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Forum Name: Congenital Heart Disease in Adults

Question: Former repair of ASD and VSD and not SVtachardia


 kaesmom - Mon Mar 07, 2005 8:04 am

I am on the brink of losing my mind. I had a ASD adn a VSD repaired when i was 5 years old. That was back in 1974. SInce then I have had numerous test done for chest pain, ache, etc. Well, i went to see my cardiologist to make sure it would be okay for me to become preg and he wanted to do a nuclear stress test just to make sure there were no problems. It was negative for Ischemia and he said it would be perfectly fine. At twenty weeks pregnant I was just standing at work talking to someone and my heart started to race. I started to pass out and they called the ambulance but by the time they arrived my heart rate was back to normal and my blood pressure was fine. Well, just three days later it happened again while at home. I was just sitting on a chair. This time the racing would not stop. I went to the emergency room. My heart rate was 217. Right before they gave me the meds to slow it down it went down by itself, but it lasted almost an hour and a half. I went to my doctor the next day and he did a echocardiogram and put me on digoxin. The echo showed no valve issues and at first they had my ejection fraction at 40 percent but he said that could not be correct just by looking at my muscle working. He redid it and got it at 55 percent. I got a call after my cardiologist looked at it and the nurse told me that he said again no valve issues but that they could not get a clear veiw of my atrial wall, or muscle??? He wants to do a transesophageal echo after the baby is born. The tech that did the echo did tell me that it looked like my atrial muscle was not working as hard as it should. I am SCARED to death of dying before my baby is born. I already have a two year old that needs her mommy. The nurse told me that he wanted to do this procedure to see if after the baby comes but that it SHOULDNT be a problem during my pg. WHAT! I don't have another appt wth him until April 4th. Lately my chest has been hurting and in between my shoulder blades. I don't know what is is but i am scared. Its kinda a strange pain. I cant even discribe it. It is not excrutiating but it is very worrisome. I don't even really know what I am asking. Well one thing,, is the 55 percent EF normal? Should i be concerned? Should I ask for more test? And can anything test wise even be done with my being pg? My baby is due the end of May and I am terrified!
Thanks for your time.
 Dr. Yasser Mokhtar - Thu Mar 17, 2005 11:28 am

User avatar Dear Kaesmom,

Females of the child bearing age are naturally protected against coronary disease. Having chest pain during pregnancy has to be reported to your physician. Even though most of the times, it is no big deal, yet sometimes it proves to be due to something serious (yet unrelated to coronary disease). Acid reflux disease is not a serious cause but it is a common cause of chest pain in the pregnant females.

There is no need to worry, an ejection fraction of 55% is normal. What the doctor meant that it could wait after pregnancy is that there is no emergency in doing the transesophageal echo now and since it is going to be uncomfortable for you during pregnancy, it is better to wait till after pregnancy and have it done.

The question is why have you had these 2 episodes of svt? What did the ecg that you had in the ed show? i assume that you had all the blood tests needed including a thyroid function test and electrolytes in the blood. You need to have enough sleep and rest. Your history of and asd its correction can be the cause behind the arrhythmias or the arrhythmias can just be primary, meaning due to a cause in the conduction electrical system of the heart itself.

Digoxin is not going to prevent other episodes, it might make the episodes less fast.

If you have another one of these episodes, i suggest that you see an electrophysiologist, a cardiologist specialized in arrhythmias.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 kaesmom - Wed Mar 30, 2005 10:33 pm

Thank you SO much for your reply. When seen in the emergency room for my svt they just told me that is what it was. I did go see my cardiologist and have seen him again since I posted the first question to you. He was trying to explain it is terms I can understand and he told me that on my echo it looked like the hole they closed when i was five (the asd) seemed to possibly have a "little air coming in from under the door" He is not sure of the extent and that is why he wants to do the transesophageal echo after the baby is born, he told me that it should cause me no issues with the pregnancy. If there is a leak could it cause the SVTs? I asked him if they were preg related and he said he can not be sure at this point. He will know more when he does the procedure. I never had them before. As a matter of fact, the reason I saw him before I was pregnanct was for a SLOW heart beat! I am so confused. I am also worried that the issue with the asd could cause cardiomyopathy. Can it cause that? ONe more thing,, you said that women in thier child bearing years are protected against coronoary artery disease? So you cant have a heart attack at my age? Im 34 years old. That always scares me! Both my parents have heart issues and my dad has had two bypasses. My mom has had a heart attack as well. Hers was a blood clot. Anyway, thank you SOO very much for answering my post..
Thanks again
Melissa

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