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do i need to see a doctor?
hi, i just received a copy of a letter from a doctor, telling my gp the results of a 24hr ecg i had. my consultant has left so iv been sent back to gp. i cant understand what the letter means and im a bit scared. i was sent for tests after i passed out while driving. letter says sinus rhythm throughout,2runs of 4ve's seperated by 1 sinus beat, 1triplet, isolated runs of bigeminy, longest 14cycles. occasional runs of trigeminy longest 27 cycles. frequent ve's, isolated sve's, during first symptom of palpitations 3 ve's are seen. my doctors receptionist says i dont need to see my doctor about this but im very worried, and i dont no what to do next, please help, thank you, belinda
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I am in the UK too and whilst our health care is free and usually good, the GP system where you can struggle to make appointments is frustrating. My friend is a gp and at her practise, and at my gp, they no longer allow the receptionist to give out test results - for exactly the reason you are experiencing. The receptionist can only say, 'results OK' they can't explain or clarify them. Could you ask for a telephone consultation with the gp? The cardiologist will have written a comment or report on the results - it would certainly have said if further testing was required - so I would think the results are ok. Nonetheless if you are still concerned you have every right to see your gp just to put your mind at rest. If the fainting persists you must definitely go back. Best wishes.
I am in the UK too and whilst our health care is free and usually good, the GP system where you can struggle to make appointments is frustrating. My friend is a gp and at her practise, and at my gp, they no longer allow the receptionist to give out test results - for exactly the reason you are experiencing. The receptionist can only say, 'results OK' they can't explain or clarify them. Could you ask for a telephone consultation with the gp? The cardiologist will have written a comment or report on the results - it would certainly have said if further testing was required - so I would think the results are ok. Nonetheless if you are still concerned you have every right to see your gp just to put your mind at rest. If the fainting persists you must definitely go back. Best wishes.
thank you for your advice, trouble is i cant see my gp, receptionist has told me that if doctor needs to see me, he will comtact me, at my gp surgery you have to ring in morning each day to get an appointment...iv been trying for over 2weeks, thats why iv been worried. thank you all for all advice and help x
Make an appointment with your gp and have them explain the results. The gp may well have noted on the letter that your results were within normal parameters and you didn't need to see him/her, but if you are anxious you need them explaining. The fainting could be a whole host of things, like vagal reaction or just a passing virus or overheating, but it definitely needs further investigation if it keeps happening.
A common cause of passing out is a Vasovagal reaction. The thing that distinguishes this type of issue from a cardiac one is usually your awareness of a problem that can lead to a vaso vagal reaction.
I ran into this issue myself in November last year, and was concerned because I have documented non sustained VT. It was strongly recommended to me that I see an electrophysiologist for evaluation, which I did do.
There is a very detailed paper on the subject matter if you have the time and energy to read it. More importantly, you may want to note that some of the authors are well known electrophysiologist in the US with some solid knowledge on the subject matter.
The name of the paper is "Guidelines for the diagnosis and management
of syncope (version 2009)" and you can find it here:
http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-syncope-FT.pdf
I ran into this issue myself in November last year, and was concerned because I have documented non sustained VT. It was strongly recommended to me that I see an electrophysiologist for evaluation, which I did do.
There is a very detailed paper on the subject matter if you have the time and energy to read it. More importantly, you may want to note that some of the authors are well known electrophysiologist in the US with some solid knowledge on the subject matter.
The name of the paper is "Guidelines for the diagnosis and management
of syncope (version 2009)" and you can find it here:
http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-syncope-FT.pdf
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Bigeminy is a normal beat and a premature beat in an alternating pattern. I get these in long episodes, it's annoying, but not harmful. Trigeminy is two normal beats and a premature beat. I get these as well, again, annoying, but not harmful.
Frequent VEs, Ventricular Ectopics or Extrasystoles. Essentially PVCs (premature ventricular contractions). Frequent is relative. On my last 24 hour Holter, I had 6000 of these. Too many of these and it can weaken your heart, but you'd have to have more than 20,000/24 hours for many days on end before it would even start to be a problem.
Isolated SVEs (Supra Ventricular Ectopics). Supra means "above". Your heart has 4 chambers, two on top (the atria) and two on the bottom (ventricles). Supra Ventricular means that the origin of the cells that were causing the premature beats was above (not on) the Ventricles. Isolated means it was not a couplet, triplet, or combined with anything, just one by its lonesome. SVEs are usually of less concern than ventricular ectopics, and most ventricular ectopics are of no concern as well.
Couplets and Triplets are two and three rapid premature beats respectively.
2 runs of 4 Ventricular Ectopics separated by 1 sinus best. 3 or more successive Ventricular Ectopics are considered Ventricular Tachycardia. You had 4, a normal beat, and 4 more if I read that correctly. This sounds to me like Non Sustained Ventricular Tachycardia.
"Non-sustained ventricular tachycardia (NSVT) is one of the most common problems encountered in modern clinical cardiology. The term, defined as 3 or more consecutive beats arising below the atrioventricular node with a rate 120 beats/min and lasting less than 30 seconds......... In the documented absence of heart disease, spontaneous NSVT does not carry any adverse prognostic significance."
The biggest concern is why you fainted. Most if not all of these events above are of little consequence in the absence of heart disease. Have you had an Echo-Stress Test or a Nuclear Stress Test? These would help to assure that nothing is wrong with your heart or its blood supply. Fainting may be caused by Non-Cardiac events as well as events related to circulation, such as a Vaso-Vagal reaction that drops the blood pressure. I have a coworker in fine health, young, and he had a small cut on his hand, he fainted at the sight of his blood and was found in a heap outside the bathroom. As a joke, someone took white tape and made it look like a crime scene.
You should be able to speak directly with your doctor, tell him/her your concerns, ask for their analysis of the 24 hour EKG.