Four Months Since PM Insert

So after having the St. Jude placed on 02.25.21 I joined this forum and posted my thoughts and fears which the responses that I received were excellent and helpful.  Here we are 4 months later and I still am having some "MINOR" issues. This past Saturday night I was getting ready to go to bed and my heart felt like a flat tire being driven at 100 mph.  I should've pressed the button on the monitor but didn't.  It was a weird and horrible experience. I don't know what caused it but I do have an appointment with the dr who installed it this Wednesday.  I dread even speaking to him becasue he always overtalks me and shoots down everything I bring up.  If I DO NOT get satisfaction on this visit I WILL seek a second opinion.  Here is his "Encounter Diagnosis" of what he found while doing the exploritory heart cath before the insertion of the PM.

Sick Sinus Syndrome (Final)

Atrioventricular Block, Second Degree (Final)

Syncope and Collaspe (Final)

Supraventricular Tachycardia (Final)

Ventricular Premature Depolarization (Final)

Atrial Premature Depolarization (Final)

Essential (primary Hypertension (Final)

Type 1 Diabetes Mellitus without Complications (Final) 

Mixed Hyperlipidemia (Final)

Can someone give me the English version of all this?  When I went for my first two interrigations they told me that the PM was only being used at 8%.

I am STILL having chest aches as I call them at the heart. I have ZERO cholesterol blockage.  I can't figure out why the chest pains. If I didn't have them, I believe I could live with the minor issues/complaints of the PM.

PLEASE HELP me with some clarifications.

Thank you all


5 Comments

Hopefully a few answers

by Gemita - 2021-06-28 17:20:47

Mark,

First of all, importantly if your chest discomfort is worrying you, please make this the most important part of your follow up appointment and get some answers from your doctor, or seek emergency help if you need to.  Chest discomfort should never be ignored.  That pain you describe should be investigated and I am not sure that it would be picked up by any pacemaker interrogation unless the pain was due to a fast arrhythmia like your SVT.

Quite a lot to go through and I will do my best.   Quick observation is that these are all your (final) or (confirmed) diagnoses, not all found at the time of your exploratory heart catheterisation though?  No doubt you know about all your health conditions, but I will give my understanding of your diagnoses:-

Sick Sinus Syndrome = indicates your heart’s natural pacemaker called the sinus node, located in the right atrium, is not functioning well and needs some pacemaker support either for pausing or bradycardia.  The tachycardia part - SVT - (supra ventricular tachycardia) will be controlled by medication like a beta blocker to slow the heart rate while the pacemaker prevents it from dropping too low.

Atrioventricular (AV) heart block = impairment of electrical conduction from the atria (upper chambers) to the ventricles (lower chambers) via the AV junction. This impairment occurs when the atrial impulse is either delayed or does not conduct to the ventricles. The sites of block include the AV node, the bundle of His, and the bundle branches.  You have a second degree block, so it is not a total loss of conduction, but it is still serious and without your pacemaker to support you, it could intermittently lead to a loss of consciousness, or worse, cause the heart to stop beating.

Syncope and Collapse = loss of consciousness (LOC)/faint, leading to collapse.  Presumably your monitoring at some stage confirmed a LOC to support this diagnosis?

Supra ventricular tachycardia (SVT) = an abnormally fast heartbeat that affects the heart's upper chambers.  Again this was probably picked up during previous monitoring or confirmed during heart catheterisation?

Atrial/Ventricular Premature Depolarization = premature atrial or premature ventricular beats occurring in the atria or ventricles when one section of the heart depolarizes slightly before the rest. These extra beats disrupt your regular heart rhythm, sometimes causing you to feel pausing, skipping sensations in the chest.  They can be quite disruptive and cause symptoms when frequent, but we are told they are benign, especially in the absence of serious heart disease.

Type 1 Diabetes, without complications = that you do not have any diabetic complications like diabetic nerve injury (neuropathy), diabetic eye disease, kidney disease, cardiovascular disease which can develop with diabetes type 1 or 2.  

Essential primary hypertension = high blood pressure without a known cause, e.g.arteriosclerosis (hardening of the arteries).  However you do have diabetes, a known risk factor for hypertension, especially if diabetes is not well controlled.

Mixed hyperlipidemia = ?a genetic disorder. If you have this disease, it means you have higher-than-normal levels of cholesterol, triglycerides, and other lipids in your blood. The disorder if not controlled can lead to  heart disease and strokes.  

 

Although you only seemed to need 8% pacing support for the period of monitoring, your heart condition may change over time, so this figure can be expected to change too.  SSS and AV Block usually progress.  I am paced 100% almost entirely in my right atrium, although I have up to 7% ventricular support at the moment.

Good luck on Wednesday and please let us know the outcome 

Thank you Gemita

by MarkHart66 - 2021-06-28 17:53:40

Thank you for the explainations.  I have never lost conciousness.

Syncope

by AgentX86 - 2021-06-28 18:54:53

If you didn't lose consiousness, you should get this taken off your record.   It may be important to you later down the line.

I have to do the same, if I remember.  My record says that my carotid was stented.  They went in to place a stent but found that the arteries weren't blocked, as the CTA said they were, so there was nothing to stent.

Post Appointment

by MarkHart66 - 2021-07-01 11:55:47

Well the office visit went better than any that I have had with the doctor.  He told me that the chest pains are "Chest Wall Aches" due to the flesh, muscles and nerves that he cut to insert the PM.  He told me that this is my new way of life and that I can take tylenol or something like that to relieve teh aches.  He swore that it was NOT Angina.  I walk 32-40 miles a week and he said that I would be dead in the street if I had Angina.  So at this point I have to believe his words and trust he is 100% correct.

I would ask about the SVT diagnosis

by asully - 2021-07-01 22:16:40

It's a catch all term for many types of arrhythmias that occur above the ventricles (so in the atria) it could be ectopic, a fib, a flutter etc.   These arrhythmias are known to cause palpitations, pain, and a racing heart (among other symptoms).  Your pacemaker can't do a whole lot to help with SVT and they usually need to be medically or even surgically (ablation) managed.

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