High pulse rate with aneurysm/near syncope

[Shelster56]

Hi,

I'm 52, female, and had an aortic valve replacement/aneurysm repair nine years ago. It was my second open heart surgery. I take coumadin and have been doing well, but a ct scan back in November showed an ascending aortic aneurysm of 4.5 cm.  A couple of the arteries (brachiocephalic and the origin of the left common carotid) also showed aneurysms.

My blood pressure and pulse have always been very good but something weird happened yesterday.  First, I noticed my heart going a little fast and went to my blood pressure machine.  My pulse rate - normally in the 60s or 70s -  was 120. I checked it a few times over the course of the day and it was in the 120s for at least 10 hours.  The last time I checked it the rate was129. When I went to bed I could feel an extremely strong pulse in my right carotid artery along with a fast heart beat.

My blood pressure was also a bit wacky. The systolic number was fine but the  diastolic was in the 90s and and at one check was 103.  I don't think my diastolic has ever been that high.

Then this morning I got up and my blood pressure must have gone way down because I nearly fainted.  Laid back down and was ok after a few minutes.  Got up but it happened again.  It finally passed.  This same thing happened a couple of years back but this is the first occurrence since then.

My BP and pulse are now good.

Can prolonged tachycardia like I had yesterday cause a problem with the aneurysm? I have a bicuspid valve and other factors so I worry about possible rupture/dissection. Could the tachycardia have been the cause of this morning's near syncope?

Any information would be greatly appreciated.  Thanks so much.

[Cleveland Clinic]

Yes this is very worrisome and you should have sought emergent medical assistance both to control your blood pressure, diagnose what tachycardia you actually had and perhaps to rule out worsening of the aneurysm via a CT scan. I would suggest you seek emergent medical assistance if it recurs, but if not to see your PCP at the next available time slot.

[Shelster56]

To follow up on my original question, I did have my previous episode of near syncope checked out and was told that it was vasovagal syncope. I am also only 4'11" so perhaps that's why I'm a bit more concerned about an aneurysm of 4.5 cm when they usually don't become worrisome until around 5 cm.

Thanks again!  

[Shelster56]

Thank you so much for your comments.  I spoke with my cardio's office today and they don't seem concerned about it at all.  Just said to call if it recurs and they might put a monitor on me.  

However, I think I'll take your advice and go to the emergency room if it happens again.    

Thanks again!