Heart Palpitations

Hi Mikeyp,
You say that the doctors cannot find anything wrong even though you have had several tests. I have a question about the two
24 hour Holter monitors that you had. I am assuming that when you were wearing the monitors you did not experience an "episode"
and that your heart was in normal sinus rhythm. I am wondering why you don't try a two week monitor or month long monitor. I have had both
since my electrophysiologist could not "see" the problem I was describing since I didn't experience it in the 24 hour period that I was
wearing the Holter Monitor. I had SVT all my life and in my 50's I developed AF. I am now free of any rate or rhythm problems after a successful PVA (pulmonary vein ablation). I also had a standing order for an EKG so I could walk into a lab or hospital and have an EKG when I was experiencing symptoms. It sounds like your EKG showed no rhythm or rate disturbances. If you get these episodes once or twice a day, I am assuming that when you wore the monitor you could hit the "episode button" and then record your symptoms. Did this happen the two times you wore the monitor? If you were symptom free during those two times, it would seem to make sense to ask for a monitor that you can wear for a week or two to ensure that you can document the problem. What do you think?
Martishka

@mikeyp, I ran across some added questions to raise with your cardiologist-led medical team. The questions were suggested by a symptom-checker on the WebMD web site. Here's the extract relating to "aortic dissection" in which the lining of the aorta (or a major artery near the heart or kidneys) separates from the wall of the vessel:

"Virtually everyone who has an aortic dissection experiences pain—typically sudden, excruciating pain, often described as tearing or ripping. Some people may faint as a result of the pain. Most commonly, the pain is felt across the chest but is often also felt in the back between the shoulder blades.

"The distinctive symptoms of an aortic dissection usually make the diagnosis obvious to doctors . . . In about two thirds of people with aortic dissection, pulses in the arms and legs are diminished or absent. Depending on the location of the dissection along the aorta, there may be a difference in blood pressure between the right and left arm. A dissection that is moving backward toward the heart may cause a murmur that can be heard through a stethoscope.

"Chest x-rays are the first step in detecting aortic dissection. X-rays show a widened aorta in 90% of people with symptoms. However, this finding may be due to other disorders. Computed tomography (CT) done after injecting a contrast agent (dye) can quickly and reliably detect aortic dissection and thus is useful in an emergency. Standard or transesophageal echocardiography or magnetic resonance angiography can also reliably detect aortic dissections, even very small ones."

Have you had 1) transesophageal echocardiography or 2) standard transesophageal echocardioigraphy or 3) magnet resonance angiography (MRA) to check out the major arteries on and around your heart?

Hi Mikeyp,
You say that the doctors cannot find anything wrong even though you have had several tests. I have a question about the two
24 hour Holter monitors that you had. I am assuming that when you were wearing the monitors you did not experience an "episode"
and that your heart was in normal sinus rhythm. I am wondering why you don't try a two week monitor or month long monitor. I have had both
since my electrophysiologist could not "see" the problem I was describing since I didn't experience it in the 24 hour period that I was
wearing the Holter Monitor. I had SVT all my life and in my 50's I developed AF. I am now free of any rate or rhythm problems after a successful PVA (pulmonary vein ablation). I also had a standing order for an EKG so I could walk into a lab or hospital and have an EKG when I was experiencing symptoms. It sounds like your EKG showed no rhythm or rate disturbances. If you get these episodes once or twice a day, I am assuming that when you wore the monitor you could hit the "episode button" and then record your symptoms. Did this happen the two times you wore the monitor? If you were symptom free during those two times, it would seem to make sense to ask for a monitor that you can wear for a week or two to ensure that you can document the problem. What do you think?
Martishka

@mikeyp, I ran across some added questions to raise with your cardiologist-led medical team. The questions were suggested by a symptom-checker on the WebMD web site. Here's the extract relating to "aortic dissection" in which the lining of the aorta (or a major artery near the heart or kidneys) separates from the wall of the vessel:

"Virtually everyone who has an aortic dissection experiences pain—typically sudden, excruciating pain, often described as tearing or ripping. Some people may faint as a result of the pain. Most commonly, the pain is felt across the chest but is often also felt in the back between the shoulder blades.

"The distinctive symptoms of an aortic dissection usually make the diagnosis obvious to doctors . . . In about two thirds of people with aortic dissection, pulses in the arms and legs are diminished or absent. Depending on the location of the dissection along the aorta, there may be a difference in blood pressure between the right and left arm. A dissection that is moving backward toward the heart may cause a murmur that can be heard through a stethoscope.

"Chest x-rays are the first step in detecting aortic dissection. X-rays show a widened aorta in 90% of people with symptoms. However, this finding may be due to other disorders. Computed tomography (CT) done after injecting a contrast agent (dye) can quickly and reliably detect aortic dissection and thus is useful in an emergency. Standard or transesophageal echocardiography or magnetic resonance angiography can also reliably detect aortic dissections, even very small ones."

Have you had 1) transesophageal echocardiography or 2) standard transesophageal echocardioigraphy or 3) magnet resonance angiography (MRA) to check out the major arteries on and around your heart?

@mikeyp, I ran across some added questions to raise with your cardiologist-led medical team. The questions were suggested by a symptom-checker on the WebMD web site. Here's the extract relating to "aortic dissection" in which the lining of the aorta (or a major artery near the heart or kidneys) separates from the wall of the vessel:

"Virtually everyone who has an aortic dissection experiences pain—typically sudden, excruciating pain, often described as tearing or ripping. Some people may faint as a result of the pain. Most commonly, the pain is felt across the chest but is often also felt in the back between the shoulder blades.

"The distinctive symptoms of an aortic dissection usually make the diagnosis obvious to doctors . . . In about two thirds of people with aortic dissection, pulses in the arms and legs are diminished or absent. Depending on the location of the dissection along the aorta, there may be a difference in blood pressure between the right and left arm. A dissection that is moving backward toward the heart may cause a murmur that can be heard through a stethoscope.

"Chest x-rays are the first step in detecting aortic dissection. X-rays show a widened aorta in 90% of people with symptoms. However, this finding may be due to other disorders. Computed tomography (CT) done after injecting a contrast agent (dye) can quickly and reliably detect aortic dissection and thus is useful in an emergency. Standard or transesophageal echocardiography or magnetic resonance angiography can also reliably detect aortic dissections, even very small ones."

Have you had 1) transesophageal echocardiography or 2) standard transesophageal echocardioigraphy or 3) magnet resonance angiography (MRA) to check out the major arteries on and around your heart?

@mikeyp, your magnesium deficiency suggests that you might have a kidney problem -- or a dysfunctional hormone generator such as thyroid or adrenal gland. You might consider asking a nephrologist and an endocrinologist for their diagnoses. My problem was resolved in that way; I had potassium deficiency that cardiologists, internists, and another nephrologist decided was "essential" and of unknown cause or importance. My second nephrologist cared about finding both primary and secondary causes and enlisted an endocrinologist in the search. Together, they found an inherited kidney dysfunction (Liddle Syndrome) that let the potassium get away but gave lab results of a fake ("pseudo") hormone condition. My mystery and yours seem familiar, and I hope you find the answer soon.

@mikeyp, your magnesium deficiency suggests that you might have a kidney problem -- or a dysfunctional hormone generator such as thyroid or adrenal gland. You might consider asking a nephrologist and an endocrinologist for their diagnoses. My problem was resolved in that way; I had potassium deficiency that cardiologists, internists, and another nephrologist decided was "essential" and of unknown cause or importance. My second nephrologist cared about finding both primary and secondary causes and enlisted an endocrinologist in the search. Together, they found an inherited kidney dysfunction (Liddle Syndrome) that let the potassium get away but gave lab results of a fake ("pseudo") hormone condition. My mystery and yours seem familiar, and I hope you find the answer soon.

@mikeyp, your magnesium deficiency suggests that you might have a kidney problem -- or a dysfunctional hormone generator such as thyroid or adrenal gland. You might consider asking a nephrologist and an endocrinologist for their diagnoses. My problem was resolved in that way; I had potassium deficiency that cardiologists, internists, and another nephrologist decided was "essential" and of unknown cause or importance. My second nephrologist cared about finding both primary and secondary causes and enlisted an endocrinologist in the search. Together, they found an inherited kidney dysfunction (Liddle Syndrome) that let the potassium get away but gave lab results of a fake ("pseudo") hormone condition. My mystery and yours seem familiar, and I hope you find the answer soon.