Helping a friend

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Helpnhand
New Member


Date Joined Apr 2005
Total Posts : 2
   Posted 4/22/2005 8:45 AM (GMT -7)   
Salutations
 
I am here on behalf of a friend of mine who has recently been diagnosed with Chronic Sinus Tachycardia. The doctors are finding it particularly interesting to find a medication to perscribe, because for a currently unknown reason she has unusually low blood pressure. The medicine traditionally used to treat this condition lowers bloodpressure as a side effect, and so she is unable to take them. Her bp usually sits at 88/60, and she is under no circumstances supposed to go under that. They currently have her taking Effexor 150 mg. There isn't much that I am able to find about Chronic Sinus Tachycardia itself, much less the conundrum of trying to treat it while dealing with hypotension. I was hoping to find someone who knew anything about the heart condition, or better yet had the same problem. I was also hoping to find out anything about health insurance for a chronic health problem. She is currently covered by her husband, but they are in the midst of getting a divorce. Because of the amount of time she has had to spend at the doctor's  office and the disabeling dizzyness and fatigue from the low bp she had not been able to hold a job. Once they find her a medication that will work, she hopes to be back in the work force. Until then, any information or advice on where to look and/or how to go about getting her non cost-prohibitive insurance would be awesome.
 
Thank you very much for your time,
Helpnhand

Teri16
Veteran Member


Date Joined Dec 2003
Total Posts : 5230
   Posted 4/22/2005 11:03 AM (GMT -7)   

Hiya Helpnhand and Welcome to HealingWell!! tongue

While I'm pretty familiar with some of the arrhythmias, I'd like to recommend that you look at some of the other threads and posts in this forum first to see if any of them offer you some info or insight into this problem?!

The current medication that your friend is on is an antidepressant that when looking it up, I noticed that it can actually increase the blood pressure.  Does your friend take her BP on a regular basis?  Perhaps with her current situation you could mention this might be a good idea for her to get a more continuous record of her BP.

I've found some additional sites that I can recommend to you and these sights themselves will lead you to more info if you need it.

Please keep in touch and let me know if this helps at all?!  Best wishes to you and your friend!!

Teri tongue

http://www.nlm.nih.gov/medlineplus/ency/article/001101.htm

http://www.americanheart.org/presenter.jhtml?identifier=560


"Because he is he and I am I."......E. V. Lucas
 
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gain
Regular Member


Date Joined Dec 2003
Total Posts : 101
   Posted 4/23/2005 3:51 AM (GMT -7)   
Hi Helpnhand,

There are drugs available to help with arrythmia problems. Drugs like Digoxin and Amiodarone are used to control arrythmias without lowering blood pressure. Like your friend, I have very low blood pressure and also suffer from arrythmias. I take amiodarone and have an ICD. My blood pressure has remained stable while I have been taking this drug. It is a powerful anti-arrythmic drug with its share of side effects. Your friend may want to speak to her doctor about this.

Digoxin is used to help the heart beat stronger while at the same time slowing the electrical impulses. My father takes this drug without any problems. Once again, your friend may want to talk to her doctor about this.

Your friend may also want to ask her cardiologist about seeing an Electrophysiologist as well. These EP docs specialize in the electrical side of the heart. While a cardiologist is a "Plumber" , and EP doc is an electrician.
The EP doc can do a study of your friends heart that maps the pathways that the electrical impulses are taking and can make corrections in many cases with drugs alone. It might be worth a shot for your friend.

Good luck and keep us informed.

Steve
I had a massive heart attack on May 4, 2003.    Thru the course of diagnosis while in ER and catheterization it was determined that I had 3 arteries 100% blocked, 1 artery at 98% blocked and 1 artery at about 85% blocked.  I have EJ fraction around 20 and have had numerous echo-cardiograms to monitor heart function. I lost 60% of my heart that night. I cannot do what I used to but feel great.  In September of 04 I had an AICD implanted more or less to act as a saftey net for when my heart stops and have developed alot of arrythmia problems.  I also have two aneurysms.  One is on my ascending aorta and is distorting the aortic valve.  The other is an abdominal aortic aneurysm.  Both of which need to be repaired.


Teri16
Veteran Member


Date Joined Dec 2003
Total Posts : 5230
   Posted 4/23/2005 9:38 AM (GMT -7)   
Thanks for the added knowledge, Steve~it is always welcomed!!
Hugs, Teri
"Because he is he and I am I."......E. V. Lucas
 
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gordspen
Veteran Member


Date Joined Aug 2003
Total Posts : 822
   Posted 4/23/2005 12:37 PM (GMT -7)   
Some info that may help with regards to your query about chronic sinus tachycardia




Sinus Disturbances


Sinus arrhythmia
Sinus arrhythmia is defined as a slight variation in cycling of the sinus rhythm, usually one that exceeds 0.12 seconds between the longest and shortest cycles. Sinus arrhythmia is a normal finding in children and young adults and tends to diminish or disappear with age. Sinus arrhythmia is often somewhat more prominent with fluctuation in the respiratory cycle as heart rate accelerates with inspiration and slows with expiration. The alternating acceleration and deceleration of heart rate with respiration is mainly the result of fluctuations in vagal tone. Sinus arrhythmia may be aggravated by any factor that increases vagal tone.
Sinus tachycardia
Sinus tachycardia is defined as sinus rhythm with a rate of greater than 100 beats/min. To be certain that sinus tachycardia is the etiology for a supraventricular tachycardia (tachycardia with its origin in the AV junction, atria or SA node), one must identify a constant single P wave for every QRS complex. Sinus tachycardia usually represents a physiologic response to fever, intravascular volume depletion, hypermetabolism, anxiety or the administration of pharmacologic agents that dramatically increase sinus rate, such as catecholamines. Sinus tachycardia may also be a response to severe emotional distress, fright and strenuous exercise. Other causes may include a response to anemia, CHF, hemorrhage, extensive heart muscle damage associated with a reduction in cardiac output and pulmonary embolism. Physiologically, sinus tachycardia results from either vagal withdrawal and/or endogenous release of catecholamines.

One should not treat sinus tachycardia per se, but instead should be concerned with the reasons for its development. Obviously, if intravascular volume depletion, fright, fever or sepsis is responsible for sinus tachycardia, the preferred approach is to identify the etiology and treat it, expecting the sinus tachycardia to respond to treatment of the basic abnormality. Alternatively if the sinus tachycardia is due to extensive heart muscle damage resulting from an acute MI or severe CHF, efforts must be made to support the pump function of the heart rather than to potentially depress it further with certain pharmacologic interventions. Sinus tachycardia is often an early warning sign of some altered physiologic state that should itself be identified and corrected.

Never "treat" sinus tachycardia: treat the cause of sinus tachycardia.

Summary of ECG criteria


Identify a constant single P wave for every QRS complex
Normal-looking QRS
Rate: Greater than 100 beats/min
Rhythm: Regular
P waves: Upright in leads I, II and aVF
Sinus bradycardia
Sinus bradycardia is the term for a sinus rate of less than 60 beats/min and may be seen in the normal adult population. Sinus bradycardia during exercise, fever or congestive heart failure is abnormal. Persistent rates of less than 45 beats/min are also considered abnormal, and in the absence of drugs such as digitalis, beta-blockers and calcium channel blockers, reflect abnormality in the sinus node. Sinus bradycardia can be present in otherwise normal individuals and is common in well-trained athletes and in most persons during deep sleep. It is part of the normal reaction to vagal stimulation. Sinus bradycardia may also be related to metabolic abnormalities, including hypothermia and myxedema. Nonvagally mediated sinus bradycardia also may occur as a manifestation of organic heart disease, including ischemic heart disease, particularly when the SA node is damaged, as with certain types of acute MI and in association with severe chest pain of acute MI. Sinus bradycardia may also be a complication of myocardial disease in which the SA node is damaged by scarring or infiltrative processes associated with aging as part of a degenerative conduction system process.

Asymptomatic sinus bradycardia requires no treatment. If sinus bradycardia is so extreme, however, that symptoms result, including syncope, congestive heart failure (CHF), angina pectoris and hypertension, and/or if it leads to the development of ventricular ectopic beats (slow sinus rates predispose to re-entry mechanisms), then it should be treated, and in some instances temporary and sometimes permanent ventricular pacing is necessary.

Summary of ECG criteria


Normal-looking QRS
Rate: Less than 60 beats/min
Rhythm: Regular
P waves: Upright in leads I, II and aVF
Sinus arrest and sinoatrial exit block
Sudden disappearance of sinus P waves for variable intervals can produce different patterns. Since sinus node activity is not recorded on the surface ECG, it is difficult to determine if sinus node automaticity or sinoatrial conduction abnormalities are responsible in a given patient. When PP intervals have a pattern and are a multiple of the basic sinus cycle, the term sinoatrial block is generally used. Both types of sinoatrial block can be diagnosed from the surface ECG. In type I (Wenckebach phenomenon), the PP cycle is progressively shortened until there is a pause and the cycle is repeated. The pause is due to the dropped P wave and measures less than twice the PP cycle. It is similar to the behavior of the RR intervals in type I second-degree AV block. Type II second-degree sinoatrial exit block is characterized by an unexpected drop of the P wave, and the resultant pause is a multiple of the basic sinus cycle. Blocked atrial premature beats sometimes mimic second-degree sinoatrial block. Third-degree sinoatrial exit block cannot be distinguished from sinus arrest when the sinus node ceases to fire. Under such circumstances, subsidiary pacemakers in the AV junction or ventricles may take over.

In theory, sinus arrest cannot be distinguished from complete SA block. In both conditions there is an absence of P waves. However, in patients with complete SA block, the block is frequently associated with atrial or AV junctional escape rhythms, while sinus arrest or pause is usually associated with depression of other potential atrial pacemakers, so that atrial escape is infrequent.

Sinus arrest is an uncommon rhythm disturbance, but is occasionally noted in elderly patients, in those with ischemic heart disease (particularly with acute inferior or true posterior MI), in some patients with myocardial disease, and sometimes with digitalis toxicity. The treatment of SA pause or arrest ordinarily includes administration of atropine or temporary or permanent ventricular pacing. Reasons to pace sinus pause or sinus arrest include the development of an AV junctional or ectopic ventricular pacemaker that is slow enough to result in such problems as syncope, CHF, angina, or frequent ventricular ectopic beats. If the escape AV junctional or ectopic ventricular pacemaker is rapid enough, particularly if the pacemaker is an AV junctional one, it may not be necessary to treat the underlying sinus pause or arrest except to ensure that it is not due to digitalis toxicity and, when possible, to determine its etiology. If this rhythm disturbance is associated with brady- or tachyarrhythmias and appears to be an integral part of the sick sinus syndrome, then pacemaker therapy is indicated. Pacemaker therapy is also indicated when any of the above-mentioned signs or symptoms are a consequence of the slower AV junctional ectopic pacemaker

God bless,

Gordon and Michelle
When you feel you have had enough of the world and what it throws.
 
Just tune into the Archers on the BBC radio 4 and just listen :- Sorry no news until I have had the chance to catch up with the serial.


Helpnhand
New Member


Date Joined Apr 2005
Total Posts : 2
   Posted 4/23/2005 6:53 PM (GMT -7)   
Thank you all so very much for your helpful information. I will be speaking to my friend later this evening, and I will definitely ask her about which other drugs they tried her out on, to see if the two Steve mentioned were given a trial. I also will tell her about the heart 'electricians.' It will take a me a few minutes of read throughs to memorize all of the special terminology, so please forgive me. I will keep you posted, and any other information will be welcomed and appreciated. I am really thankful that this site exists. :)

Teri16
Veteran Member


Date Joined Dec 2003
Total Posts : 5230
   Posted 4/24/2005 7:16 PM (GMT -7)   
HelpnHand,
 
How is your friend doing?  I hope the info was helpful?!~and if you need anything else please be sure to come on back!
 
Teri tongue
"Because he is he and I am I."......E. V. Lucas
 
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