WHEN DO YOU GO TO HOSPITAL?

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I am 20yo, female and have been diagnosed with IST (with additional VT or SVT type attacks - jury is still out on that one). I had what I would describe as the worst attack yet.

Whilst my HR was only between 130 and 160, it was within that range for a period of five hours. I couldn't stop it with anything I did, and medication wouldn't work either. When it started, I felt like I had the air knocked out of my lungs. I could feel a pounding in my neck and stomach - so weird.

I was extremely breathless, couldn't focus and became really faint towards the end. I didn't go to hospital as I kept thinking that it would convert on its own, as I have never had one that lasted this long. Shortly after I finally did make the decision to go to hospital, it dropped from 140 to 80 in seconds (before I got there of course). I am still a little on the breathless side following that episode.

I am meeting with my cardiologist this week, but I would be interested to hear what you have been told as to when you should go to hospital. In hindsight, I know I probably should have made that decision sooner.

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16 Replies

  • Posted

    I recently asked this question to my cardioligist.   He said that I am healthy and my heart is strong so he would wait a 1/2 hour before going there.  My last episode though I was at 244 bpm.  

    Have you considered an ablation?

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    • Posted

      sorry to hear you experience a similar sort of thing with a much higher heart rate!

      I would like to go down that path but at this stage, I have been told that I am not a candidate. because my issue is twofold, the ablation would only help with managing/eliminating the extra attacks. it sadly has little to no impact with IST and can be high risk.

      what about you? have you had an ablation or are you considering having one?

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  • Posted

    This is a big one for me... I just find the advice given by medical staff to patients with svt very conflicting...One said, "Oh your heart can go on for hours at a rate of 160" yet another said, "Well my advice would be to head down to the hospital after about 15 minutes if it's not settling at that rate"!!!

    Does your blood pressure rise during an episode?

    I tend to know when it's a really bad one and I just start to head dow to hospital.

    I've seen me getting nearer and it settling down and I just go home.

    I think that's what I find really unsettling.

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    • Posted

      I don't normally have any blood pressure issues during an episode or in general. thankfully.

      given that I've never been to hospital for one I also don't know what to expect - whether they would consider it to be a waste of time or even warrants me being there.

      in your experiences, what usually happens when you go? do you get seen to quickly?

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    • Posted

      If you start to feel unwell during an episode, that's when you really should go to hospital. ie chest pain dizziness, feeling faint.

      !30 is not that high and I don't think they would be doing much with that sort of heart rate apart from maybe monitor and wait to see if it settles.

      I have been seen really quickly whe I've gone down, been admitted twice though. The first time my troponin level was mildly raised which could indicate a heart attack - But they tink it was due to my heart rate being so fast!!!

      How did they diagnose you with ist and ? vt and svt ?

       

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    • Posted

      In terms of testing, I've had xrays, ecgs, holters, echos and stress tests. IST was diagnosed from having two separate holsters and each returned an average HR for 24hrs well over 100bpm. stress test confirmed that I have an exercise intolerance which causes rapid increases with minimal exertion which is consistent with IST.

      Whilst the holter monitors showed frequent ectopic beats - there were ventricular ectopics in bigeminy/trigeminy runs but separately, it also showed some supraventricular patterns. I haven't been able to catch a full blown attack on an ECG but I have a Garmin which monitors my heart rate. I have produced those records to my cardiologist who can see there is clearly a problem, but just hasn't quite been able to confirm whether it is VT or SVT specifically.

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  • Posted

    I had an ablation about one month ago.  The last SVT attack was so bad and took 3 doses of Adenosine to convert.  

    The EP thinks he was able to ablate the area and is hoping for no additonal issues.  

    I am so sorry you are going through this!  

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    • Posted

      hopefully that means you'll be in the all clear in no time at all!

      it is certainly something i will jump at if and when i get the all clear to go ahead with!

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  • Posted

    update: as it turns out, I have been diagnosed with ventricular tachycardia/ventricular ectopy (in addition to the ist) and I should have taken myself to hospital. whoops. i'm very lucky that it didn't degenerate into a more dangerous rhythm.

    I undertook another holter for a period of twenty four hours and I averaged 300 to 400 ventricular ectopic beats per hour with a number of bigeminy and trigeminy runs. it only captured a mini attack and whilst my heart rate wasn't as high as the attack above, it was enough to show the runs of ventricular ectopics.

    we are now talking ablation as soon as possible (at least to resolve the vt) in order to reduce the risk of having another, more serious attack.

    just thought I'd leave an update if anyone was interested.

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    • Posted

      Well now that the doctor's have managed to confirm a definate diagnosis it allows you to have the necessary treatment...

      Do you feel the ventricular ectopic beats? I have had a non sustained ventricular tachycardia caught on monitor only an 8 beat run - I also suffer from ventricular ectopic beats but the doctor has said they are "normal"!

      Thanks for the up date, and my thoughts are with you...

      Take Care and keep us updated  

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    • Posted

      I don't feel them as much as I would have thought unless they (a) trigger a tachycardia episode (b) they wake me at night or (c) they happen at rest.

      If I do feel them it's more of a lurching sensation or a series of hard thumps. I find that it's more the racing sensation that I feel. do you feel them?

      In my previous tests, there were always ectopic beats and my doctors have also described them as being normal/benign. I also never had any sustained runs of ectopics in those tests and reducing the inappropriate sinus tachycardia rate was the primary focus. I recall however, that there was always concern about the occurrence of ectopics during and post-exercise - they were abnormal.

      Given that the sinus tachycardia has been resolved with medication, and the attacks started/worsened my cardio has indicated that they are not so "normal" and actually trigger the episodes of vt.

      hope they don't cause you too much grief!

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    • Posted

      I do feel the ectopic beats - I am always vert aware of them...

      I had the holter monitor on when they picked up the 8 beat run of nsvt - I was very aware of that and felt it as very definate thuds in my chest it also made me feel light headed and gave me a sort of dropping feeling.

      My cardiologist had said that many people suffer from this and are not even aware of it! And in a structrually normal heart they are nothing to worry about!

      My worry is that they turn into vt...

      Worry Worry Worry!!!

      How are you coping with all this going on and have they gave you advice on what to do if you become symptomatic again!?

       

       

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    • Posted

      I was hoping it would be svt, but unfortunately that was not the case. I am over the initial shock, but still slightly terrified about vt - knowing that it can be quite dangerous.

      I've just been advised to go to hospital if it happens. I've otherwise been told that I can start taking a beta-blocker to supplement my current meds, although I'm not really wanting to start that.

      are you on any medication?

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    • Posted

      I am on the highest dose of verapamil now, it's a calcium channel blocker. I know a lot of people can't seem to tolerate it but I don't seem to have any side effects and I have been on it for over a year now.

      Can I just ask when and how did you notice your first symptoms?

       

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    • Posted

      I started having complications (IST) about three years ago, but looking back there were probably signs well before that. I noticed that I was lightheaded and nauseous all the time. I started to struggle with the simple things like having a shower, walking upstairs and cleaning. I've had difficulty breathing for years and just always had a really tight chest. I then started having difficulty training and would nearly pass out at the gym. I invested in an exercise heart rate monitor and I was so shocked at how high my heart rate was all of the time. I went to my GP and he arranged a holter the same day and an appointment with my cardio a week later. I started taking ivabradine and it has been life changing. However, once my sinus rate was normal that's when I started noticing the ectopics and the extra episodes that were above and beyond my original issue. I'm sure I had them before, I was just used to having a high heart rate so considered it to be somewhat normal for me.

      I first clued on to the fact that it probably wasn't normal about a year ago after my first large episode and unfortunately I haven't stopped noticing them since haha!

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