3811]

There can definitely be a stomach component to heart rhythm issues.  The vagus nerve gets irritated and signals get sent to the heart that make it act up.  I almost always get pvcs after I eat that last for an hour or so and then go away.  Beyond the gluten free diet you might also try antacids though long term use I believe can lower your magnesium levels so you may want to make sure those levels are checked and take supplements if they go low.  As for the event recorder I would think you would want to go to a cardiologist for that and any other heart issues you are having as opposed to your GP but not sure how your health system works in your country.  Sometime in the states certain insurance plans require a referral.  Being tired is a tough symptom to track.  There are any number of reasons for you to be tired.  If your blood tests showed that you are basically in balance and not fighting an infection your sleepiness may simply be related to not getting a good nights sleep.  There is a possibility you are not getting enough deep sleep and subsequently waking up tired.  You may need to have a sleep study done to determine if your sleep is being interrupted and why.  

[Imaz]

I have made an appointment to see a GP on wednesday - You need to make appointments here!  I will request to get my stomach discomfort checked out again and cardio referral for a 30day monitor..  I even thought of buying a monitor! - though dont think it comes reasonable cost.

I can tell you for sure I started having ab discomfort since my very first "almost faint" symptoms started in 2007.  I mean literally exactly the same day, because I mentioned it to my first GP..

[Imaz]

Thanks - yes the 7 day is not enough..

You mentioned you had worked as a tech at a cardiology.  Do you have a rough idea what these monitors cost?

Can these monitors do more than just rhythm? ie valve prolapse etc?

[tom_h]

30 day monitors are simple 2 lead devices... at least the ones I've dealt with.  It's monitoring electrical activity as opposed to acoustic abnormalities.  I don't know the fee charged for a 30 day monitor, but I'd venture a guess and say on the order of $5K-$10K.  The cost lies not in the device, but the professionals who take your calls during the monitoring period.

[tom_h]

I searched back thru my claims, and I think I might have found it;  $2100
If so, my initial estimate was way too high.

[Imaz]

I went and saw a GP who was able to review my past results on file.  With regards to my abs discomfort, she's sending me to get a colonoscopy and endoscopy done! Ouch!!!!!!!

Also I requested for a referral to a cardiovascular to get a 30day patient activated recorder - she's never heard or know's who offers one for that long.  So she asked me to find a place in my city and then she will write up the referral. I rang a few places, but so far no one offers the PAR for that long!

The GP also said when she was younger she had fast irregular heart beats then settles for no reasons making her dizzy/fainting symptoms.  She would press on the artery at the neck which leads to the avnod? and that would interrupt the signal and resumes regular pulses quicker  Fortunately for her, this all subsided after being pregnant...

GP looked back at my holter monitor results for 2010, and also the report says Normal - it does state my pulse ranges from ~30 - 80 for that 24hr period.

[Imaz]

Correction, 24hr holter recorder 49 - 138 for pulse

[tom_h]

30 day monitoring periods are quite common here in the US.  The device is often referred to as "King of Hearts" monitor.  Regardless of the duration, the monitors usually record only 3 events before they must "phone home" and then reset to record again.  In a previous post, I wrote a detailed description of the device and how it works.  I'm sure you can find it with a search of the forum.

[Imaz]

One of the cardiology I inquired got back to me and said their devices can do 30 days, but they need to check.  Another cardiology which I normally go to have one new device by omron which can do 30days and you dont need to wear the electrodes - you just hold it to your chest during an event.  However, because it is new, they are not offering the service yet!

How much do these devices cost to purchase?  

[MichelleP_3811]

I actually have one of those.  It was around $300 US dollars and I got it through Amazon.  The problem though for diagnosis is that it will not catch how the event started which I think may be important in interpreting if it is sinus tachycardia or svt.  But it will show how your heart is beating when it is in tachycardia so in that respect it would work.  It will also show if you have any ectopic beats and what type they are.