Aa
Should I fire my cardiologist? I am terribly upset!
“Scared my doctor to death”, now I’m supposed to suck it up and not worry about it? Is he serious?
I desperately need input on how long a run of VT is dangerous. I have read 30 seconds, but I almost passed out with an eight second run.
I had PVC's and then an eight second run of VT on a treadmill stress test and almost passed out walking to the table to lie down. My cardiologist said at that time I "scared him to death". He said it was fast VT (monomorphic), and set me up for testing and seeing an EP immediately.
My second opinion EP says it was not a very fast VT and he doesn't think that caused me to almost faint. He thinks my legs were probably tired with the treadmill test. That is not true, really. The cardiologist had taken me off the treadmill early because of PVC’s and couplet’s and while sitting in a chair the VT began. I watched it on the screen, and then I almost passed out while walking to the table.
I am in the process of getting all this sorted out with doctors and I AM FEELING DISMISSED BY SOME OF THEM. I had all the tests, cardiac MRI, heart cath., etc., all normal. But two treadmill tests were not normal. My cardiologist won’t do another treadmill test on me because again he said I “scared him to death”.
The second treadmill was done with the EP at the hospital. I had frequent ectopic beats but I got my heart rate up to the maximum. I DID NOT FEEL I WAS GOING TO PASS OUT AT ANY TIME, so again I wonder why I felt like I was going to pass out with the first treadmill test with the VT. The EP didn't like what he saw and did the cardiac MRI at this time checking for ARVD. I got a call saying the MRI was normal and he had released me back to my cardiologist. I WAS ASTOUNDED BECAUSE I THOUGHT I WOULD CERTAINLY HAVE A CHANCE TO ASK QUESTIONS. I pushed for another appointment with him and after waiting a few days and not hearing from the EP office, I went ahead and made an appointment with my cardiologist, thinking he would direct me on what to do.
NOW MY CARDIOLOGIST SAYS NOT TO WORRY ABOUT THE RUNS OF VT, THAT I WILL BE HAVING THEM OCCASIONALLY!!!! NOT TO WORRY? I had told him that while at home, I felt my heart doing something strange so I checked my pulse and for a couple of seconds I felt the extremely fast beat, then normal pulse. The run was probably 4 or 5 seconds. I also have PVC's during the day. SO I AM NOT TO WORRY ABOUT SHORT RUNS OF VT AT HOME WHEN I “SCARED HIM TO DEATH” WITH AN 8 SECOND RUN IN HIS OFFICE? He was not helpful during this office visit. He even asked why I went to the second EP (not in his practice). I told him he told me to. When asked what to do, whether to seek a third opinion, he said it was up to me. When asked about going out of state, again up to me. When asked about a specific doctor, up to me. He was always helpful before this appointment with directing me, now this!!!!! Before, during my appointments with him he was concerned and caring. This time I was almost in tears as I listened to him. I needed direction and guidance but I got nothing. My son thinks I should fire him and get another cardiologist. I don’t know what to think or where to go from here.
I finally got a call from the EP office and I am to see him again in one month.
I desperately need input on how long a run of VT is dangerous. I have read 30 seconds, but I almost passed out with an eight second run.
I had PVC's and then an eight second run of VT on a treadmill stress test and almost passed out walking to the table to lie down. My cardiologist said at that time I "scared him to death". He said it was fast VT (monomorphic), and set me up for testing and seeing an EP immediately.
My second opinion EP says it was not a very fast VT and he doesn't think that caused me to almost faint. He thinks my legs were probably tired with the treadmill test. That is not true, really. The cardiologist had taken me off the treadmill early because of PVC’s and couplet’s and while sitting in a chair the VT began. I watched it on the screen, and then I almost passed out while walking to the table.
I am in the process of getting all this sorted out with doctors and I AM FEELING DISMISSED BY SOME OF THEM. I had all the tests, cardiac MRI, heart cath., etc., all normal. But two treadmill tests were not normal. My cardiologist won’t do another treadmill test on me because again he said I “scared him to death”.
The second treadmill was done with the EP at the hospital. I had frequent ectopic beats but I got my heart rate up to the maximum. I DID NOT FEEL I WAS GOING TO PASS OUT AT ANY TIME, so again I wonder why I felt like I was going to pass out with the first treadmill test with the VT. The EP didn't like what he saw and did the cardiac MRI at this time checking for ARVD. I got a call saying the MRI was normal and he had released me back to my cardiologist. I WAS ASTOUNDED BECAUSE I THOUGHT I WOULD CERTAINLY HAVE A CHANCE TO ASK QUESTIONS. I pushed for another appointment with him and after waiting a few days and not hearing from the EP office, I went ahead and made an appointment with my cardiologist, thinking he would direct me on what to do.
NOW MY CARDIOLOGIST SAYS NOT TO WORRY ABOUT THE RUNS OF VT, THAT I WILL BE HAVING THEM OCCASIONALLY!!!! NOT TO WORRY? I had told him that while at home, I felt my heart doing something strange so I checked my pulse and for a couple of seconds I felt the extremely fast beat, then normal pulse. The run was probably 4 or 5 seconds. I also have PVC's during the day. SO I AM NOT TO WORRY ABOUT SHORT RUNS OF VT AT HOME WHEN I “SCARED HIM TO DEATH” WITH AN 8 SECOND RUN IN HIS OFFICE? He was not helpful during this office visit. He even asked why I went to the second EP (not in his practice). I told him he told me to. When asked what to do, whether to seek a third opinion, he said it was up to me. When asked about going out of state, again up to me. When asked about a specific doctor, up to me. He was always helpful before this appointment with directing me, now this!!!!! Before, during my appointments with him he was concerned and caring. This time I was almost in tears as I listened to him. I needed direction and guidance but I got nothing. My son thinks I should fire him and get another cardiologist. I don’t know what to think or where to go from here.
I finally got a call from the EP office and I am to see him again in one month.
Best Answer
I do hope you will find your answers, for you and your children. It does sound as if you may have one of the inherited kinds of VT. I would try to get gene testing done if I were you. Especially since your children are having symptoms.
I had a grand mal seizure in my early twenty's and the doctor couldn't determine the cause. My grandmother supposedly had epilepsy and died from it. Now I wonder. That was on my mother's side of the family and I don't know much about them because they live out of state. It's interesting that your mother had epilepsy too. I have also had many episodes of being lightheaded or dizzy. I went to several doctors for that, neurologist, dizziness clinic, but they couldn't figure it out. So you have episodes of dizziness also? I have three children, and so far none of them have exhibited signs of this, but I have three grand-children who run cross-country, so I worry. I have read one account of a lady in her fifty's who carried the gene for CPTV, but she had no symptoms and was unaware of it. But one of her sons had the symptoms, so she got checked out, and it was in some of the other family members also.
My first EP thinks I have had this all my life, and said the grand mal seizure was probably caused by the arrhythmia, and possibly the dizziness in the past, but of course there is no way to tell now.
Have you been on the site "Inspire"? It is similar to this one and very good.
I had a grand mal seizure in my early twenty's and the doctor couldn't determine the cause. My grandmother supposedly had epilepsy and died from it. Now I wonder. That was on my mother's side of the family and I don't know much about them because they live out of state. It's interesting that your mother had epilepsy too. I have also had many episodes of being lightheaded or dizzy. I went to several doctors for that, neurologist, dizziness clinic, but they couldn't figure it out. So you have episodes of dizziness also? I have three children, and so far none of them have exhibited signs of this, but I have three grand-children who run cross-country, so I worry. I have read one account of a lady in her fifty's who carried the gene for CPTV, but she had no symptoms and was unaware of it. But one of her sons had the symptoms, so she got checked out, and it was in some of the other family members also.
My first EP thinks I have had this all my life, and said the grand mal seizure was probably caused by the arrhythmia, and possibly the dizziness in the past, but of course there is no way to tell now.
Have you been on the site "Inspire"? It is similar to this one and very good.
sorry if part of my messages seem disjointed or out of order; sometimes I have really horrible problems with memory and cognitive things.
the first EP I saw told me I was probably going to go into heart failure if I didn't have an EP Study because I had problems for so long and had been in bigeminy quite a bit since April 2007.
I had an ekg just a few months before the procedure that showed no arrhythmia's or problems at all and I didn't feel bad; just alot of skipped beats; that ekg only picked up bradycardia probably from the decreased cardiac output
I went to get 2nd & 3rd opinions because I had been told by so many dr's there was nothing wrong with me and really believed it couldn't be as serious as he said it was.
the last EP gave me Toprol which was supposed to a wonder drug and cure me and stop the problem; but instead I ended up in the ER with severe problems they couldn't stabilize me for quite awhile...that scared me so I went back to the first EP and said just do the procedure.
even though I had a "structurally" normal heart, my stress test showed all kinds of problems but they had no clue any of it meant because a key piece of the puzzle was missing - the ER failed to send my test results to the EP so he didn't know I had multifocal pvc's, enlarged heart etc and I didn't find this out until almost a year later.
they don't know if I had sustained VT before but that's what they suspect with my fainting episodes.
I was awake talking to them and remember the whole procedure through twilight sedation, even when my heart started to burst; I yelled several times for them to stop the surgery but after they defib'd me they put me fully under; I still have nightmares about it all
I'm not sure if I do have HOCM; I know something caused the P-VT and other episodes and I've had every test they can do to find the cause so I have to stick with the dx until I see a HOCM specialist to figure it all out
I'm pretty sure my problems are genetic because I've this all since age 9, my oldest daughter's fainted and had arrhythmia's since age 6; she's 24 and still has arrhythmia's but hasn't fainted in years; but my oldest son who's 25 started fainting last year during PT (Air Force) and they found different arrhythmia's and some slow VT.
The other interesting thing I think I read through this forum, was the association with epilepsy and arrhythmia's genetics etc. my mother had epilepsy at age 13 and had blackouts (not sure if it was fainting episodes she died 25 years ago) so I'm going to ask the dr about the genetics thing because my youngest daughter (9) started having tachycardia last year.
hang in there; hopefully you'll find some answers quickly =)
the first EP I saw told me I was probably going to go into heart failure if I didn't have an EP Study because I had problems for so long and had been in bigeminy quite a bit since April 2007.
I had an ekg just a few months before the procedure that showed no arrhythmia's or problems at all and I didn't feel bad; just alot of skipped beats; that ekg only picked up bradycardia probably from the decreased cardiac output
I went to get 2nd & 3rd opinions because I had been told by so many dr's there was nothing wrong with me and really believed it couldn't be as serious as he said it was.
the last EP gave me Toprol which was supposed to a wonder drug and cure me and stop the problem; but instead I ended up in the ER with severe problems they couldn't stabilize me for quite awhile...that scared me so I went back to the first EP and said just do the procedure.
even though I had a "structurally" normal heart, my stress test showed all kinds of problems but they had no clue any of it meant because a key piece of the puzzle was missing - the ER failed to send my test results to the EP so he didn't know I had multifocal pvc's, enlarged heart etc and I didn't find this out until almost a year later.
they don't know if I had sustained VT before but that's what they suspect with my fainting episodes.
I was awake talking to them and remember the whole procedure through twilight sedation, even when my heart started to burst; I yelled several times for them to stop the surgery but after they defib'd me they put me fully under; I still have nightmares about it all
I'm not sure if I do have HOCM; I know something caused the P-VT and other episodes and I've had every test they can do to find the cause so I have to stick with the dx until I see a HOCM specialist to figure it all out
I'm pretty sure my problems are genetic because I've this all since age 9, my oldest daughter's fainted and had arrhythmia's since age 6; she's 24 and still has arrhythmia's but hasn't fainted in years; but my oldest son who's 25 started fainting last year during PT (Air Force) and they found different arrhythmia's and some slow VT.
The other interesting thing I think I read through this forum, was the association with epilepsy and arrhythmia's genetics etc. my mother had epilepsy at age 13 and had blackouts (not sure if it was fainting episodes she died 25 years ago) so I'm going to ask the dr about the genetics thing because my youngest daughter (9) started having tachycardia last year.
hang in there; hopefully you'll find some answers quickly =)
I just want to say that I understand totally what you are going through. I had somewhat the same thing happen to me and I spent a week in the hospital undergoing investigations for nonsustained VT. It scared me and I was sure there was something seriously wrong with me and no one was able to reassure me or tell me where I stood with regards to this. I was a wreck for months. Only now, almost three years later do I understand that as my heart is structurally normal, I am at little or no risk when I have these runs of VT. I stay on Metoprolol 50 mg twice a day which seems to prevent them. I was offered an ablation but turned it down at that time, however, if they get worse I will definitely go that route. In the meantime, I need to go for an MRI every year or two just to make sure that there are no heart abnormalities (they could not totally rule out ARVD as the right ventricle did show slight dilatation). It has been a rocky road for me but I am finally relaxing a bit and realizing that I am most likely OK. I think the reason you do not get reassurance from your doctor is that they are unable to tell you you are OK because of liability reasons - you just never know what might happen, and they don't want to commit themselves. I have wanted reassurance so badly but realize I am not going to get it 100%. So thankful for this wonderful forum to know we are not alone with this.
Wow, I was on the edge of my seat as I read your post. It’s amazing that with a “structurally” normal heart you were found to have all these problems after all, and for so many years. I think when a person faints as much as you did, for years, the doctors should have done much more. I have read so many accounts of doctors totally missing something very dangerous, or just shrugging off a patient that desperately needs the right medical help. I am so sorry you have been through so much.
You say you chose to have the ablation, so the doctors must have left it up to you? Wow, it certainly sounds as if you made the right choice. I hope you find the right answers; you have battled this so long. Were you awake during your ablation, and when they had to defib you?
You didn’t know until the EP study that you had the long sustained VT? My VT was non-sustained, and showed up on my treadmill test, thankfully. The doctor said I was fortunate it showed up during that test, that many people don’t know they have it. My EP said I have episodes of VT happening and probably have had it all my life, I just didn’t know it. He said you don’t know it unless you have symptoms (passing out for you). It sounds like you probably have had it all your life. Have they said that? I’m so glad you have the ICD. My husband also has one, but he went into heart failure with a heart attack leaving his ejection fraction in his left ventricle about 38%, and they were concerned about arrhythmia. The next few months the ejection fraction picked back up to 45%, so now the doctor says he is not in heart failure. He has had the ICD for about four years, but it has never fired.
My daughter also has four children, and she has fought with her own medical problems, not her heart, but a large brain tumor (acoustic neuroma) which thankfully was successfully removed with no lasting problems…so far. She has to get MRIs every few years to make sure no other tumors are developing. Being a mother with four children, and fighting the battle you are fighting…my heart goes out to you.
You say you chose to have the ablation, so the doctors must have left it up to you? Wow, it certainly sounds as if you made the right choice. I hope you find the right answers; you have battled this so long. Were you awake during your ablation, and when they had to defib you?
You didn’t know until the EP study that you had the long sustained VT? My VT was non-sustained, and showed up on my treadmill test, thankfully. The doctor said I was fortunate it showed up during that test, that many people don’t know they have it. My EP said I have episodes of VT happening and probably have had it all my life, I just didn’t know it. He said you don’t know it unless you have symptoms (passing out for you). It sounds like you probably have had it all your life. Have they said that? I’m so glad you have the ICD. My husband also has one, but he went into heart failure with a heart attack leaving his ejection fraction in his left ventricle about 38%, and they were concerned about arrhythmia. The next few months the ejection fraction picked back up to 45%, so now the doctor says he is not in heart failure. He has had the ICD for about four years, but it has never fired.
My daughter also has four children, and she has fought with her own medical problems, not her heart, but a large brain tumor (acoustic neuroma) which thankfully was successfully removed with no lasting problems…so far. She has to get MRIs every few years to make sure no other tumors are developing. Being a mother with four children, and fighting the battle you are fighting…my heart goes out to you.
Thanks for your reply, Mom2four85. That is what I was told, because it was NSVT and my tests showed my heart function was normal they say I will be OK. I am really not comfortable with that. I want to know what is causing it. Also, I am having many PVCs and even a short run of VT that I caught at home.
My first EP did say he could do an ablation with 65% chance of finding and ablating it. My second EP said he thought there was a 0% chance of finding it for ablation. He was looking for ARVD with the MRI.
Wow, you really have been through so much. Did you end up going to one of the larger clinics? Thankfully they have finally fitted you with an ICD and possibly are on the right track. It is amazing that they thought yours was monomorphic until they did the ablation. I will keep that in mind in my case. I hope they will finally determine for sure what is wrong with you.
I also had a grand mal seizure in my early 20s and have had several episodes of light-headedness of undetermined cause. Did you ever experience any of this?
My cardiologist told me my monomorphic VT was fast. My EP said it was not fast, but I need to ask him also if it was monomorphic.
My first EP did say he could do an ablation with 65% chance of finding and ablating it. My second EP said he thought there was a 0% chance of finding it for ablation. He was looking for ARVD with the MRI.
Wow, you really have been through so much. Did you end up going to one of the larger clinics? Thankfully they have finally fitted you with an ICD and possibly are on the right track. It is amazing that they thought yours was monomorphic until they did the ablation. I will keep that in mind in my case. I hope they will finally determine for sure what is wrong with you.
I also had a grand mal seizure in my early 20s and have had several episodes of light-headedness of undetermined cause. Did you ever experience any of this?
My cardiologist told me my monomorphic VT was fast. My EP said it was not fast, but I need to ask him also if it was monomorphic.
so sorry for the typo city there :(
correction:
Typically slow monomorphic VT in a healthy heart can be tolerated well even if sustained for minutes to hours..
correction:
Typically slow monomorphic VT in a healthy heart can be tolerated well even if sustained for minutes to hours..
anytime you don't think you're getting the care you deserve and the answers you need to understand what's going on; you should find another doctor
Sometimes I think doctor's forget we're patients and not just another number they've herded into their office; when this happens the care we receive is lacking.
Typically slow monomorphic VT in a healthy heart can be tolerated well for tolerated even if sustained for minutes to hours, but it doesn't make it any easier to deal with it. RF Ablation can sometimes cure this type of VT if meds don't work at alleviating it.
I've had NSVT episodes frequently for about 35 years and assured it was nothing to worry about until 2 years ago at the age of 42 I found out it wants the typical "monomorphic" vt they thought.
I went in for testing to figure out why I was having fainting episodes so much and VT. During the ablation the dr found I had polymorphic VT and when I faint my heart stops which was found on a tilt table test. I had to have a pacemaker/defibrillator implanted.
They suspected ARVD but then dx me with HOCM which I still question.
Because I don't have answers and dr's won't find what's wrong, I've switched drs quite a bit trying to find answers.
good luck in finding answers and the right doctor - it may be helpful to go to one of the large clinics where they're used to dealing with a large number of different patients yearly like Cleveland, Mayo, Vanderbilt etc.
Sometimes I think doctor's forget we're patients and not just another number they've herded into their office; when this happens the care we receive is lacking.
Typically slow monomorphic VT in a healthy heart can be tolerated well for tolerated even if sustained for minutes to hours, but it doesn't make it any easier to deal with it. RF Ablation can sometimes cure this type of VT if meds don't work at alleviating it.
I've had NSVT episodes frequently for about 35 years and assured it was nothing to worry about until 2 years ago at the age of 42 I found out it wants the typical "monomorphic" vt they thought.
I went in for testing to figure out why I was having fainting episodes so much and VT. During the ablation the dr found I had polymorphic VT and when I faint my heart stops which was found on a tilt table test. I had to have a pacemaker/defibrillator implanted.
They suspected ARVD but then dx me with HOCM which I still question.
Because I don't have answers and dr's won't find what's wrong, I've switched drs quite a bit trying to find answers.
good luck in finding answers and the right doctor - it may be helpful to go to one of the large clinics where they're used to dealing with a large number of different patients yearly like Cleveland, Mayo, Vanderbilt etc.
Thanks for your advice, Bob. People are so unpredictable. You really need a compassionate and helpful doctor that you can trust, especially dealing with an arrhythmia that is very frightening.
Thanks for your suggestion to get a copy of all records if I leave my cardiologist. I also try to keep a copy of all records at home also, especially since this arrhythmia has started. Yes, I am strongly considering switching. The only problem is my husband is in poor health with his heart also and he uses the same doctor. It is so frustrating.
Very strange. From your story there is no explaining his behavior or the EP's for that matter. I'd get another cardiologist.
I am so sorry that the added stress of having poor communication with your doc is upon your shoulders as you worry about your occasional onset VT. If you are not comfortable with your doc, find a new one. I feel the positive relationship you have with your doctor is part of the healing. I did have a very unfortunate event happen with my cardiologist and I fired him. I found a new one and I am as happy as a clam.
I would suggest that you get a copy of all records so that you can hand carry them to your new doc. This saves another visit.
Good luck to oyu.
ksig
I would suggest that you get a copy of all records so that you can hand carry them to your new doc. This saves another visit.
Good luck to oyu.
ksig
Have an Answer?
You are reading content posted in the Heart Rhythm Community
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
In June 2009 (age 42) I fell broke my foot and went in to a dr when it didn't heal. He checked my foot but because I complained of my left shoulder and side where I fell into a door jamb; he did an exam and heard what he thought was valve problems.
He sent me to a cardiologist & EP and the testing began - I stayed with the same local cardiologist. I had many EKG's, stress test, echo and holter monitor. I was quite shocked I had roughly 50,000 pvc's and some minor valve problems; but deemed "strucutrally" normal.
I chose to have an EP Study to find what was going on and ablation to try to get rid of whatever they found. Right before the EPS I had a Tilt table test to try and find out why I've fainted for so long. The test showed when I faint, my bp tanks and I have no palpable pulse.
During the EPS the dr was able to trigger long sustained runs of polymorphic VT several times and they had to defib me. He did ablate 2 or 3 areas that got rid of my pvc's/vt for a bit after the procedure; then they returned.
After the EPS I had a CTA, Xrays, Cardiac MRI and Cardiac catherization to try and find a cause but nothihng was found; just all kinds of disconnected results. They did find I had an enlarged heart and cardiomyopathy; so they dx me with Hypertrophic Obstructive Cardiomyopathy.
The difference with me is my pvc's are multifocal and my VT is high rates; >220 and many times higher - my ICD has sensed my VT at 350 - 425 and I've had NSVT and Vtach episodes since my implant.
There are others who have had successful ablations for VT; it all depends on your system and what's really going on. Sometimes, there are no answers and we just have to live with the episodes and try to deal with them with lifestyle changes and find meds that work for our bodies.
I've found Inderal LA to work great for me; it really helps the strong VT episodes and I don't have as many as before, but hasn't touched my syncope & dizziness.
An ablation may yield some answers and help alleviate symptoms if meds don't work well for you.