New diagnosis of Vasovagal reflex

[Hr181]

Hi,

I’m 37, 240 lbs, 5’ 4”, Caucasian, female...I was working my usual 12hr shift (on 8/22/18) and was about 6hrs in when I felt a flutter in my chest with nausea. I quickly sat down and hooked myself up to a bp machine. My heart rate was 58 and I got an error reading on the machine for my blood pressure. I then manually checked my pulse and felt I was skipping beats randomly every 3-7 beats. Luckily I work at a hospital and was sent directly to the ER, but all they could do were labs, X-ray and EKG, no treatment to make it stop. Labs showed slight elevation of TSH and EKG showed PVC’s. They told me to contact my PCP and a cardiologist. For the next 12+ the PVC’s and fluttering continued. The next morning I no longer felt the fluttering and the PVC’s were hardly palpable. I saw my PCP and she got me in to a cardiologist the next day, which was the best way to do it because I called 5 cardiologists the day before and none could see me sooner than 3 weeks! When I saw the cardiologist he reviewed everything done in the ER and said he didn’t suspect hypothyroidism because the TSH was borderline high and said he’d recheck it in a few months. He did and EKG and an echocardiogram, results were normal with an ejection fraction at 56%. He also ordered a halter monitor and a stress test. I could barely do the stress test, I have never felt so out of shape in my life! My heart rate went up to 179 and I was told they saw PVC’s. I wore the halter monitor half day at home and the other half at work. That day I wore it I didn’t feel like myself, I felt foggy and slow, I even asked my co-workers to help me because I couldn’t focus even with a cup of coffee. After my shift I cried all the way home and called off of work for the next week. I have stopped drinking caffeine, which I only drink 1 cup on days that I work (3 days a week). I’m still waiting on the halter results which I was told would take 2-3 weeks. Based on the stress test he believes that I have something called Vasovagal Reflex. I can’t find any information regarding this diagnosis. He just told me to keep my systolic BP around 140 and my heart rate less than 140, drink cold water in the morning and increase my salt intake. I also informed him that my heart rate on my series 3 Apple Watch was showing dips in my heart rate to the 50’s and 40’s through the day but at night I’m stable between 60’s-80’s with no drops. This morning I woke up at 1:20am freezing because that AC was left on so I got up to turn it off and went back to bed only to get an alert that my hr was 32. I didn’t feel anything because I was barely awake to begin with but now that I’m more awake I’m feeling the fluttering again in my neck a few times every hour and I feel a lack of energy. I wish I knew what was wrong with me, intuition says the doctor doesn’t know and the only way we’re gonna find out is when I collapse or die. I have begun to lose hope in my own medical institution, doctors, and even myself as an RN.

[jointpain]

Try not to worry about this or anything else, my own hr used to be down to 29 quite often, now it some times goes to 40 and I am 62 years old soon. A year ago it went up to 88 for no reason when I went to bed, that lasted for around 90 minutes. I am still alive and kicking and try not to worry about anything. And yes plenty of salt helps increase your blood pressure. My bp is often around 100/60 with hr of 42, very few faints now but when hr was lower quite often felt faint on standing up from a sitting position.

[cali111]

I agree with you that the doctors can`t be precise. Three years on and I am still struggling along but I think they have finally come up with the best way forward. I am not able to take these powerful drugs and om only taking 62.5msg of digoxin and 1.25mg nevibolol together with a diuretic. They are going to offer me an ablate and pace and I am going to discuss this with my EP when he writes to me with an appointment to clinic. I am assuming that you are in the USA as we refer to a ECG in the UK. I turned down the ablate and pace last year but after lots of research came to the conclusion that this is NOT curable so if they offer again I will accept. Several acquaintances have said that this restored normality to their lives and now at 74 I don`t feel I have time to mess around in the hope that they get it right. I hope that you can get a solution to your problems but as this is an electrical problem in the heart it is very difficult for doctors to treat without powerful drugs and for myself I would sooner be dead than take the side effects so maybe a pacemaker IS the way forward.

Good luck, take care!

[DisneyMom3]

You’re story sounds a lot like mine except my heart rate doesn’t dip that low. Mostly 55-60s which is normal if your not doing anything. But the PVCs are ruining my quality of life. They keep telling me it’s my anxiety. When I feel one I get anxious and that causes more! Throwing up use to help them stop but during my last PVC storm that didn’t work and I ended up in the ER where (of course) they didn’t find anything. all of my tests were normal. I also have GERD and take medicine for it so they think that maybe that has a lot to do with it too. But I hate it. It’s the worst.