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What Causes Irregular Heartbeat And Mild Chest Discomfort While Having Depression?
Question: Hello. I am 68 now. When I was 39, I was living a difficult life style with an alcoholic husband, raising 5 wonderful children, and experienced 2 house fires due to his drinking. Finally divorced. I had a Panic Attack and later was diagnosed with WPW- Wolfe-Parkinson-White (an irregular heartbeat). Recently I was going through many heart tests for a month. This brought me worry and emotional stress. I went dancing and had 2 drinks with my friend. That night after I slept 2 hrs. I awoke with a racing heart (160) and mild chest discomfort, and went to the hospital . They did the cardioversion and it was successful in bringing the beat more to normal. The specialist are telling me that I no longer have the WPW. I didn't know that it could go away, Could it? Anyways, I have Atrial Fibrillation and am on meds and a blood thinner. I am only 5 feet and weigh too much 183. If I lose the weight, could I get rid of the AFib, or not have another episode? Thank you for this opportunity to hear your opinions.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I passed carefully through your medical history and would like to explain that, in the case of WPW syndrome, then may diagnostic features are gathered from the resting ECG (the presence of XXXXXXX wave, short PR interval and secondary ventricular repolarization abnormalities).
If the above mentioned changes have been present on your previous ECGs (also coupled with history of episodic tachy-arrhythmias), then the diagnosis of WPW syndrome is clear.
But, when the above ECG signs disappear, means that the electrical properties of the accessory pathways (responsible for this syndrome) have changed to that level that the ventricular pre-excitation through those pathways is not obvious. In such case the risk for generating dangerous ventricular arrhythmias and sudden death is almost disappeared. And this is quite possible, as the abnormal accessory pathways (responsible for WPW syndrome) may get through the same degenerative and aging processes as the other parts of human heart and several tissues.
So, returning to your direct question, I would reply with YES!
It is quite possible that WPW ECG criteria disappear after many years. It is theoretically possible and also observed in a few cases.
But, before arriving to that conclusion, it is necessary to carefully review all the previous and actual ECGs recordings in order to confirm the presence of WPW and possible recent changes.
Regarding recurrent atrial fibrillation, it may be triggered by large amount of alcoholic drinks (holiday heart syndrome), and this may explain your last atrial fibrillation bout.
Now, returning to your therapy, I would explain that it is necessary first to avoid any possible triggering factors (alcoholic and caffeinated drinks, thyroid gland dysfunction, uncontrolled hypertension, to explore for possible cardiac ischemia, etc).
Also, losing body weight could be beneficial for decreasing the frequency of atrial fibrillation episodes (especially if overweight is associated with hypoventilation syndrome and potential sleep apnea).
One definite therapy for recurrent atrial fibrillation is cardiac ablation.
You need to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I passed carefully through your medical history and would like to explain that, in the case of WPW syndrome, then may diagnostic features are gathered from the resting ECG (the presence of XXXXXXX wave, short PR interval and secondary ventricular repolarization abnormalities).
If the above mentioned changes have been present on your previous ECGs (also coupled with history of episodic tachy-arrhythmias), then the diagnosis of WPW syndrome is clear.
But, when the above ECG signs disappear, means that the electrical properties of the accessory pathways (responsible for this syndrome) have changed to that level that the ventricular pre-excitation through those pathways is not obvious. In such case the risk for generating dangerous ventricular arrhythmias and sudden death is almost disappeared. And this is quite possible, as the abnormal accessory pathways (responsible for WPW syndrome) may get through the same degenerative and aging processes as the other parts of human heart and several tissues.
So, returning to your direct question, I would reply with YES!
It is quite possible that WPW ECG criteria disappear after many years. It is theoretically possible and also observed in a few cases.
But, before arriving to that conclusion, it is necessary to carefully review all the previous and actual ECGs recordings in order to confirm the presence of WPW and possible recent changes.
Regarding recurrent atrial fibrillation, it may be triggered by large amount of alcoholic drinks (holiday heart syndrome), and this may explain your last atrial fibrillation bout.
Now, returning to your therapy, I would explain that it is necessary first to avoid any possible triggering factors (alcoholic and caffeinated drinks, thyroid gland dysfunction, uncontrolled hypertension, to explore for possible cardiac ischemia, etc).
Also, losing body weight could be beneficial for decreasing the frequency of atrial fibrillation episodes (especially if overweight is associated with hypoventilation syndrome and potential sleep apnea).
One definite therapy for recurrent atrial fibrillation is cardiac ablation.
You need to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for the information. My friend has persistant AFib. She is very heavy and the cardioversion didn't work for her 3 times. They informed her that she has to lose 70 lbs. before the can do the ablation.
I only have the occasional 1 drink at our Happy Hour monthly in our Condo. On this day I was dancing ever dance and had 2 strong gin and tonics served to me. I will stay away from any alcoholic drinks in the future. That was my only episode with the severely racing heart. I tend to worry. The cardiologist told me that I can get it again. He said that I don't have to race to the hospital. That with the meds and the thinner, that I should try to relax and the beat should come down on it's own. Is this so?
I spoke to the Lab that was doing my test for the whole month. They did the Blood pressure machine, the Holter Monitor, the Stress Test and the Loop. They told me that all appear to be fine. I returned the last test machine on Oct. 27th. Then on November 5 I went dancing, and at 4:40 a.m. November 6th, I had my first episode of AFib. One would assume that it would be spotted on the tests that I was taking before this.
And also I would like to know if I could do some dental work and do I have to stop the thinners for it. I am scheduled for my (every 5 yrs. Colonoscopy). My doc of 30 yrs. passed away. My new doc of a few visits says no one will touch me now with the thinner........but my cardiologists and the doc in the hospital said I could get it done but will have to stop the thinner beforehand.
Thank you for your information. I will try to maintain a better life style. And will also ask more questions when I have the appt. with my regular cardiologist on November 28th. Thank you once again.
I only have the occasional 1 drink at our Happy Hour monthly in our Condo. On this day I was dancing ever dance and had 2 strong gin and tonics served to me. I will stay away from any alcoholic drinks in the future. That was my only episode with the severely racing heart. I tend to worry. The cardiologist told me that I can get it again. He said that I don't have to race to the hospital. That with the meds and the thinner, that I should try to relax and the beat should come down on it's own. Is this so?
I spoke to the Lab that was doing my test for the whole month. They did the Blood pressure machine, the Holter Monitor, the Stress Test and the Loop. They told me that all appear to be fine. I returned the last test machine on Oct. 27th. Then on November 5 I went dancing, and at 4:40 a.m. November 6th, I had my first episode of AFib. One would assume that it would be spotted on the tests that I was taking before this.
And also I would like to know if I could do some dental work and do I have to stop the thinners for it. I am scheduled for my (every 5 yrs. Colonoscopy). My doc of 30 yrs. passed away. My new doc of a few visits says no one will touch me now with the thinner........but my cardiologists and the doc in the hospital said I could get it done but will have to stop the thinner beforehand.
Thank you for your information. I will try to maintain a better life style. And will also ask more questions when I have the appt. with my regular cardiologist on November 28th. Thank you once again.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I agree with the treatment assigned by your doctor; rhythm/rate controlling agents coupled with blood thinners are an optimal strategy for minimizing the changes of atrial fibrillation recurrences and also to avoid any underlying cardio-embolic complications if atrial fibrillation occurs.
An important clue to be aware of is always considering the potential complication of bleeding due to trauma or excessive dosage when on blood thinners.
In this regard, I would recommend periodic blood tests (complete blood count and coagulation tests).
In addition you need to be careful about traumatic injury and potential interference of other drugs with blood thinners leading to dangerous excessive anti-coagulation (with subsequent bleeding).
Now, coming to the issue of those invasive procedures, such as tooth extraction/gingival manipulations, or colonoscopy; you could undergo those procedures by interrupting for a short period blood thinner and re-assuming the therapy after the procedure.
Hope to have clarified your uncertainties!
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I agree with the treatment assigned by your doctor; rhythm/rate controlling agents coupled with blood thinners are an optimal strategy for minimizing the changes of atrial fibrillation recurrences and also to avoid any underlying cardio-embolic complications if atrial fibrillation occurs.
An important clue to be aware of is always considering the potential complication of bleeding due to trauma or excessive dosage when on blood thinners.
In this regard, I would recommend periodic blood tests (complete blood count and coagulation tests).
In addition you need to be careful about traumatic injury and potential interference of other drugs with blood thinners leading to dangerous excessive anti-coagulation (with subsequent bleeding).
Now, coming to the issue of those invasive procedures, such as tooth extraction/gingival manipulations, or colonoscopy; you could undergo those procedures by interrupting for a short period blood thinner and re-assuming the therapy after the procedure.
Hope to have clarified your uncertainties!
Wishing you a pleasant weekend!
Kind regards,
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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