I was diagnosed with A fib with RVR a week ago.

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At the time I was taken to the ER, everyone acted like this was some big dangerous emergency. Now I am told I can wait a month for and echocardiagram. I do not understand. Is an echocardiagram important or not, and if it is important and this is an emergency, why is it suddenly safe to sit and wait a month for further tests? I an currently wearing a heart monitor at home that I am supposed to wear for two weeks. the have also put me on blood thinners and upped my hbp meds, the reduced them six days later. I do not understand any of this. The cardiologist did tell me I have to lose weight, as if the two hundred pounds I have managed to lose on my own is not good enough. I feel like a victim of medicaiditis. C an anyone help me understand the up, then down, with the pills, why it is only an emergency if I am standing in an office, but not an emergency when they call my home to arrange tests? I am so confused by all of this.

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6 Replies

  • Posted

    I presume they already took an echocardiagram in the ER, and the scheduled one is a follow-up? And because of what they saw in the ER, and otherwise diagnosed, they don't expect anything immediately? Does the monitor that you wear immediately report any incidents, or do you upload it once a day, or anything like that?

    Which BP meds did they increase, what was your BP before the incident, during the incident, and since? Was one of the meds temporarily increased a beta blocker?

    Congratulations on losing 200 pounds, but I guess the question is, does that put you at a "normal" weight or is there still an issue?

    Is this a new diagnosis?

    Many of us have seen that various arrhythmias are treated by doctors as very low priority items, and I guess that's generally correct, no matter how awful they feel.

    Unfortunately in this case I don't think it's a medicaid (United States lower-tier levels of care) issue, that's how pretty much all doctors at all levels treat these things.

    • Posted

      They have done two EEG's, bloodwork, and UA. They will to the first echocardiogram on the eighth of February. after I wear this heart monitor for two weeks, I mail it to the company in California, they download it, and send my doctor here in Oregon, the report. I guess I am on my own to deal with this. they raised the 25 mg of Metoprolol to 100 mg, , and put me on Eliqis, then four days later, with no further tests, I was told by the cardiologist to cut the Metoprolol back to 50mg.

      I started losing weight when I found out I had pre-diabetes. i still have more to lose, but I am still losing. I lost nine pounds last week without trying too hard.

      During the incident, my blood pressure was normal but my pulse was 100 and two hours later it was 110. I just felt reallt spacey, and when I went to lay down, I suddenly felt really dizzy and nauseated, so I went to the ER.

  • Posted

    I agree with the previous post but just wanted to add something that when I discovered it I stopped worrying. I felt exactly the same as you. The blood thinners they put you on are to prevent a stroke. When in AF the blood pools in your heart and can form clots that can dislodge and cause a stroke or other problems. By taking blood thinners this prevents the clots forming so prevents strokes. My doctor told me that by taking them I was less likely than other people not on them to have a stroke. Hence the change from emergency treatment to appointments. Good luck. I actually discovered that another tablet for incontinence I was taking may have caused my AF so check all the side effects of medications you are taking. Once this was discovered and I had stopped the meds I was checked 6 months later. I wore a fit bit to monitor my heart rate which was always normal so I have now been discharged from hospital back to GP care. I hope this helps. Good luck.

  • Posted

    Hello MadameKelly: I am not a medical professional, but I have had Afib for 17 years, and I can tell you my experience. I started with a very few episodes a year, then last year they were coming fast and furious (to me, anyway!) every week or two,30 hours at a stretch, high heartbeat of up to 150 (never higher). I had tried amiodarone to good effect a couple of years ago, but could not tolerate the side effects. Now I am on Multaq, which is doing the job but makes me dopey. If that is a side effect of keeping episodes of Afib away, so be it. Every time I visit my cardio, which is a couple of times a year, he takes an electrocardiogram, and maybe once a year takes an echocardiogram. (This is paid for by our Canadian public health service.) He tells me that these tests are to see if there is any damage to your heart, not a treatment. In the beginning i used to go to the hospital, but have not been to emergency for years. My Afib stops on its own in10 to 30 hours, and leaves me faint and exhausted. I have also heard that Afib does not kill you, but in the long run can cause damage to your heart. I would guess that your doctor probably wants a base line: taking these tests so that he can see if there is any damage, and to compare to similar tests in the future. On my latest visit, the doc said I had no damage, which is good, after 17 years! I am 84 years old, weigh about 135, and try to keep it there. I don't have much energy, but I exercise every day (a little!) and life is good, so calm down, it is a scary diagnosis, but the reality is less so. I hope you will get good advice from your doctor, and don't worry too much.

  • Posted

    Hi madamekelly, let me correct my last post a little, I meant the must have done the electrocardiagram (ECG or EKG) in the ER. So you were asking about the different test, the echocardiagram. Which they will do after you finish with the Holter/Event monitor you're wearing now.

    Funny thing about that, when I first started having these issues about twenty years ago, my doctor then went right to the echo and stress-echo tests. But when I changed doctors a few years ago he did this test and that test, but no echo. So I finally asked, "Hey, why haven't we done an echo yet?" and he said, "OK, let's do an echo!" So I gather that they have for some reason fallen out of favor, generally. He was more excited about doing an echo on my carotid artery, as part of a general evaluations.

    Increasing the beta blocker seems a natural step for someone with new arrhythmia problems, it's not an automatic cure, but it's something to try and is often helpful. But you don't want to be on a large dose for no reason. Part of the increase is also just to calm you down, which it generally does.

    Finally, on the weight - you lost 9 pounds in one week? That is a lot of weight to lose that quickly. Now, I don't know much about serious weight issues, but there is this, that losing weight that fast is liable to upset something - your electrolytes, your blood glucose, ketones, and who knows what else. I'm sure they checked most of those in the ER, did they mention anything, about the electrolytes in particular? Or "dehydration", a terms they overuse for different things? Several of those things can trigger heart arrhythmias.

    • Posted

      Thank you so much for your calm explanation of things. you and other people have gone above and beyond in allaying my fears.

      A little history -

      I did not see a doctor at all until I was eighteen, and pregnant with my first child. Dad said doctors were only for sick people, but never took us in when we were sick... so I have an odd relationship with them. I tend to wonder what the motive is, stupid I know, but there it is. At the age of 26, I was involved in a car accident that broke my neck. A neurosurgeon tried to convince me to have a steel rod placed in my neck so that I sit up in a wheel chair, no matter how much I to,d him he was wrong. I signed myself out APA , and walked out on my own feet with a bit of help from two friends. six months later a Chiropractor showed me the real problem. M y spinal cord was being pinched by a slid out of place neck bone. He fixed the problem in that first visit, and taught me exercises to keep it in place. I was nearly good as new.

      At 32, I suffered a cerebral hemorrhage that took three separate Er visits to get them to believe there was something wrong, because all I kept saying was "there is something wrong in my head". the first two days, they sent me home and gave me orders to see a shrink! When I was taken back the third time, I was vomiting blood everywhere. I guess it was enough to convince them to take a closer look and order a CT scan (this episode was enough to increase my distrust of doctors in general).

      I now have Epilepsy from the damage, and medicating me for the seizures has been one long nightmare of horrible side effects, so I chose to give up the drugs, and use medical marijuana for them. It worked, I have not had any seizures since, and while I would never recommend people quit meds, it has brought my life back to my control. (My neurologist is supportive of my decision, since it gives him a chance to study the effectiveness of medical marijuana for seizures and no more horrific side effects for me.) (I douse it in capsule form because smoking it was awful, and I use it at night to avoid the "stoned" feeling. bonus-it helps me sleep better. that is my story for clarity.

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