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did i have a vagal response or something worse?
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did i have a vagal response or something worse?

hi guys. i am a 34 year old male who most recently was diagnosed with coronary artery disease. what happened to me was after my angiogram was complete and i was in the the recovery room,i was expecting to hear good news. but when the cardiologist told me that my entire LAD artery stenosis from 80 to 95 percent throughout,i really freaked out. i started thinking too much and i became very lightheaded,my ears started ringing and there was white fog in front of my eyes.

i told the doctor that i was about to faint and i was quickly hooked up to a monitor. my blood pressure during this event was 152/70 and my pulse was 42. they gave me some water to drink and some ativan and about 10 minutes later,my head cleared up and i actually had a cheerful disposition. the heart monitor,which was showing lead ii,had a ventricular escape rhythm anywhere from 39-44 bmp for those 10 minutes that i was sick. my b/p was 135/95 after i became fine.

the cardiologist said that i just had an excessive vagal tone and that i will not die from it. can someone help me with this,is it normal for the sinus node to fail during a vagal response and have the ventricles become the pacemaker? this lasted for a full 10 minutes and has be bothered but what has me really stressed is my CAD and the suggestion of the cardiologist to get off pump bypass for my LAD. i am so scared,i do not think that i can survive the thought of surgeons opening up my chest.

i have been taking ativan for a week now after my diagnosis and i want to know,if i freak out again and have another lowing of my HR,can it be fatal? i am really nervous,i am way too young for this.  
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OK, take a deep breath here and do not freak out at what I'm going to write.  It's a matter of figuring things out, which will enable you to take the correct course.

Everything hinges on *exactly* what caused your heart rate to slow down during this episode, and you are going to have to go back to your doctor to clarify the matter.

Who told you that lead ii showed you had a ventricular escape rhythm?  The reason I ask is that if that really occurred, it is, as you say, a case when electrical impulses from both the S-A node and the A-V node failed to get through to the ventricles, which then assumed their 'escape' or  'rescue' function with that low rate.  This would be a serious matter indicating that the heart's electrical conduction system was really goobered up, which can indeed happen with blocked coronary arteries, which you have been told you have.  If this describes what was going on, then surgery to fix the problem of clogged arteries is probably in your very near future.

However, on this same occasion, you say that your cardiologist told you that you were having a huge vasovagal response, which just caused sinus bradycardia.  This would indicate he thought your S-A node was in working order, but just generating a very slow rate due to stimulation of the Vagus nerve when you tried to process the scary information you had just received.

So, you need to clarify this issue, for which you have two different and contradictory pieces of information.  Addressing this will be better for you than sitting around going nuts with fear, so take your artivan and write questions and notes on paper to help you keep your wits about you, and then call your doc either for  another appointment or a phone consult.

The answer you get will determine the course you and your doc need to take.  And believe me, if your life is at stake and there's a good chance that it can be lengthened by having your chest cut open, you WILL find the courage to have the surgery.

Please keep us posted on what you find out.  It's a learning experience for us all.





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