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What Do Recurring Heart-attack Symptoms Indicate?

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Posted on Wed, 11 Oct 2017
Question: I have had 2 cardiac ablations and several cardio versions for a-fib, sometimes flutter has occurred as well. I have been to the ER twice this weekend for classic heart attack symptoms. First, rapid heart rate(201, my normal is 60), jaw pain, sweating, shortness of breath, weakness, tightness in neck and left shoulder pain. Second time in ER, same symptoms. My heart rate is down to 110, but I can't seem to convert. I feel there is something else going on, especially since the procedures have not worked. My last ablation was 6 mos. ago. I am a 62 yr old female, not diabetic, take care of myself. I am very frustrated at this point, especially with the newer symptoms, including vision problems during these episodes. Any suggestions? Doppler Echo?

I was diagnosed with SVT on Thursday night and given the drug (twice) which stops the heart. All my labs are good except for the PBNP which was 1558 pg/ml. standard range is less than 226 pg/ml


I also had a chest xray and a CT with contrast looking for pulmonary embolism, clot.
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that the blurring vision could be related to low blood flow to the brain during these episodes. A TIA from the cardiac arrhythmia can not be excluded either.

You should know that during tachycardia, the blood amount pumped by the heart is reduced. This can cause a low blood flow to the brain, especially when there is narrowing of the carotid arteries.

For this reason, I would recommend performing a Doppler ultrasound of the cervical arteries to examine the blood flow in them and exclude possible narrowing.

Anyway, even if the Doppler results altered, you are actually under anticoagulation, which help prevent possible stroke. So, basically you are protected against these events.

Regarding the episodes of chest pain, I would like to know if they performed cardiac enzymes.

Anyway, I would recommend performing one of these tests to investigate for possible coronary artery disease:

- nuclear perfusional cardiac stress test
- dobutamine cardiac stress echo
- a coronary angio CT scan.

Hope you will find this answer helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (17 hours later)
They did perform the Troponin blood test in XXXXXXX and in Kalamazoo. Both showed no signs of cardiac muscle damage. My BUN/Creatinine ratio was a both high at 30. BUN was 25 mg/dl. My TSH was at 6.24. I am still in tachycardia (126-110) this is quite high for me since my normal is 60. I am very fatigued, weak, and am sweating. I have not experienced the severe symptoms I had the past couple of days.
doctor
Answered by Dr. Ilir Sharka (10 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Your TSH levels are slightly elevated. For this reason, a thyroid dysfunction should be considered. You should know that the thyroid gland is closely related to the heart rhythm. For this reason, I would recommend consulting with an endocrinologist. Further tests may be needed.

Regarding the increased heart rate, you should discuss with your doctor on the possibility of increasing the dose of Cardizem.

Regarding coronary artery disease, although troponin levels have resulted normal, I would recommend performing the above mentioned tests to exclude this disorder.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (15 hours later)
I was admitted to the hospital today where a cardioversion was performed. My heart rate has returned to normal. I was in atrial flutter, not sinus tachycardia as diagnosed by the ER physician. I will be seeing another electrophysiologist on Friday for further. Thank you.
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

I agree with you on the fact that consulting with an electrophysiologist would be the right step to follow in your clinical situation.

Hope to have been helpful!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 4513 Questions

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What Do Recurring Heart-attack Symptoms Indicate?

Brief Answer: My answer as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I passed carefully through your question and would explain that the blurring vision could be related to low blood flow to the brain during these episodes. A TIA from the cardiac arrhythmia can not be excluded either. You should know that during tachycardia, the blood amount pumped by the heart is reduced. This can cause a low blood flow to the brain, especially when there is narrowing of the carotid arteries. For this reason, I would recommend performing a Doppler ultrasound of the cervical arteries to examine the blood flow in them and exclude possible narrowing. Anyway, even if the Doppler results altered, you are actually under anticoagulation, which help prevent possible stroke. So, basically you are protected against these events. Regarding the episodes of chest pain, I would like to know if they performed cardiac enzymes. Anyway, I would recommend performing one of these tests to investigate for possible coronary artery disease: - nuclear perfusional cardiac stress test - dobutamine cardiac stress echo - a coronary angio CT scan. Hope you will find this answer helpful! Best wishes, Dr. Iliri