That Occurs Only While Asleep
Thanks very much for the chance to ask my questions.
First, the history. In February of 2008 at the ripe old of age of 37, I experienced a kind of fainting spell in which I did not faint but went to the ER with very low blood pressure, shaking, and then diarrhea began.
For three months, I had the diarrhea, but often, these episodes occurred at night, while asleep, waking me to rush to the bathroom, feeling like I was going to faint, racing heart, sometimes palpitations, followed by a BM, then some relief, slowing about an hour later.
My doc referred me to a cardiologist who specializes in the electrical aspect (sorry, don’t know the technical terms), who diagnosed me with Neurocardiogenic Syncope after a tilt table test.
However, I didn’t take the medicine and began to feel better over the course of the summer (I’m a teacher, so spent much of the time resting). This recent fall semester, everything started up again with a little switch. I began waking up with a racing heart, faster than before, but no fainting really, except once in awhile.
The cardio doc put me on a halter monitor for a month in November(or something akin through CardioNet) because now she suspects an arrhythmia. I have also been seeing a GI since my BMs oscillated between normal and some diarrhea now and then. He concluded, today actually, that he thinks the GI symptoms are a reaction to something else and recommended an allergist, who also will test for more in depth hormonal issues. Anyway, my cardiologist met with me yesterday and noted that all of my racing heart episodes occur after I’ve fallen asleep (according to me and the monitor results). She said that arrhythmias that only happen lying down are very rare and didn’t seem to be leaning towards that. However, she now wants to do an EP to determine if I have an arrhythmia and then ablation if so.
My questions are:
1. Does anyone hear have experience or knowledge of arrhythmias that happen only when you are lying down and asleep? If so, do you know why they manifest only then? Why not while I’m conscious?
2. Do arrhythmias make one feel strange in the chest? During the day, I often feel alternately a strange “weakness” or an odd pressure or something that causes me to need to stretch my arms and chest for relief. My heart is not racing when this happens.
3. I had some coffee today but not that much, though I haven’t had it for a week since I cut it out while dealing with a cold. When I laid down just now to go to sleep, I began to have the strange feeling in my chest, began to feel jittery/shaky, then suddenly had to have a BM. Does an arrhythmia have such an effect on the body? And can it be brought on just by lying down?
4. Is an EP and possible ablation risky? Problematic afterward? Etc.
5. Finally, can arrhythmias simply appear this late in life? I’ve been fine until this last year.
I’m very frustrated because this all has been going prada handbags on for nearly a year and still prada handbags no real diagnosis. Could something else be happening? They did a sonogram of my heart with normal results. My thyroid is fine. All sorts of GI tests came back fine. No parasites. The one thing that seemed to make me feel a little better has been about six days of taking GSE (Grapefruit Seed Extract) at 125 mgs/day. This seems to have at least put my intestines in order and made me feel better during the day, yay!
Thank you in advance for any advice, speculative, certain or otherwise!
First, yes, arrhythmias can start at any time in life, and your age group is one of the more popular ones, statistically. You may have neurocardiogenic syncope (or plain vasovagal faint) syndrome, but I believe there is something else going on as well. I strongly suspec prada handbags t the GI symptoms are related also, s prada handbags ince the vagus nerve, which controls peristatic action in the stomach and intestines, also controls the slowing of the heart. If the vagus nerve isn’t behaving appropriately the sympathetic side of the control system can allow the heart to speed up. Further, there are known arrhythmic syndromes which are triggered by position. While your particular problem, if it truly is happening (and the event monitor seems to bear this out), is rather unusual, it’s not unheard of at all.
There are some other distinctive things about this that you’ve mentioned, such as the “odd” feeling in your chest even when not having an actual arrhythmic episode. This could be due to anything from anxiety to a nerve acting improperly to a space in the septum between the atria (the upper chamers of the heart). This is usually called an atrial septal aneurysm, even though it’s not an aneurysm as usually understood and is not dangerous. These often are the cause of positional arrhythmias.
As for the electrophysiology (EP) study, I think this makes by far the most sense, since the sort of problem you’re having, at best, is disruptive to your life and activities. At worst it could result in you passing out and being injured. Generally that’s the biggest concern with these things. Perhaps you can learn the name of the specific type of arrhythmia that was detected by the event monitor and let me know? It would be helpful in sorting this out. Even if you’re unable to do that, I’d strongly recommend going through with the EP study. Now to answer your concerns about that:
1) I have both experience and knowlege of EP studies, cardioversion and radio frequency ablations. I’m a huge fan, in fact.
2) Arrhythmias usually do make people feel “strange” in the chest. Sometimes, if there is an anatomical anomaly associated with them, this can happen even when there’s no actual arrhythmia going on, as you’ve described.
3) We’ve covered this one in the body of my response, but to save words, yes to everything you asked under this one.
4) While all invasive procedures carry some risk, the relative risk posed by EP study with or without ablation is statistically very low and the success rate very high. It would be comparable to something like having a tooth extracted, risk wise, but a lot less uncomfortable.
5) This one got answered up top. Yes, they can.
I hope this helps ease your concerns about the procedure, which, again ,I’d strongly advise you to go through with. This may be a lot less complex than it sounds, and you may just be extremely somatically sensitive; on the other hand, the strange sensations you experience and the unusual presentation of the arrhythmias certainly make this something I personally would want corrected if at all possible. If it were to turn out to carry some additional risk discovered only during the procedure, this would either have been discussed in advance or the procedure would be stopped and you’d be informed afterward what was found and what would be needed. In some very rare instances there’s some anatomical anomaly that just won’t allow the thing to be corrected via ablation, and then usually it is just handled medically. In the long run, the EP study is definitely worthwhile, though, because these cases are so rare, and so often the thing can be corrected in one visit, no medication is needed afterward, and the whole thing can be forgotten. This is by far the most common outcome of these studies.
Again, I hope this is helpful. If you have any further questions please don’t hesitate to bring them to us here. Best of luck to you, and keep us updated, please.
Wow, thanks so much for your thorough and enlightening response! I’m heartened by your informative explanation and advice and am feeling much better about the prospects of the EP study. Even if it proves no arrhythmia, at least it won’t be harmful, but rather, will provide some insight, fingers crossed.