Irregular heart beat

[mknkt2006]

My husband is a healthy 26 year old man. He has had problems for the last year or two with a weird and uncomfortable feeling in this chest. Then we found out the other night from the E.R. Doc that it was heart palpitations. He had an appointment with the doctor today and she told him:
- You have high blood pressure that should have been treated a long time ago and I don't know why it was not.
- You have a heart murmur
- And now for the last year or 2 , what we now know to be heart palpitations, that the E.R. Doc told us of.
She then informed him that this could definently be something but due to the fact that we have no health insurance, they could do nothing for him. We don't even know what this "something" could be. We have no idea what we can do next. If you could give us any idea of what all these symptoms could add up to we would really appriciate any ideas. Thank You!!

[Momto3]

Hmmmmm.....I haven't heard of only being able to feel the fluttering only where the murmur is, but it could just be because the extra beats are originating somewhere right around the valve that has the murmur.

I'm glad you guys went to the Fire Dept.  Although anxiety can exascerbate things, I wouldn't be so quick as to say that's the cause of the elevated HR and BP.  

Tomorrow would be a good day to contact your local Health Department or Community Hospital to see what services he would be available for.

Also, you mentioned your husband was in the USAF...any chance he could be seen at the VA??

[mknkt2006]

His heart rate seems to stay very low for some reason normally. His normal heart rate is anywhere from 40-56 or so. He is pretty physically fit but does nothing to maintain it. He does not run, jog, work out, etc. I have no idea why it would stay so low with out being an athlete? He had another episode tonight. We went to our local fire station to have him checked out. When we got there his HR was 158, and BP 160/100. The guy there told us his HR was abnormal, skipping beats throwing beats, all kinds of stuff. He called the paramedics because he wanted them to look at him. Of course by the time they got there everything was pretty much back to normal, the BP was still high though. He mentioned he has had some problems with anxiety before and the whole thing was blown off as a panic attack, which some of it was, but not all of it. His chest had been tight with some fluttering for about 30 mins. prior to getting there. I don't know what we can do to make them take us seriously. I think it only makes sense to feel panic when you think there is something wrong with your heart( it is a pretty inportant component in staying alive!!) As a matter of fact he started having panic attacks when this would happen a while after all of the heart stuff started. I had another question though in all this rambling, if you don't mind? Is it weird that you know of for him to be feeling all of this fluttering,etc. in the exact and only spot that the doctor can hear the murmur? He has always had all the discomfort in one exact spot on his chest, when he was in at the doctors the other day he found out that is the spot where the murmur is. Again Thank You So Much!!

[Momto3]

Marked sinus bradycardia - a definite indication that there were episodes of a slow heartrate.  Technically, bradycardia is defined at less than 60bpm.  Some episodes can be "normal" for some people, but the fact that it says "marked" would seem to mean it is more than typical.

I'm not sure about the T wave abnormalities.  However, I think I've have heard that can be significant, or not (sorry, not much help there).  I think I've seen that in "normal" workups also.  When we have an EKG, the computer generates potential diagnoses based on the data from our recordings.  That's definitely something I'd want clarification on once the doctor puts all the pieces together.  It may be nothing, but I'd want to be sure.  The T wave abnormalities may have been what triggered the "abnormal ECG" result.

The max heart rate is high if he was resting.  However, it's entirely possible he was exercising or doing something strenuous when the HR was recorded...hard to tell unless he still has the Holter diary (where he would have written down anything unusual, etc)

An HR of 37 is low and even though our HR's can drop during sleep, I'd want to know more about why his dropped to 37 (especially given the "marked bradycardia" mentioned earlier).

A couple of years ago (after 2 ablations), my BP started to rise.  Because of the heart murmur (mitral regurgitation), my doctor wanted me to take medications for optimal BP control.  The medication (lisinopril) keeps my heart from working too hard.

You might try posting a question re: the T wave abnormality and see if one of the members who knows about EKG readings will respond.

Connie

[mknkt2006]

Well it's worth a try, definently won't hurt anything.
These results are from the Holter moniter:
- Marked sinus bradycardia
- Nonspecific T wave abnormalities
- Abnormal ECG
Max heart rate during test 158
Min heart rate during test 37
Any ideas?

From what I'm reading the Echo was negitive.
Also does anyone know if high blood pressure can make a murmur worse? His blood pressure has been high for 8 years and is only now being treated, starting last night, that was his first pill. Thanks again!!

[Momto3]

Hi again,

You're welcome!  Glad to help....been there : )

I do know that murmurs are sometimes assigned a grade 1-4, with 1 being trivial, 2 mild, 3 moderate and 4 severe.  Maybe his is 3 out of 4.  Mine has been graded 2+ - 3+, so that might be what the 3/4 means.

There are also gradations of Murmurs (how they sound), but this may not mean too much in his situation.
Grade 1 Very faint, heard only after listener has "tuned in"; may not be heard in all positions.
Grade 2 Quiet, but heard immediately after placing the stethoscope on the chest.
Grade 3 Moderately loud.
Grade 4 Loud, with palpable thrill (ie, a tremor or vibration felt on palpation)[2]
Grade 5 Very loud, with thrill. May be heard when stethoscope is partly off the chest.
Grade 6 Very loud, with thrill. May be heard with stethoscope entirely off the chest.

I'm not a doctor, but am somewhat familiar with the terms just because I've had a lot of echos, etc.  There are a couple of people on the forum who are really good at deciphering the tests.  

[mknkt2006]

Thanks for writing back so quick, you are great!! We do have copies that we will be dropping off to the doctor. From what we can understand from the tests it's seems that everything came back o.k. Not really sure though since we don't understand all the medical terms. Do you have any idea what a 3/4 murmur is? I don't but from what I could find it is a rating they give, but nothing saying if it's on the bad side or not. If you understand some of the terms I would be more thatn happy to post some of it here if any one can help us to understand it. Again, Thank You.

[Momto3]

Can you get copies of those results?  They may contain some helpful information.  I do think current tests would be helpful, but having the prior records might give the doctor a better idea of what's going on.

Does he remember any of the resuls?  Postive Tilt test?  Anything from the echo?

[mknkt2006]

Hi. I had one more question. We remembered yesterday that when my husband was in the Air Force he had passed out,  when that happened they ran all kinds of tests on him. We started looking through all the paper work and found that he has had an Echo, Tilt Table, EKG, that is all I can think of right now. What I am wondering is if all of those tests were done 8 years ago, before he started having any problems like this, are the test results good, or should he probably have them re-done? I'm not sure what to think. Like I said all of the tests done were due to the fact that he passed out. They were afraid he had a seizure or something along those lines. Thanks again!!

[Momto3]

Please let us know how you're doing and what you're able to find out re: having the test,etc.  You can also contact your local Health Department to find out if they are aware of any reduced rate testing centers, etc.  Most teaching hospital have great programs for people without health insurance....If you are near a major city, find out if there is a teaching hospital nearby.

Keep us posted

[mknkt2006]

I'm going to try contacting local Cardiology places and find the cheapest ones and see if they'll take payments, then I'll see if there are any programs I can go through for payment assistance.  I really do hope it's one of the inocent murmurs rather than one of the serious, we'll see.

[sonny372]

I am 31 and have been dealing with this since 2004. I started getting increases in heart palpitations. I have had 4 in a row of these palpitations before. They are scary. I am to in the postion where I do not have insurance. I did apply for medi-cal here in california. I think it is either state or county ran. Anyway I must pay 2000 up front before they cover any thing beyond that amount. I was surfing ehealthinsurance today and a rep told me aetna insurance was the most lienyant of preexisting conditions. Try them. I am. However the conditon you have will not be covered until a year has passed. After that they are not allowed to discriminate against your preexisting condition. Just look online for programs where conditions are convered. I have been. good luck to you.

[Momto3]

Hi husband and wife : )

My echocardiograms were closer to $1000, but that could be because of insurance.  Is there a community hospital where you could be evaluated for the arrythmia?  If you were to go to the ER and tell them about the ups and downs of your HR and BP, would they see you?  

It's not unusual to hear a murmur more from different positions, so don't be concerned just because of the change when you lie down.  

It's possible your BP was up because of anxiety, but it's hard to say for sure.  Here's one thing that may help -- Call the hospital where you were taken and ask what you need to do to get complete copies of the records, including test results from your visit.  Those documents may give you something to go on....

Will the doctor at the clinic allow you to have an echo and make monthly payments?  Sorry you have to deal with the insurance stuff while you're trying to figure out what's going on.....Hang in there.

connie

[MegMc]

I am a 27 year old woman, and I was in a similar situation as you.  I have palpitations which have turned out to be PVC's (premature ventricular contractions- harmless, but scary).  I do not have good health insurance, so I ended up paying for all my tests out of my pocket.  I paid $600 for the echo.  I also had a stress test, which was $250.  Not cheap.  Sorry to be the one to tell you this.

[mknkt2006]

Hello, I am the 26 yr old husband and no I haven't had an echo, do you have any idea how expensive one might be?

[mknkt2006]

Thank You. The doctor that told my husband they could not do anything was the F.P. Doc he saw today. That was at our local community clinic that we are seen at. They are not willing to do any tests to find out about the murmur, but I do know they said it was worse when he was laying down. I think they may have done a echocardiogram at the hospital, but I'm not sure. They did do blood tests and an EKG, everything came back good. I know when the paramedics were here he threw an extra beat and his blood presssure was way up, and heart rate was pretty low. By the time we got to the hospital his heart rate was around 41-45. He has been having a problem with this for a while now, this episode the other night was the worst though, a lot more intense than the others. Thank You for getting back to me. I just don't really know what to think or do.

[Momto3]

That's somewhat of a strange thing to tell a patient in the ER....YIKES!!

Palpitations are the awareness of one's own heartbeat. Premature atrial contractions and/or premature ventricular contractions are the terms used for when the heart tosses out an extra beat (feels like a skipped beat).  They can be isolated beats, in patterns, runs, etc.  The key is whether you have a structurally normal heart.  That's determined by an echocardiogram.  Did your husband have an echo?

Murmurs can range from innocent to serious.  Do you have any more information as to the type of the murmur.  

Is there a community hospital nearby where he could be examined?  Hopefully, all is well, but it's good to doublecheck.

connie