heart and head

[turtlegreen]

Hi,

I have a couple of questions and hopefully, I will do my best in asking them clearly.

I have been experiencing heart palpitations since about this time last year.  The first time my heart felt weird, I checked my pulse which would go from approx 50 bpm to 80 bpm within minutes.  I eventually went to the ER because it made me quite nervous.  I was admitted and stayed in the hospital for a few days with bijeminy and trigeminy.  When discharged, I saw my FNP at my PCP office who gave me a holter monitor.  Besides a skip or two, nothing showed up and up to about a month or so ago, I felt fine.  I would have an occasional skip, but it didn't cause me any concern as I was told many people have this kind of thing happen.

About a month or so ago, I experience about two weeks of this constant skipping, missing, extra beating kind of symptom (whatever one wants to call it).  I requested a holter monitor from my FNP, who because of some other issues, perhaps didn't find it necessary to give it to me right away.  That was a Thursday.  I picked up the holter on Monday.  When the results came back, my FNP called me and said she had the results back and the reports looked pretty uncomfortable (thanks).  By the time she called, the weird beating thing, had gone.  She told me she discussed the results with the doctor and then said if I wanted to do so, I could go on a pill.  I declined taking a pill as this was the first time since last year anything like this had happened.  I asked if I should see a cardiologist and she didn't think it was necessary.

During the past week and a half, I've been experiencing the same kind of irregular heart beats.  I didn't call the doctor/FNP because the impression I was given the last time we spoke was that this was fairly normal and it wasn't going to kill me.  I figured I'd just deal with the discomfort.  

On Wednesday (Apr 22), I was scheduled for an S1 Nerve Block via conscious sedation.  The doctor asked me if I had any kind of heart issue and I told him about the bi/tri geminy I had last year and the occasional palpitations I had and told him I was having them at the moment and for about the past week.  He asked his assistant to do an EKG.  Then, my doctor came back after reading the EKG and said he wouldn't be able to do the injection because of the EKG.  The EKG read:  2nd Degree AV Block (Mobiltz 2) with Premature Tarch (not sure how to spell that out).  Needlesstosay, this scared me.

I immediately went to my partner's PCP office and saw her nurse who after taking two more EKG's and having the docctor read all three, said the EKG taken by my back doctor was over read.  I asked her if she thought I should see a cardiologist and she didn't think so (I've since made an appointment to see a cardiologist).  She also prescribed a beta blocker for me and told me to come back in a week.  I've taken the beta blocker (propranolol) and still have the irregular heart beats a couple hours after taking it.

Brief history:  I am overweight (obvious suggestion is to lose weight).  I am a smoker (obvious to quit and I've been cutting down).  I am a 100% disabled veteran and have had 5 knee surgeries in the past 14 years, have some interesting problems with my feet (not sure what they are) and have retrolisthesis and herniations in my back L5/S1 & L3/L4.  I have PTSD and ADHD and take Wellbutrin 200 mg per day and Adderall XR 20 mg per day.  I have an rx for clonazepam, 1 mg up to 4x per day and an rx for dilaudid, 4 mgs up to 3 x per day.  I take the dilaudid and klonopin sparingly and as little as possible.  If my pain flares in my back or feet, I take the dilaudid.  If I am having extreme symptoms from the PTSD, I will take the klonopin.  Occasionally, I take zantac 150 mg for upset stomach (maybe 2-4 times per month).  

In December, I was having some extremely strange and very painful headaches lasting all of 30 seconds which I saw my nurse for.  She ordered an MRI which came back as having a bulbous something on my pituitary gland and that a contrast MRI should be done.  She checked my prolactin which was normal, then classified my headaches as "other headache syndrome" without any further investigation.

It seems to me (here come my questions, I guess), that my FNP's seem to think I don't need to see a specialist for either of these problems.  Here are my questions:

I am wondering if the headaches and irregular heart beats can be connected?

How often are EKGs over read?  Can they be under read?  Do I need to be concerned about the latest EKG saying I have a 2nd degree AV block (type 2)?

Are any of the medications I am taking contributing to any of the symptoms I am having?

I have an extremely good sense of what it feels like to have a panic attack or anxiety and this doesn't come close to what those feel like.  I can have the irregular heart beats regardless of being in a good mood or a bad mood, nervous or not nervous, anxious or not anxious.  I can say that if I am anxious or nervous, it seems to make the irregular heart beats more noticeable or perhaps skip more (I'm not sure about that).

I limit caffeine and am trying to quit smoking (but won't take chantix).  Although I used to, I do not eat an unusual amount of fast food (perhaps a McDonalds hamburger once or twice a month).  I've eliminated most soda from my diet, limiting myself to one or two glasses a month and do not drink anything but diet.  I drink a lot of water (usually with crystal light)

I'm not really sure what else to say except that I am a bit concerned that I've had two episodes with my heart that have lasted more than a week/two weeks and really am not sure what can be contributing to it.  I get the occasional stabbing headache pains but they are unpredictable so I cant comment on them more than I already have.

Any suggestions would be helpful.

Thanks,

[Barbmag]

You could ck out some of the  herbal teas too. I never really cared for them until I started making ice tea and gradually got use to them. The one that I still have trouble drinking is chamomile. The health food store carries a variety and the tulsi ones are suppose to be good for stress. I will buy fruit juices as well but not with high fructose corn syrup. It's just that they all have a lot of sugar. Again, the ones from the HFS seem to have less sugar and more of the healthy ingredients.
Good luck, TG and let us know how you do.

[turtlegreen]

Hi, thanks for the information and the support in seeing a cardiologist.  My guess is that if something can be over read, then it can also be under read so hearing that gives me hope that I'm doing the right thing.  

As far as the aspartine, you are probably right and I will certainly google the side effects of it.  This wasn't an issue when I was a kid.  I didn't drink soda, just concentrated frozen juices (which I'm assuming was much better).  As it will take time getting used to not smoking, it will probably take tiime getting used to drinking just water.

Thank you for all of the responses and interest.  And yes, FNP is short for family nurse practitioner.  

Thanks again!
TG

[Barbmag]

If it were me, I would def go to a cardiologist. You need an expert in the field.
Also, I was listening to a talk show recently, and a guest was on talking about the horrible side effects from drinking anything with aspartame, splenda, and all of the artificial sweeteners. I did not pay that much att b/c I had heard similar discussions before and just could not stand the taste of the stuff. Google 'negative side effects from artificial sweetners' and see what info is out there re. this. I had a friend who suffered from many ailments, none serious but her v progressive doctor told her to stop all diet soda, even regular sodas, etc and her symtoms went away within a week! This was 2 yrs ago and her health has been perfect.
You are cutting back on the 'smokes'...continue this and you will be so thankful that you quit!!!
And re caffeine, I can not have any....even a small amount will start my palps so it's just not worth it. I can drink a small amount of tea but mostly drink herbal teas from the health food store which are quite nice..even iced.
My best to you and thank you for your service to our country.

[DodyRosy]

A cardiologist should read your ekg. They are the experts in this field and I am telling you as someone who works in the medical profession that other physicians and nurses just can't read them accurately. They can only read the common arrhythmias and overlook the ones that aren't seen frequently. They don't do this all the time and there are a lot of subtle things they can miss.

If you do have second degree block, beta blockers are not always a good idea. They can affect the av node.

Go to a cardiologist. Make a list of your questions and ask them all. Even if they act like they don't want to answer them ask anyway.

[Jerry_NJ]

Interesting tale... and while I don't know what an FNP is... hum, Family Nurse Practitioner ?? Sounds like something like that how your interface is described.  In any case, whatever it is, I think it reasonable to see a cardiologist.maybe even advisable.  

For sure, stop smoking, I quit 25 years ago, and while it was hard for a couple of years, I have not had any reaction to smoking other than disgust for the past 15+ years, I mean that in the sense of I hate the smell of smoke, and thus have no desire to ever smoke again.  It is a nice freedom to achieve and I'm sure it will make you feel better all around.  Now quitting smoking and not gaining weight...that could be another struggle, but it sounds like you've moved already to a "heart healthy" diet, so just keep it up.  I can't say I'd recommend the diet soda, but I do drink it myself, I suppose about 24 oz a day.

Good luck,