What a way to be diagnosed...

Yesterday was hubby's birthday, the sun was shining and it should have been a happy day.... and it was till the postman came!!!! I open it to find a copy of a letter sent from the hospital to my GP, calmly announcing I don't have sleep apnoea (lovely Consultant told me this at appointment in sleep clinic) but have heart issues - a fast sinus rate and ventricular standstill and he is arranging for me to be fitted with a pacemaker "in the near future"!!!!
Good Grief!!! talk about a mean way of telling U!!!!
Years of my old GP saying "oh everyone gets little fluttery feelings in their chest now and then". New GP has it diagnosed in under 6 weeks!
Sorry but I felt this was one heck of a way to find out and am now wondering what on earth sinus rate and ventricular standstill means. Is it an arrhythmia as both my Dad and sister have Bradycardia? Sigh! Sorry for ranting. I just feel so lost.

6 Comments

big names

by Tracey_E - 2015-04-26 04:04:23

Jeez, that's awful! I wonder if the office was supposed to have called you before it was mailed from the lab. That would maybe excuse it. Sort of. Ok, not really, someone skipped the bedside manner class.

GP's do not make decisions about pm's. Cardiologists or electrophysiologists (cardios with a sub-specialty in electrical issues) would make the final diagnosis. Next step is a referral to a specialist. The next step after that would be a Holter monitor, which is like an ekg but you take it home for a few days up to a few weeks. This tells you how slow you get, how often it happens, how long the pauses are. From there, you decide with your dr if you need the pm or if monitoring is sufficient for now.

Bradycardia is just a slow rate, under 60 bpm. It's more a symptom than diagnosis and many things can cause it.

Here are some great animations on how the heart beats, the various conditions that would lead to a pm and how the pm works
http://health.sjm.com/arrhythmia-answers/videos-and-animations

In nutshell, your heart is 4 chambers- 2 atria and 2 ventricles. The atria are the brains. They monitor oxygen levels in the blood and raise/lower your hr as needed. That's your sinus rate. Ventricles are the brawn, they make the strong beat we feel as our pulse.

So, sometimes your atria races, and sometimes your ventricles pause. The pm won't do anything for the racing, it can't stop the heart from beating so it'll just sit back and watch. If the atria beats but the ventricles don't keep up, that's called an av block (the electrifal signal is blocked between the sinus node in the atria and the av node in the ventricles).

The pm can fix pauses and blocks very easily. It's set to watch. To keep the math easy, let's say it's set with a minimum rate of 60 bpm, or 1 beat per second. If the atria pauses for a second, it kicks in with a signal that mimics what the heart should have done on its own, the heart responds by contracting (beating). If the atria beats but the ventricle doesn't keep up (I'm guessing this is what they are causing ventricular pauses), the pm kicks in and paces the ventricle. It sounds all complicated and scary but it's really pretty basic.

Racing is generally treated with medication, however if you aren't having symptoms and it's not that fast, it may not be necessary. Also, if you are having pauses they may not want to give you a medication that slows your rate. In that case, then a pm would be appropriate because it would enable them to treat the racing while the pm prevents pauses. However, that's assuming it even needs treated. As your first GP said, lots of people have harmless things once in a while. He really wasn't in the wrong there, his not checking to make sure it wasn't more was his mistake, assuming it was nothing.It still may be nothing!! Little irregularities are normal and this may turn out to be nothing more than that.

Wow Tracey!

by NiceNiecey - 2015-04-27 04:04:58

She just gave such a marvelous explanation; way to go.

It really sucks (pardon my language if you find it offensive) to have learned about a possible problem via mail. That probably wouldn't happen in the US but that's because they don't usually 'deliver' bad news in writing!

As Tracey suggested, take it a step at a time. At least you now have the benefit of gathering all the facts and getting use to the idea that you may have something that needs attention. (I feel so diplomatic saying it that way!)

Please keep us posted along the way.

Thanx Tracey..

by TartanTiger - 2015-04-27 07:04:15

for your reply. I understand so much more now and about the PM thank you for your post. I was admitted and had tests to rule our heart attack blood, echocardiogram etc and then had a 3 day holter - results showed bradycardia (consultant phone pm on a Friday just to tell me!!)

He wanted me tested for aponea, results showed it wasn't that so, all letter says is "generally has a high sinus rate but results are unusual given her age (I am 42) as interspersed with ventricular standstill, there is little option but to proceed with permanent pacemaker implant. I will arrange for this to be done at the Southern General Hospital in the near future".

Just called his secretary to ask for explanation and just what by "in the near future" he means as due to go on holiday in 3 weeks! I am glad they picked up what is wrong - hubby is already making Bionic Woman and Robo-wife jokes.

Yes, NiceNiecey a wonderful post and so well explained.
trust me my language was more erm, colourful than yours. So true I at least understand why I feel unwell.

Been Where You Are

by MathTeacher - 2015-04-27 08:04:28

Hi TartanTiger,
I was surprised like that, too. I recently saw a cardiologist to make sure my SVT hadn't taken a toll on my heart in the last 20 years, just a routine checkup, so I thought. I was originally "diagnosed" with sleep apnea all those years ago (just like you), though I now know that it wasn't. My cardiologist had me wear a heart monitor for a month but cut it short a couple of weeks after she diagnosed me with SSS (sick sinus syndrome), so I have the bradycardia, too, along with the SVT. She got me into an EP the next week who saw me for about eight minutes, threw me a model pacemaker and brochure, and told me to make an appointment with the scheduler to have it installed...sort of like scheduling a part for your car. I was in shock, too. I was left with two weeks of having to freak out about what it would be like to have a PM. I am five days post surgery and have to say I felt immediate results with my heart. Still a lot of adjusting to do, but I wanted you to know I definitely sympathize with what you're going through.

Not just me then...

by TartanTiger - 2015-04-28 06:04:39

thanks for sharing your story with me. That is good to hear that your feeling the benefits already. I know that to the doctors etc it is routine and just another day at work but for us it is major life change. Not allowed to travel so holiday in 3 weeks now canceled and a fight with the insurance company on the cards, just waiting for a phone call to go in.

travel

by Tracey_E - 2015-04-28 09:04:51

Why can't you travel?? There are people who travel to get their pm, then fly home the next day. You won't be able to lift anything heavy or raise the arm higher than shoulder level for 4-6 weeks after. Other than that, you can do what you want. You probably won't want to do much the first week, but 3 weeks should be ok if you want to still go. Or can you wait until after your trip for the surgery?

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