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PLEASE HELP
Last Tuesday night at the beginning of his work shift, my husband experienced tachycardia while sitting. His pulse was about 120 BPM. Initially he wasn't concerned, until he started experiencing slight disorientation. Upon sitting for 15-20 minutes he could not get his heart rate to decrease so I picked him up and took him home.
Pulse rate declined on the ride home while he was sitting in the car, however, by the time he made it to the bedroom his heart was beating out of his chest and his mental state became severely altered. His pulse rate was in the 140's. Needless to say an ambulance came and took him to the emergency room. Later he was admitted into the hospital. For the next day and a half or so, his rate was in the 130's, 140's, 150's.
The doctor originally thought it was meningitis, and treated it as such with IV antibiotics being constantly hung until Friday afternoon. By this time his heart rate had gotten down to 80's and 90's, which is still high for him but apparently stable enough for him to go home.
His CSF was negative, so the doctor ruled out meningitis. His CT was negative. All of the cardiograms showed normal function. The doctor said his heart was running fine, not on it's own but like it was being told to run by a chemical. All tox screens were negative. My husband doesn't take drugs besides caffeine when he wakes up. He had a cup of coffee's worth 4 hours before work and that's it.
Our biggest concern right now is that ever since this incident, my husband feels intoxicated like he's had a couple drinks. His thinking isn't really noticeably altered to him, but perceptually he says things aren't right. His spatial perception is slightly off, his timing is reduced, and he is slightly unsteady on his feet. He has an appointment with a neurologist on Thursday, but we were just wondering what this could be. Could it still be meningitis even though the CSF was negative? Glucose was apparently normal, white cell count was 11.89.
Pulse rate declined on the ride home while he was sitting in the car, however, by the time he made it to the bedroom his heart was beating out of his chest and his mental state became severely altered. His pulse rate was in the 140's. Needless to say an ambulance came and took him to the emergency room. Later he was admitted into the hospital. For the next day and a half or so, his rate was in the 130's, 140's, 150's.
The doctor originally thought it was meningitis, and treated it as such with IV antibiotics being constantly hung until Friday afternoon. By this time his heart rate had gotten down to 80's and 90's, which is still high for him but apparently stable enough for him to go home.
His CSF was negative, so the doctor ruled out meningitis. His CT was negative. All of the cardiograms showed normal function. The doctor said his heart was running fine, not on it's own but like it was being told to run by a chemical. All tox screens were negative. My husband doesn't take drugs besides caffeine when he wakes up. He had a cup of coffee's worth 4 hours before work and that's it.
Our biggest concern right now is that ever since this incident, my husband feels intoxicated like he's had a couple drinks. His thinking isn't really noticeably altered to him, but perceptually he says things aren't right. His spatial perception is slightly off, his timing is reduced, and he is slightly unsteady on his feet. He has an appointment with a neurologist on Thursday, but we were just wondering what this could be. Could it still be meningitis even though the CSF was negative? Glucose was apparently normal, white cell count was 11.89.
MEDICAL PROFESSIONAL
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
It sounds like your husband had an episode of fast heart beat associated with some confusion and some unsteadiness. With normal CSF, meningitis is not a likely diagnosis. With a fast heart rate, a cardiac cause is more likely than a neurologic one. The neurologic symptoms of unsteadiness and confusion would be secondary to the brain not receiving enough blood because of abnormal heart function. A fast heart rate could be electrophysiologic, due to an abnormal heart rate generator, or metabolic, from something else going on in the body such as thyroid problems. As you mention, toxic exposures can lead to this as well. Continued follow-up with a cardiologist is certainly recommended if these episodes of fast heart rate occur again.
There are very few neurologic causes to fast heart rate, but one would be seizure; it sounds like you are set up for EEG, which would be useful in elucidating this further. The other neurologic cause of the fast heart rate associated with the symptoms described above could be due to a problem with the autonomic nervous system. The autonomic nervous system is the part of the nervous system that controls blood pressure, heart rate, and other functions. It is not located in one specific part of the brain or other body part but is rather made up of several different components: a region in the brainstem, certain receptors located on blood vessels and in the heart, and small nerves in our skin, among other areas. Dysfunction of the autonomic nervous system due to whatever cause can lead to a variety of symptoms including but not limited to orthostasis (which means symptoms or signs resulting from assuming an upright posture), light-headedness with drops in blood pressure when sitting up or standing up (this is an example of orthostasis), fast heart rate, syncope (passing out), constipation, diarrhea, sweating abnormalities etc. If there is a problem in the small nerve fibers, what is medically termed a small fiber neuropathy, in addition to these symptoms, burning/tingling in the feet and hands or mild sensory loss may also occur. One type of autonomic dysfunction is POTS syndrome, a condition with no known definitive cause in which the heart rate goes up inappropriately, leading to palpitations and light-headedness, and this is treated with medications that prevent these heart rate increases such as beta blockers. Disorders of the autonomic nervous system are diagnosed by testing such as a tilt table test.
While evaluation by a neurologist with completion of the tests you specify above is recommended, continued evaluation by a cardiologist is important as well.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
It sounds like your husband had an episode of fast heart beat associated with some confusion and some unsteadiness. With normal CSF, meningitis is not a likely diagnosis. With a fast heart rate, a cardiac cause is more likely than a neurologic one. The neurologic symptoms of unsteadiness and confusion would be secondary to the brain not receiving enough blood because of abnormal heart function. A fast heart rate could be electrophysiologic, due to an abnormal heart rate generator, or metabolic, from something else going on in the body such as thyroid problems. As you mention, toxic exposures can lead to this as well. Continued follow-up with a cardiologist is certainly recommended if these episodes of fast heart rate occur again.
There are very few neurologic causes to fast heart rate, but one would be seizure; it sounds like you are set up for EEG, which would be useful in elucidating this further. The other neurologic cause of the fast heart rate associated with the symptoms described above could be due to a problem with the autonomic nervous system. The autonomic nervous system is the part of the nervous system that controls blood pressure, heart rate, and other functions. It is not located in one specific part of the brain or other body part but is rather made up of several different components: a region in the brainstem, certain receptors located on blood vessels and in the heart, and small nerves in our skin, among other areas. Dysfunction of the autonomic nervous system due to whatever cause can lead to a variety of symptoms including but not limited to orthostasis (which means symptoms or signs resulting from assuming an upright posture), light-headedness with drops in blood pressure when sitting up or standing up (this is an example of orthostasis), fast heart rate, syncope (passing out), constipation, diarrhea, sweating abnormalities etc. If there is a problem in the small nerve fibers, what is medically termed a small fiber neuropathy, in addition to these symptoms, burning/tingling in the feet and hands or mild sensory loss may also occur. One type of autonomic dysfunction is POTS syndrome, a condition with no known definitive cause in which the heart rate goes up inappropriately, leading to palpitations and light-headedness, and this is treated with medications that prevent these heart rate increases such as beta blockers. Disorders of the autonomic nervous system are diagnosed by testing such as a tilt table test.
While evaluation by a neurologist with completion of the tests you specify above is recommended, continued evaluation by a cardiologist is important as well.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Does the tachycardia and severely altered mental state last for 2 days with a panic attack? His pulse was revving up to 150 even when he was out cold. It wasn't until nearly 48 hours later that my husbands resting heart rate finally got below 100. Upon getting up it would rocket back into the 140's and 150's during this time.
All the doc could say is it was like something "wore off", after his heart rate finally went down.
Appointments and more tests are getting scheduled for next week (EEG,MRI). We are just still wondering what this could possibly even be while we wait. Until whatever happened to him gets identified I am still fearful that it could happen to him again at the drop of a hat like it did the first time.
All the doc could say is it was like something "wore off", after his heart rate finally went down.
Appointments and more tests are getting scheduled for next week (EEG,MRI). We are just still wondering what this could possibly even be while we wait. Until whatever happened to him gets identified I am still fearful that it could happen to him again at the drop of a hat like it did the first time.
I have panic attacks this sounds similiar to what i experienced.
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