Medical Event that Led to Hospital Emergency Room

• by TheOneGuy
• 2023-07-26 02:18:18
• Conditions, Meds & Tests
• 321 views
• 4 comments

Hello,

We are from Israel. My elderly mom had AICD Endurity DR PM2162 pacemaker installed 7 years ago. She's been on checkups twice a year until recent two years when they made it annual checkup. Her doctor recommended her pacemaker after an event when she started feeling unwell and fainted. She believes that hospital's intern did the implantation under the surgeon's supervision. On the night after the implantation her condition became bad which prompted the near patient to alert medical personnel. There were language barriers since mom does not understand the language. Mom told me that they did not tell her what caused such a condition but she felt like she is going to die.

After the surgery she would be called for a pacemaker checkup every two months. She would sometimes in between the checkups feel unwell and weak, mentioning discomfort and we would take taxi to pacemaker department. The cardiologist would do the testing and would constantly talk about raising the "threshold". Eventually all would be okay. She still has an issue of becoming tired soon when doing light physical activity like cooking and washing dishes. She used to walk faster and longer distance but in recent years she does little of that. Throughout years and not often she would feel unwell, usually during summer when we have heat waves and high humidity.

For the first time she felt pretty bad compared to how she usually does. After shower she felt unwell at heart. The blood pressure was as follows:

At 7AM:

125 / 76 with 120 BPM

At 7:11:

160 / 112 with 88 BPM

At 7:40:

182 / 83 with 121 BPM

She had to go to her doctor's appointment but sat on the chair and could not stand up, nor walk. She felt weakness. Said also she felt pain in the upper stomach and she was belching. She also felt like that area was pulsing and said she could see her belly reflecting that by looking at it. Only 40 minutes later when I called her HMO that the nurse issued permit to visit near medical center where they performed blood pressure test and ECG. The printed sheet had 120 HR mentioned on it. I watched on the monitor and saw how her heart rate would go to 120 BPM stay there for about half a minute and then go down to 90 BPM only for 5 seconds until rising fast to 120 again. They decided to transport her to emergency room in the hospital where they implanted her pacemaker where that heart rate condition stayed until 12:00 noon and then started to subside to now being between 65 BPM and then rising within several seconds to 95 BPM. She felt a little better. After another 20 minutes the condition has stabilized and she felt stable more or less. The pain in stomach was less than before and the frequency of belching decreased.

They performed X-Ray and blood tests which were normal, gave her infusion and I took here to the pacemaker department where they diagnosed the device. The cardiologist said that there were events that happened and believes that was the problem. I think by events he refered to frequent activity that I descrived before, with heart rate being unstable. On the graph it looked like spikes one after another. He said that the threshold was high in the last pacemaker checkup and he reconfigured it. Said that the situation was not life-threatening. When I asked about stomach pain, belching and belly pulsing the cardiologist said he does not know if that is connected to the pacemaker but the device is working in the proper order.

To me it's strange why cardiologist does not see the link between stomach pain, belching and pulsing and pacemaker and/or cardiovascular system because I read that one of them affects another. My mom planned to fly abroad in the next 3 weeks and he said she can depending on how she feels. He described the situation as not life-threatening but it seems to me that such frequent activity that I described beforehand wears out the heart since the pacemaker has to work constantly by stimulating the heart. Could the cardiologist's scope of specialization who reconfigured her pacemaker be more on the pacemaker programming side than general cardiology?

My mom sees her cardiologist twice per year and he attributes the stomach pain, belching and pulsing to the pacemaker. From time to time there are days when she feels not so good and she noticed that when she raises both of her hands upward it makes her feels worse. To that cardiologist did not comment. I wonder if it's only a pacemaker that is not optimally configured or needs more frequent adjustment and not worsening of heart's condition or of cardiovascular system that affected how pacemaker responds like this time? I think that ideally cardiologist who's scope on pacemaker programming and general cardiologist should both cooperate to find out what is the cause of aforementioned conditions but I don't know how to have this done. There's a shortage of medical specialists here in general and we have country protests where people are going on a strike, including medical specialists.

I wonder if there is such a thing as implantation that was done properly to begin with that could be the root cause or an additional cause of pacemaker not working optimally?