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Widening QRS in hospital
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Widening QRS in hospital

Hi everyone, new to the forum here.
I am 38 years old with a 10 year history of different heart arrhythmias. A fib, A flutter and SVT have all been documented through event monitors and such in the past. I have a mountain of questions I'd like to throw out there but something happened recently that concerns me more than most everything else.

I went to the ER recently after having some strange feeling arrhythmias (not the ones I am used to feeling) and near passing out. Hospital admitted me for observation. the next day I was bending over to pick something up and straining a little because I couldnt quite reach it. Suddenly the muscles in my legs felt like they were on fire and I was gasping for breath. Went limp and sat down on the floor. I felt a really bad discomfort in the middle of my chest and my heartbeat felt strained. My wife was there and helped me back into the bed. I just happened to look up at the 5 lead monitor they had me hooked to and noticed the QRS spikes had widened. What I mean is, if you think about a QRS spike (tall upside down V shape on the monitor) the line on the left went up and the right line that goes back down was now separated on the monitor and coming down at a different angle making the spike wider than before. The nurse walked in just then and I asked her about the spikes. She took a look and said "yeah they do look a little funny, kind of like a Bundle Branch Block". She then called for an EKG tech to come to my room. As luck would have it the only availabale EKG was apparently on the other side of the hospital and it literally took the guy 15 minutes to get to me. By that time the QRS spikes had gone back to normal and I also felt better. They took the EKG anyway. I was a little ticked because I was really hoping to get the EKG before things went back to normal. Anyway, several hours later I was released and the doctor mentioned nothing about it. I'm not sure he was even aware and I was so happy about getting out I forgot to ask at the time.

I guess my question is this....is it possible for QRS to suddenly widen and then return to normal in just a few minutes? Or was it possibly just a quirk in the monitor or the leads? If anyone thinks the reading was possibly real then what could have caused it? Could it have actually been a short lived bundle branch block or something?

Thanks for any answers on this, it's really bugging me as I have had a few similar episodes since I got out of the hospital.
Tags: QRS, widening, arrhythmia, Heart, ekg, hospital, spikes, complex, atrial, ventricular, lbbb, rbbb, bundle branch, bundle branch block, Monitor, Heart Attack, PAC, PVC, Afib
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3 Comments Post a Comment
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1124887_tn?1313758491
There are several possibilities.

Yes, short bundle branch blocks are possible. This will usually happen with changes in heart rate (often with increased heart rate) and as far as I know usually do not cause symptoms.

Another possibility is that you went into what is known as AIVR (accelerated idioventricular rhythm) which is a rhythm that origin in the ventricles, but at a rate similar to normal sinus rhythm (a slow ventricular tachycardia). That will often cause symptoms, but also usually (but not necessarily) change the QRS axis significantly.

Atrial arrhytmias will usually not change the QRS duration (except irregular rhythms where the interval between beats vary, like A-fib and PACs).

Your question is almost impossible to answer, and of course, technical problems may also be to blame, but again, this would not cause any symptoms. It all sounds a little weird, and if you have those symptoms occationally, it may be a good idea to investigate them. Ask your doctor.
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1807132_tn?1318747197
Yes, I would say if they continue to happen you should go get an event monitor to catch it.  Have you by any chance had the svt treated?  I know afib and flutter can be hard to treat but some svts are quite easy to fix with an ablation.  If you have frequent svt episodes it could be making your other heart issues worse and if you get it fixed it might help give your heart a little breathing room.  Well, just asking.  It sounds like you have a lot to deal with.  Take care and I hope you feel better soon.
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Avatar_m_tn
Thanks for the answers people.
Michelle, yeah actually I have an appointment at the Ross Heart Hospital at Ohio State University coming up. An electrophysiologist there is going to do an EP study and ablation if needed. I'm going to tell him about it. I don't know what all they look at when doing an EP study but hopefully he will be able to see most of what is wrong in there.

Take care.
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