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svc and a-fib irregular heart beats

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  • svc and a-fib irregular heart beats

    I wasn?t going to post but then I thought it might help someone else. I went in to the ER once on Thursday and by the second time Friday I was there the ER called for an ambulance to come and take me to St.Vincents hospital cardiac unit. I came in once in A-fib and then I had irregular heartbeats which a nurse said was svt (super ventricular tachycardia). My heart rate kept going to 180-190bpm. It was a horrible feeling. I am small and my shirt moves with my heartbeats as it is but nothing like that. The nurses on the first visit Friday got it under control with injections of toporol but the second time it was a different shift and they didn't want to try anything. I was really upset. When the ambulance guys got there they were mad that I had laid there for 3 hours with a heart rate of 180+ without any drugs to help slow it down. They loaded me in the ambulance and started meds to try to lower my rate and to "reset" my heart back to a normal rhythm. Anything they gave me only worked short term and I went right back but they kept the toporol going so at least my rate was better. I spent 4 days in the hospital and just got home yesterday. I am on two new drugs to keep my rhythm regulated plus I am still taking toporol. The new drugs are working but they make me feel really lousy. I hope after I am on them for a while the side effects will ease off a bit. My INR was 7.1 when I got to the hospital so I had an injection of vitamin K. My cardiologist is now going to get my INR stabilized and only have my regular doctor test my blood but not adjust me. My reg. doc seems to only want to try 2.5 or 5. I am not going to let this frustrate me. I have the very best cardiologist and I trust him very much. Now that he is handling things I know I will be ok.

  • #2
    WOW! I had SVT and that is very unpleasant and makes you feel awful! You feel like you had just run a marathon. I was lucky. Every time I had SVT they gave me the injections and I was done. They said many people go right back into SVT. I never did. I can not imagine sitting there w/a 180-190 bpm and them not doing anything. If that were me, no one would have had to call anyone....they would have heard me loud and clear. That is incompetent. I realize they were waiting for an ambulance, but a pluse of 180-190 is nothing to play with.
    I have a tissue valve so I did not have that complication. (INR) Did they call your cardiologist the second time or who made the decision to make you stay in SVT before the transfer?? Anyway, I am so sorry that happened to you and I hope it never happens again. I hope the new meds help. I hope the side effects go away w/SVT. Good luck!

    Deb
    Deb
    Coincidence is Gods way of remaining anonymous.
    AVR 7-6-07 Bovine Pericardial Valve. Akron City Hospital Ablation 6/08, Akron City Hospital

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    • #3
      OH BOY, what an ordeal.....svt can be scary!
      I'm taking Metoprolol to calm my heart, and I would be interested to know about the other 2 meds you are taking. Thanks.
      BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
      INR Home testing since 2007 with Coaguchek XS...Self-Dosing

      "Caution: I may have been in contact with Nuts"

      Comment


      • #4
        Sorry to hear about your post-op trials and tribulations Jody.

        Out of curiosity, what new drugs did they put you on for your rapid / irregular heartbeat?

        The Down Side of getting Vitamin K to lower your INR is that it can take a couple of weeks to 'wear off'.

        Have you had your INR checked since the Vitamin K shot?
        If not, I would DEMAND that it be checked.

        Is your INR Below 2.0 now?

        If so, I would DEMAND an Rx for Lovenox Bridging to protect you from possible clot formation. Is your Cardiologist managing your anticoagulation? Hopefully he knows how to prescribe and manage Lovenox and/or Heparin "Bridging" until your INR gets back into Theraputic Range.

        'AL Capshaw'

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        • #5
          The two new drugs I am on are digoxin and flecainide. One will regulate the top of my heart and the other controls the bottom. I had to stay in the hospital for observation to make sure they worked and I didn't have a bad reaction. My INR went down to 1.5. I am supposed to take 5mg for three days and then 2.5 for 3 days and keep doing that to see if that will work for me. I had my INR done yesterday which was the 1.5 and I will have in done again on friday. My cardiologist thinks I will do best on 3mg but another doc in his group wants me to do the 5/2.5 until I see my cardio on the 23rd of this month. I didn't know the vitamin k hung around in my system. Kinda scary. Should I get checked sooner?:confused:

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          • #6
            if your INR was 1.5 yesterday, they would have been wise to send you home with a few Lovenox needles. That's what I had.
            BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
            INR Home testing since 2007 with Coaguchek XS...Self-Dosing

            "Caution: I may have been in contact with Nuts"

            Comment


            • #7
              Well, it sounds like you've seen an "old school" Doc and a "new school" Doc relative to giving a Loading Dose or Not. Current thinking is that Loading Doses don't work and may set you up for an INR Roller Coaster Ride until you finally stabilize.

              I am SHOCKED and Disappointed that they did NOT prescribe a Lovenox (Low Molecular Weight Heparin) Bridge to protect you from a possible STROKE that may result from clot formation with an INR of 1.5 Fortunately you have an On-X Valve which has a low propensity for clot formation (and maybe that's why they didn't order the Lovenox).

              I would call your Cardiologist TONIGHT (or whoever is on-call for him) and ask for a Lovenox prescription. They will probably want someone to educate you on how to Self Administer the injections so you may not get anything until tomorrow, unless you go to the ER to have a shot.

              'AL Capshaw'

              Comment


              • #8
                Yikes! Ok, I called the office and I am leaving here in a little bit to get my INR checked. The cardio that released me with an INR of 1.5 wasn't my regular cardio he was just in the same group. I will post back when I get the results which should be late afternoon. Thanks AL.

                Comment


                • #9
                  Well my INR is now 1.1. My cardio's nurse wants me to take 5mg for the next 2 days and then switch to 2.5 on sunday and get my INR rechecked on Monday. I will see my cardio on wednesday. She said not to worry and that with the way my levels shoot up that this was the best way to go. Any opinions??

                  Comment


                  • #10
                    I hope you are taking Lovenox shots....an INR of 1.1 means you are not anticoagulated.
                    BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
                    INR Home testing since 2007 with Coaguchek XS...Self-Dosing

                    "Caution: I may have been in contact with Nuts"

                    Comment


                    • #11
                      It's FRIDAY evening, all offices are closed, your INR has plummeted to 1.1 (i.e. NO anticoagulation in your blood) and your Doctor's NURSE wants you to Double Dose your Coumadin until you can test again on MONDAY.

                      If I were in that situation, I would be on the telephone to my Cardio's office (i.e. get passed to whoever is fielding after-hours calls) and INSIST that I speak with a Doctor about getting a Prescription for Lovenox Shots (and instruction in how to self administer those shots). If I couldn't get in contact with a Cardiologist within an hour or so, I would call my Primary Care Physician's office number and ask whoever is on-call for his group for the same Prescription (and instruction). Option 3 is to go to the ER.

                      Situations like this are exactly why patients need to learn to Stand Up to POOR ADVICE when they KNOW they are being placed at RISK for an adverse reaction or event.

                      I guess you are going to get an "opportunity" to participate in the NO Anti-Coagulation Trials for On-X Valves whether you want to or not :-)

                      'AL Capshaw'

                      Comment


                      • #12
                        Al

                        It was my cardio office and I told her that I was really concerned to be so low. She said sometimes they have to bring people off their meds temporarily and it was nothing to worry about. If I don't come up by monday I will have to go on something else. I thought about the on-x trials same as you! Our ER is totally worthless and I would risk my life again to go back. My regular doc agreed with the cardio. What to do? Cross my fingers I guess. If I die at least my family will have a good lawsuit??:eek:

                        Comment


                        • #13
                          Originally posted by JodyC View Post
                          It was my cardio office and I told her that I was really concerned to be so low. She said sometimes they have to bring people off their meds temporarily and it was nothing to worry about. If I don't come up by monday I will have to go on something else. I thought about the on-x trials same as you! Our ER is totally worthless and I would risk my life again to go back. My regular doc agreed with the cardio. What to do? Cross my fingers I guess. If I die at least my family will have a good lawsuit??:eek:
                          I would call the Cardio's office again, tell whoever answers that you INSIST on speaking with a Doctor. Same with your PCP. Be sure to tell them your INR is now 1.1 and you do NOT want to remain unprotected from a STOKE RISK for 4 days in a row. Are you still in A-Fib?

                          Document EVERYTHING and be sure your family knows where to find it.

                          BTW, who manages your Coumadin?

                          Comment


                          • #14
                            Al

                            My regular doc was monitoring my INR and my dosing but he kept going from 2.5 (too low) to 5 (too high) with no in between. My cardio was upset because when I was taken by ambulance to St. Vincents my INR was 7.1 thanks to being on 5mg for 4 days. Now he wants to dose me and have my blood drawn at the lab. I am in regular heart rhythm now because of my new meds. Do you know how long the vitamin k stays in your system? I had one shot of it monday.

                            Comment


                            • #15
                              Originally posted by JodyC View Post
                              My regular doc was monitoring my INR and my dosing but he kept going from 2.5 (too low) to 5 (too high) with no in between. My cardio was upset because when I was taken by ambulance to St. Vincents my INR was 7.1 thanks to being on 5mg for 4 days. Now he wants to dose me and have my blood drawn at the lab. I am in regular heart rhythm now because of my new meds. Do you know how long the vitamin k stays in your system? I had one shot of it monday.
                              I'm not sure how long the effect of Vitamin K lasts, but I have seen reports of it taking 'some time' for INR to come back up after a shot of Vitamin K (I'm thinking over a week).

                              It sounds like you REALLY need to talk with *your* Cardiologist directly (not his nurse) ASAP. He probably will not give you an Rx for Lovenox unless / until you can be instructed in it's proper use and how to self inject.

                              You may have no alternative but to go to an ER, preferably with your Cardio calling in exactly what he wants done, i.e. a *weight-appropriate* dose of Lovenox injection (for a 220 lb person the dose is 100 mg). You will need an injection TWICE per Day, i.e. every 12 hours.

                              If you cannot get through to your Cardio and your ER won't help you out, you may need to go to another hospital in another town where you can get appropriate care. I am concerned about you going 4 days with an INR below 1.5 (now 1.1). As it stands now, the ONLY protection you have is the fact that you have an On-X Valve which produces the least turbulence of the mechanical valves.

                              Jody, PLEASE Call your Cardio and INSIST that he contact you TONIGHT. I get the impression he understands your situation, he just doesn't know your current INR status. Once he is made aware, I expect he will see that something is done to protect you.

                              'AL Capshaw'

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