New potential Pacemaker recipient

Hi all,

Hoping to get some insider tips and support. I am a 31-year-old mother of five (youngest is two months old) who is potentially looking at needing a pacemaker. Basically my symptoms are that my resting HR went from about 85-90 (nonpregnant) to about 50-60 now. My heart rate is normal when I am
up and about, but I notice the sharp decrease when I am resting and in bed at night.

So far I have had an ekg, echo and a 24-hour holter as well as bloodwork. The ekg was normal with only a tiny (he said most would not even notice) right axis shift. The doctor mentioned that a pacemaker was a possibility if the holter came back badly. Friday I go for a stress echo and I am terrified that I will die during it since I get winded even dashing up our stairs!

Aside from the resting brady, I have some mild chest tightness, especially upon exertion, a ton of anxiety, and obvious palpitations particularly when I go from activity to rest (ie run up the stairs then lie in bed.)

I have had multiple cardiac workups throughout my life with no findings (I have always had mild hypertension.). I need to lose about 15 lbs because I just had a baby and was on bedrest for the last two months of my pregnancy so I am NOT "just in really good shape."

I am not afraid of a Pacemaker, I am afraid of dying and leaving my kids. I will be happy if this is something a PM can "fix." Obviously I'd rather it be nothing, but I know it's not nothing. I have no idea what happened to me or why this is going on. I had the echo two weeks ago and the holter last week. I am hoping that since I was not contacted they did not see anything TOO horrible. All my kids are little and I don't want to leave them and my husband.

13 Comments

Thanks!

by LMurph - 2013-10-14 09:10:04

Thank you Tracey! That is such an encouraging post. Fixable = good. That's all I want. I guess my overriding concern is why this happened so suddenly. What "happened?" I had a nasty cough at the end of my pregnancy... Could this be viral myocarditis? Could I have peripartum cardiomyopathy? I am a total worrier (and Googler!) and I am just really worried that my heart is sick and getting sicker.

Although I know a resting HR of 50s isn't awful - it's the huge change he's worried about. I used to run like a hummingbird, now I'm like a sloth! Also, I assume it drops even lower when I'm asleep. Yes, I am in terrible shape from the pregnancy, but it's been two months since and I'm not improving.

I guess either way I will know soon. I wish I weren't SO anxious. It's hard to parse out cardio symptoms from anxiety

Yes

by LMurph - 2013-10-14 09:10:14

Yes, I did. It was a normal result.

Thyroid

by Bostonstrong - 2013-10-14 09:10:36

I'm assuming you had your thyroid checked and ruled out post partum thyroiditis?

take a deep breath!

by Tracey_E - 2013-10-14 09:10:45

First of all, anxiety can make everything worse. Try to take everything one step at a time and not let your mind go crazy with worst case scenarios.

They are looking for electrical problems. Those of us with electrical problems often have structurally healthy hearts with clear arteries, we just got wonky wiring. If the heart goes too fast, meds will be prescribed to slow it down. If it goes too slowly, pauses or is uneven, a pm can speed it up and smooth it out. Lots of things can factor into it and it seems like a big deal but when you boil it down, the options are pretty simple. And the most important thing is it is all fixable! And not fatal, please put that out of your head.

You can get seriously de-conditioned from two months of bedrest so it's not surprising you get winded on the stairs. You will not die during the stress test!!! You'll be on monitors surrounded by medical staff, there is no safer way to find out what your heart is doing on exertion.

Under 60 is technically labeled bradycardia,or simply a slow heart rate. Most people with resting rates in the 50's do fine and do not need the pm so just having a resting rate in the 50's alone is not indication for a pm.

My dr once told me that when they find nothing, that doesn't necessarily mean nothing is wrong, but it does mean nothing serious is wrong because he would have found it. Good luck getting some answers!

step away from the google search button!

by Tracey_E - 2013-10-14 10:10:14

The internet can be a good thing, or the internet can make you crazy.

Ok, I'm no dr, but you just had a baby, that's a huge change in your body. Our hearts have to work a whole lot harder when we are pregnant. Depending why you were on bedrest, that can affect circulation too. Now you're getting back to normal, but you have a baby plus a house full of other assorted little ones to run you ragged. When is the last time you were well rested?? It's important to rule out other things, but your diagnosis might be motherhood ;o)

Did you have an old tv/phone/ipod/anything electronic that's working great while the newer one fizzled and died for no apparent reason? Electrical cardiac problems are often like that, also, they just happen out of the blue in someone otherwise healthy. Some medications can cause it or sometimes infection but usually they just happen and we don't know why. What we do know is nothing we did caused it, and that there's nothing we could have done differently to prevent it. Fluke!

In my case, I was born missing an electrical connection. It's not genetic- my parents don't have it and I can't pass it on to my kids- it's just not there so the pm steps in and makes the connection for me (av block, signal from the sinus node doesn't make it to the ventricles). I've been paced every beat since 1994. I'm healthy and active, mom to two teenagers (both born after pm). Easy fix.

p.s. the reason I'm assuming electric problems is if it was structural they would have found it by now

crazy thought, have you cut caffeine out of your diet? I get the symptoms you describe when I overdo it on coffee.

Yes

by LMurph - 2013-10-14 11:10:28

Frankc- completely true. I'm actually fine if I need a pacemaker. I know it's not a huge deal. Heck - if that's ALL this is, I'm going to be happy! Quick fix and back to normal. What I'm scared of is that this is progressive or going to kill me. Honestly, the surgery doesn't freak me out any more than a root canal would. I just want to be okay.

Murph

by Grateful Heart - 2013-10-14 11:10:33

The Doctors will get to the bottom of it. They are probably waiting for the stress test on Friday and then will give you some answers. The waiting is hard, I know.

Lots of good advice above.

Congratulations on your new baby, that's wonderful!

Grateful Heart

I'm a wimp but...

by frankc - 2013-10-14 11:10:38

I am a real wimp so when I was told I needed one I was worried more about the procedure than the result. My heart rate was 40. They started to tell me about the incision and that is all I wanted to hear as I would likely have passed out. The procedure was not bad at all. I heard them say knock him out and then I was in the recovery room. I had read all the comments people put on here and Google search on how the recovery would go. I found people tend to complain about problems more than just write that everything went right. I did not do much for a week after the PM and after that it was not nearly that bad. Now it is a remarkable difference. I feel so much better. My best friend has had malignant brain cancer twice and my best friend at church has had a kidney transplant and needs another. Compared to the other problems we could have, this is minor.

Lmurph

by Tick-tock - 2013-10-14 11:10:58

As Tracey has stated, Google can be a terrible thing!! I can relate to your concerns with being young and otherwise healthy. I too am 31 and just had my pacemaker placed 2 weeks ago. I do have autoimmune issues and have had a number of other surgeries including a thyroidectomy. However, my heart never gave me to many issues until few months ago. Of course they first checked my thyroid levels which cAme back fine. I was feeling very sluggish, extremely fatigue, short of breath,etc. I've always been active with. My health, going to the gym a few times a week, jogging, etc. I wasn't what would be considered an athlete by any means, but active. I started having difficulty getting through a simple Zumba class, and had extreme difficulty finishing an5k ( I do approximately 4 5k charity runs a year). I went to the doctor for something unrelated, and she noticed my heart rate was really low (my baseline is 70-75 ) they did an EKG which showed a heart rate of 49- from there I followed up with cardiologist who put me through. Number of tests, including stress test which is. Not as terrible as you may think. My 24 hour monitored followed which then turned into a 4 week monitor that was stopped after 2 weeks which was followed by my pacemaker for severe bradycardia- my heart rate dipped into the 20s and was in the upper 30s most of the day( sorry just trying to give you a timeline). At any rate as Tracey said, 50 is not bad. It is lower than your baseline and what physicians consider "normal" but your body just went through huge changes, and is very much stressed. Of course the anxiety levels do not help either. Hopefully, they will not find anything to serious. If you do need a pacemaker, know it is a pretty simple fix. Best of luck

Well

by LMurph - 2013-10-15 07:10:42

I got some ekg and Holter results today...
Doctor said my lowest HR was 52, he's not worried about it even though it's a big change for me.

Some arrythmias he's not concerned about. Only 8 pvcs.

The EKG spat out the diagnoses of:
Incomplete Rt bundle branch block
Right atrial enlargement
Normal sinus rhythm
Right axis deviation
Borderlinke EkG

He said he's not concerned with any of it...

Murph:

by donr - 2013-10-17 09:10:55

No, I'm NOT Grateful Heart, but Murph sounds like a natural thing to call you!

Questions & comments about your last comment.

Was that a report from a computer reading of your ECG or the cardio's interpretation?

Explain the context of your sentence "Some arrythmias he's not concerned about. Only 8 pvcs." How do the two sm,aller sentences relate to one another. I can get at least two contexts from it.

Great, so he's not concerned about any of it. You still feel like trash.

What does he plan to do for you? Send you home singing and tell you to just grin & bear it? He;s not the one feeling like trash.

Please answer those & I'll give you a few enlightening comments on your original post.

Don

Don

OK, Let's Talk...

by donr - 2013-10-18 01:10:22

Your answers are kinda what I expected.

Let's address issues one at a time.

1) Why don't you fill out your profile so we know a bit more about your problems? Start w/ profession (I know, full time mother, most likely) you sound like a nurse.(?)

2) Are you on any meds?

3) Have you discussed this w/ your OB/GYN? You are at least 2 mos Post partum, by now you should be back to normal. Ask the OB/GYN about the relative frequency of such events. Sounds like your Cardio doesn't really want to help you. Almost sounds like he has diagnosed you as SOHW (Stressed Out Hysterical Woman - an abbreviation I just made up to fit a common diagnosis when a cardio is stumped)

4) My ECG's always get whacked out evaluations from the computers that read them. The one that scared me crapless was one that said "Cannot rule out old MI." I'd never had an MI in my life - naturally the results came back on a Fri afternoon w/o any access to a human Cardio till MON. Sounds like he looked at your ECG & ruled out anything bad from the machine's comments. Not surprised.

5) Not a big deal that you lost nearly 1/3 of your formerly normal resting HR. Huh? That alone should be making you feel different somehow. That is a significant loss. I see from your OP that the 80 was pre pregnancy. Wow! That's a fast resting HR. You mean that lying in bed, relaxed, that your HR was THAT high? I would expect that number to be in the 50-60-70 range. MY Pre-PM HR was 72 resting.

6) How do you check your HR at night resting? Finger on wrist w/ watch & second hand? Or, did you get that from the Holter?

7) Do you know what a PVC is & how it is sensed by most people? Do you know how they feel to a finger at the wrist? If you cannot detect them, they can spoof you into thinking your HR is lower than actuality! Once upon a time, pre-PM, I thought my HR was low & had my wife check it. She got about 36 BPM. In reality it was 72, she just did not feel the PVC's.

8) You said "Aside from the resting brady, I have some mild chest tightness, especially upon exertion, a ton of anxiety, and obvious palpitations particularly when I go from activity to rest (ie run up the stairs then lie in bed.)

I have had multiple cardiac workups throughout my life with no findings (I have always had mild hypertension.). I need to lose about 15 lbs because I just had a baby and was on bedrest for the last two months of my pregnancy so I am NOT "just in really good shape."

There is a lot of interesting info in those two paras. First of all, that doesn't rate a ton of anxiety, that rates at LEAST 5 TONS!!!!!

Out of shape - Sheeesh! That's the understatement of the year. Bed rest for two months would kill anyone's conditioning! WHY WERE YOU ON BED REST? That could explain a lot.

Losing 15 lbs is no big deal. Try losing nearly 50 like my poor wife after our first.

Are you on meds for the HBP?

9) Why have you has multiple cardiac workups? For HBP? Other symptoms? That history would be helpful. Absent anything concrete, I'm guessing that you have had non-specific chest pains, etc that mimic electrical control system problems. Boy can anxiety induced symptoms mimic them nearly perfectly.

10) Your last para is rife w/ anxiety, caused principally by the fear of the unknown. Now, you are authorized to be anxious. Good grief - you are chasing 5 little kids, youngest 2 months, oldest no less than 5, unless you have a set of twins in there. You have a husband to worry after & heavy responsibility. Now throw into the mix HBP & now some cardiac symptoms, cause unknown. I can see a stereotypical SOHW diagnosis by that Cardio. So, he tells you he is not worried, just go home & relax & you'll be oOK.

11) If I am correct in that last sentence, I recommend you go see him & give him a good, hard kick in the shins for me. The absolute last *&^%$ thing you want to tell someone w/ your problems is to go home & relax!

12) PVC's: I have them by the thousands every day - as often as 3 a minute, averaging out to about 3 every two minutes. They are no big deal. After years of them, I finally accepted my cardio's dictum "They won't kill you." I guess not, they've been going on for at least ten yrs, now & here I sit, writing to you. You feel them at night because you are still, it is quiet & you are relaxing, trying to go to sleep. It is also probably dark in your bedroom. You go into what my cardio calls "sensory deprivation," so you can suddenly sense PVC's (or any other arrhythmia, for that matter) & they just GRAB your attention. Try the following: leave a small nightlight on and either get a background noise machine or play a radio very softly. That will remove the sensory deprivation.

13) You need someone who CAN explain what is going on. the last thing you need is more uncertainty. Try your OB/GYN for a change. - or try another cardio. This situation stinks.

14) any more questions, send me a note - be glad to chime in.

Don

Don

by LMurph - 2013-10-18 12:10:03

Haha - exactly Don. He said he thinks a lot of my symptoms are anxiety-driven or because I had a baby fairly recently.

Those "diagnoses" were from the EKG printout. He didn't even mention them to me, I just spied the readout and took a photo of it. I realize it's not the most accurate way to dx something.

He said my Holter showed some arrythmias here and there, but that "we aren't machines" so he's not worried. He said I only had 8 pvcs in 24 hours, no big deal.

He can't explain the sudden change in my baseline HR, but isn't worried because it's not "that bad." My resting hr used to be 85, now it's 55-60. He said probably because I am postpartum? Can't explain the new onset murmur. Said there is some thickening of my mitral valve but not a big deal.

Yet, I am still scared that I have something wrong. Still feeling some mild chest pains. Still feeling the PVCs at night, still get some slight dizzy spells....

I am supposed to put this out of my mind and carry on with life. I just don't want to drop dead. I feel something is up, but I am also a very anxious person.

You know you're wired when...

You have a shocking personality.

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