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What Causes Rapid And Irregular Palpitations, Nausea, Breathlessness And Light-headed Feeling?
Question: Was visiting in XXXXXXX when I became symptomatic with palpitations...rapid and irregular at 4:10 am after getting up to go to the bathroom. No sx's before that as was sleeping. I became increasingly SOB, light headed, nauseated, and had my niece take me to ER. Converted on the way with immediate relief from All sx's. Checked pulse and it was still fast but regular at 5:30 am. ER and observation showed no real changes in ekg (Slight elevation that returned to baseline) enzymes, or other labs. I am still a practicing RN, have been a cardiac educator, and started the first Cardiac Rehab program in the state in 1978. Dad had first massive MI at age 49. I am the oldest of 4 and only girl. I have 2 stents for unstable angina. One brother has 2 stents after MI, and youngest brother had 5 vessel CABG because his arteries were too small to stent. I usually present with bradycardia, and have never had an irregular heart rate previously. I know I need to f/u with cardiology, and can see a Holter monitor in my future, but do you have any other ways to "tease out" if I was in Slow VT or SVT? Am 70 yrs old.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I read carefully your question and would explain that it is quite difficult to define the exact nature of your palpitations as you have a complex medical history (cardiac ischemia, orthostatic intolerance).
Those palpitations may have been postural tachycardia, as well as atrial fibrillation, SVT,or a ventricular arrhythmia.
If those palpitations have been rare or absent in the past, it is quite difficult to be documented even by an ambulatory 24-48 hours ECG monitoring.
In such case only a prolonged monitoring with an event loop recorder could have a higher probability of detecting any arrhythmic events.
So if other associated symptoms like chest pain, repeated shortness of breath occurs again I would recommend to primary investigate an ischaemic cardiac disorder. A cardiac stress test and additional imaging tests like exercise cardiac ultrasound, a cardiac perfusion nuclear test would be helpful in addressing this issue.
Meanwhile you should continue a healthy lifestyle, diet and recommended therapy.
You should discuss with your doctor about the above issues.
Hope to have been helpful!
Best wishes!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I read carefully your question and would explain that it is quite difficult to define the exact nature of your palpitations as you have a complex medical history (cardiac ischemia, orthostatic intolerance).
Those palpitations may have been postural tachycardia, as well as atrial fibrillation, SVT,or a ventricular arrhythmia.
If those palpitations have been rare or absent in the past, it is quite difficult to be documented even by an ambulatory 24-48 hours ECG monitoring.
In such case only a prolonged monitoring with an event loop recorder could have a higher probability of detecting any arrhythmic events.
So if other associated symptoms like chest pain, repeated shortness of breath occurs again I would recommend to primary investigate an ischaemic cardiac disorder. A cardiac stress test and additional imaging tests like exercise cardiac ultrasound, a cardiac perfusion nuclear test would be helpful in addressing this issue.
Meanwhile you should continue a healthy lifestyle, diet and recommended therapy.
You should discuss with your doctor about the above issues.
Hope to have been helpful!
Best wishes!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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