Heart Flutter in 21 y/o Male

[deleted92121]

First and Foremost, I have already been examined and had a full workup and a diagnosis has been made. I am only putting this here to see what some of you think.

21 y/o M, fairly healthy and active. Non smoker, social drinker. Works EMS. Eating habits are poor. Father has Marfan's and Mitral Valve Prolapse. Mother has bouts of SVT and ectopic beats, normally associated with stress. Pt himself has been under good deal of stress lately. Pt just got back from beach one week prior.

Pt was eating dinner and felt three quick taps in left chest. Felt like something crawling or fluttering. Became SOB and dizzy. Stood up walked around and drank cold water. Pt also diophoretic. 4 days prior Pt had similar episode w/o the fluttery feeling, just palpitations. Pulse was 76 and BP 127/68 that day (checked on ambulance). Have not felt right since.

Pulse 86, BP 130/76, EKG NSR, Chest Xray good, labs looked good, unremarkable. What do you think? Also remember a diagnosis has already been made so I am not looking for medical advice, I just want to know how you think.

dxu

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[deleted6669]

PUT DOWN THE METH....
( sorry, if you presented like that at my e.d. given our demographics that would be the answer..... )

was the final dx made with a holter or king of hearts monitor?

 

[deleted92121]

PUT DOWN THE METH....
( sorry, if you presented like that at my e.d. given our demographics that would be the answer..... )

was the final dx made with a holter or king of hearts monitor?

HAHAHAHA...that is too funny. The sad thing is that it is prominent in my area as well. But then again, where is it not?

But alas, I am completely drug free.

Anywho, they were comfortable in not placing me on a holter at this moment and the dx they came to was panic disorder. I am going for a follow up today and will let you know what's up.

dxu

 

[deleted87716]

With that history, I'd still order a holter, as it's suspicious for PSVT. I might consider an echo, as well, in order to rule out structural heart disease.

 

[deleted92121]

With that history, I'd still order a holter, as it's suspicious for PSVT. I might consider an echo, as well, in order to rule out structural heart disease.

Had an echo done when I was ten for a possible heart murmur. No murmur exists today. Also, why PSVT?

dxu

 

[Gastrapathy]

Had an echo done when I was ten for a possible heart murmur. No murmur exists today. Also, why PSVT?

dxu

Were you having symptoms when your HR was 70's or had they resolved by the time you were in the ambulance? If you were having symptoms and got an EKG at that time, there is no further information to be gained from a holter. Also, unless you have daily sx, an event monitor (loop recorder, etc)would be a better choice. If the ED doc didn't want to order a holter or loop, you can understand that (f/u is a pain for them) but your PCM might still think it was appropriate. Good luck.

 

[deleted92121]

Currently on Holter monitor and had two very brief episodes on the drive home from my PCP. It was odd they happened then since these are usually very low yield. I should add that these episodes only lasted for maybe 2 seconds each time. This makes me think PSVT as a very likely possibility.

They scheduled me for an echo to rule out MV leakage or prolapse. Also checking for WPW, though PCP said highly unlikely. Also checking for DM due to my frequent urination and lethargy (plus I get hungry and clammy a lot).

I don't like this...

dxu

 

[deleted92121]

Were you having symptoms when your HR was 70's or had they resolved by the time you were in the ambulance? If you were having symptoms and got an EKG at that time, there is no further information to be gained from a holter. Also, unless you have daily sx, an event monitor (loop recorder, etc)would be a better choice. If the ED doc didn't want to order a holter or loop, you can understand that (f/u is a pain for them) but your PCM might still think it was appropriate. Good luck.

This happened when my HR was in the 70s. Did not take ambulance to ER last night. I got the EKG 20 mins post-episode and was NSR.

these feel like really small flutters, like something crawling right across my chest.

dxu

 

[deleted87716]

don't like this...

I don't like the direction this thread is taking. First you said you had a diagnosis, now it seems you're asking for personal medical advice, which is against SDN's TOS.

 

[deleted92121]

I don't like the direction this thread is taking. First you said you had a diagnosis, now it seems you're asking for personal medical advice, which is against SDN's TOS.

Once again...not asking for medical advice. No matter what I don't like what is happening.

 

[JayneCobb]

Closing. Soliciting medical advise is against the SDN TOS.