967168 tn?1477584489

I have my PCP, Cardiologist & EP shaking their heads, any clue what this is?

I've been reading here the past few weeks since I went to my pcp not feeling so great; he said he was concerned about my heart. He did a few EKG's in his office and said I was having PVC's and he thought I had damage to the valves in my heart due to previous use of Phentermine.

I have had 3 workups including CBC's, for diseases and genetic testing. All of my bloodwork came back within the normal limits with the exception of Sodium (135) & EGFR (59 & 73) lvs being alittle on the lower side.

Background on phentermine:
I started in April 2006  went off after 6 mths; lost 47 lbs, and kept with my rountine until December 2008.

I wanted to lose an additional 25 lbs so I went back on Phentermine, but only stayed on 1 month (Jan 2009) because they made me extremely "sick" feeling.  I went off Phentermine in Jan 2009 and kept my routine 5-6 days a week for a bit, but kept getting worse.

ln April 2009 I was so tired and sick plus alot of other symptoms I could barely drive. Blackouts, fatigue, breathing problems, swelling in my left leg/ankle, palpations, dizziness etc.  I went from walking & running 5-6 days a week, plus taking care of my youngest children, school, family & business to barely able to do anything.

My PCP sent me to a Cardiologist and an EP. They each did ekg's, plus cardio did ECG, stress test & holter monitor so far, and they did extra EKG's because they think my others are wrong :P   I passed out on the treadmill stress test due to 5 VT's/Pvc's (one of them, my head is still swimming from all the medical terms) in a row.

They all conclude that my heart beats an EXTRA 54,000 times in a 24 hr period, even during rest & sleep.  If my heart is healthy and there is no other cause can this be happening; are the drs "covering" for their partner and Phentermine is really the cause? Could I really have valve dmg and not know it, how do I tell?

They say I have VT, SVT's and PVC's and that every third heartbeat (Bigeminy) is one of these "abnormal" beats and ruining my life.  These specialists are wow'd and speechless when they read my reports. They told me it's amazing I am sitting in their office because at this rate I should have gone into heart failure.

The electrophysiologist wants to do ablation surgery, which makes me very uncomfortable.  He also said if it doesn't work and they remain or come back there's no reason to redo surgery at my rates - and the meds are toxic so I would have the same problem all over and in a "very short period of time" go into heart failure and cardiac arrest with NO reasoning.   Do all drs really treat symptoms without ever trying to find the cause?  

The EP said Phentermine had not caused any damage and my heart/valves were fine with just a tad of regurgitation (normal aging) .  I'm wondering about this because one of the doctors in his practice gave me the meds for over 6 mths knowing I had this problem (I had no clue at the time) from a previous EKG

My previous EKG's have said this -
Sinus Rhythm, rate 51[Normal P Axis, rate]
Multiple Ventricular premature complexes [Short R-R, wide QRS]  
Incomplete right bundle branch block [QRS 110ms, terminal forces right]
QT interval short for rate [QTC ,360 ms]

11/21/2008 (3rd EKG in a row)
Normal ECG except for rate [Sinus Bradycardia] vent rate 58

Sinus rhythm with frequent pvc's
Poor R wave progression
Septal T wave changes are nonspecific

Sinus rhythm with PVC's
Septal T wave changes ar nonspecific
I'm sorry for rambling I just have so many questions and the EP/Cardiologist don't want to give me my records, or forward them for a 2nd opinion, which alarmed me even more.

PLEASE help me...has anyone heard of this, what can cause an EXTRA 54,000 beats? what can cure it...will it really turn into heart failure and damage from it beating ("quivering") so much in a short period of time like he is saying?

I'm lost and I just need help making the right decision, any help or information who to call or where to turn is greatly appreciated.
2 Responses
612551 tn?1450022175
I believe you said you had an echocardiogram, that test is the "gold test" in my book to measure the physical condition of the heart, including all valves.  If it show the valves are working right or that there is mild regurgitation in, say, the Mitral Valve, then the heart is in good condition.

If you want a fix, not a symptom treatment, then ablation is for you.  It is an intervention, not a symptom treatment.  However, it has some risks, as does all surgery, and there is no guarantee it will work.  They EP should be able to give you an estimate of success for ablation, it should be 85% or better or I'd not be real interested.  

I've been through an open heart surgery procedure called a mini-maze for treatment of AFib.  It was given a 60% chance of working, I'm in the 40% group.

So it looks like I'm a "lifer" on beta blocker and anticoagulant.  Studies have shown that for a person my age there is no increase in my life expectancy by achieving normal sinus rhythm.  In my case, in all cases (I believe), the decision to take risk for procedures or medications is low because I am luck (so far) in that my permanent AFib isn't particularly problematic.  I no longer jog, however, and that was my "macho" and "weight control" activity.  Guess I'll have to diet to control weight, stand up straight or walk fast.
967168 tn?1477584489
Thank you Jerry.   Yes I had an Echo, my heart showed the structure was normal, which is probably why I haven't gone into heart failure thankfully.

My EP said on the "normal" ablation he has a 90% success rate BUT with mine as much as they are at 54,000 on the day of testing, he cannot give me a % but can quote some facts - which were daunting it was 30-40% if it works at all.  He's never seen anyone above 30k that hasn't been in the ER :P

At age 42 with small children I guess I will have to take that % and at least try it and see how well it works.  The other option isnt one I want to even think of - wait until I have a heart attack and/or failure due to my heart weakening so much from this 24/7.

I guess I'm searching for answers that maybe no one will ever be able to give me - I'm going another EP this week at the university near where we live, so maybe I'll get some answers :)

I read about Maze at mayo clinic after they showed a spot on our news about it, sounds like a great new treatment.   Hopefully this does well for you and helps in you - this isn't an easy thing to live with.
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