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Forum Name: Arrhythmias

Question: over 35,000 skipped beats in 20 hrs (cpk,ldh,sgot result)


 crystalriver - Fri Sep 26, 2008 4:54 pm

Hello,

I'm a 33 year old female with no signifigent medical history. In June I had an episode of incredible chest pain accompanied by difficulty breathing and sweats. After 20 hours of rest and no improvement I let my husband take me to the hospital. They kept me for 2 nights and started me on blood pressure and cholesterol medications. Because I was breast feeding my 5 month old, have a 2 year old and because I couldn't get any of the test results or speak with a doctor I checked myself out. I figured if no one was coming in to see me they must not be that concerned.

I put off seeing a doctor until one day a month later when I felt dizzy, sweaty and light headed. I went to my general who gave me the usual you're a female, you're too young just ignore it speech, then after listening to my heart he heard constant bigeminy and immediately referred me to a cardiologist. Who then gave me the same speech. After he did an EKG and saw lots of pvc's he decided to do a 24 hr holter. I wore the holter for 20 hours and there were over 35,000 benign skipped beats. I also got my test results from the hospital.

sgot-ast 63
cpk 227
lactic dehydrogenase 730

My Cardiologist is unconcerned. Should I be? What does this all mean? Yesterday I felt nauseaus, lightheaded and shaky. Today I have mild chest pain. I don't want to ignore this if I shouldn't, but I also don't want to get all worked up over nothing.

Any advice from Cardiologists would be greatly appreciated.

Thank you
 John Kenyon, CNA - Tue Sep 30, 2008 9:17 pm

User avatar Hello -

While your initial symptoms of severe chest pain, shortness of breath and sweats made your decision to be seen urgently a wise one (and if this ever happens again I would recommend you go to the ER immediately and not wait so long, even though it seems everything has turned out negative so far). These are symptoms which cannot be ignored, even though there is no known heart disease.

As for the PVCs, when one's heart goes into fairly constant bigemeny, it produces what seem like an incredible number of PVCs. Given that this was over a 24 hour period puts it into some perspective however, from a clinician's point of view. It means you averaged 24 PVCs per minute, which still seems like a lot, but only if your average heart rate was 48 beats per minute. So you see, you actually had periods where the rhythm corrected briefly. This is not to dismiss nor minimize the discomfort and anxiety this must cause, but to try and put it into some sort of context. PVCs are, in and of themselves, almost never of any diagnostic value. They are not, in themselves, predictive of anything. Some people actually have ventricular bigemeny as their regular rhythm. Of these, some have it go away when they become active, only to have it return when they are at rest. For others it works the other way around. Generally, though, in the absence of any significant heart disease, they mean nothing -- technically speaking. And yet they are among the most disturbing of symptoms and one of the most unpleasant sensations one can experience. Yet, again, some of those who have this as their "normal" rhythm never are aware of them. It is a very random thing as far as perception goes.

The lightheadedness and dizziness is, in all likelihood, a by-product of the blood pressure medicine you were put on, if, indeed, you are still taking it. If you had high blood pressure while in the hospital, however, you may have simply been stressed by the (justifed) anxiety over the symptoms that brought you there, and then the experience of being in the hospital (some patients run a higher than normal pressure until they are discharged and, after returning to the relative peace and familiarity of home, it returns to normal). The cholesterol medication would suggest you have elevated cholesterol, but I wonder at both of these prescriptions. Among your lab results provided, you don't include your lipid profile, nor do you provide a figure for your blood pressure while in the hospital nor currently. These would be helpful, if available, since you are young and presumably otherwise healthy.

If your cardiologist is not concerned about the PVCs I can understand this, but you need to have the reasoning for that conveyed to you. Too often doctors forget that what doesn't concern them may still concern the patient a great deal. I am more interested in your blood pressure and cholesterol at this point, since the reason for those meds is not given. The PVCs, as horribly unsettling as they can be, are almost never a cause for concern. That doesn't mean, however, that nothing else could be going on. I'd love to be able to take a deeper look.

I hope, at least as far as the PVCs are concerned, that I have been able to ease your mind somewhat. I know this must be very difiicult to put up with, but when you are able to relax it will likely become less and less of an issue. It's not easy, but it's true.

Best of luck to you, and please follow up with us here as needed.

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