Horrible Day Ambulance

[Achilles2323]

Yesterday around 12 midnight my heart started to rise and it got to 190hr and i could not breathe and my fiance and father called the ambulance

by the time they came it went down to 160 and then by the time i got to the hospital it was at 104 they ran blood test and chest x rays

The test they ran were

cbc + automated Diff

Sed Rate

Prothrombin Time and inr plasma

activated partial thromboplastin time

Metabolic Panel

tsh

cpk

troponin t serum

magnesium serem

c reactive protein

potassium was low 3.2

glucose was high 118

biliribun high 1.8

Wbc count high 11.1

hematocrit low 36.9

auto neutrophil high 8.5

they ran cardiac enzymes twice in 6 hours and said they were ok

the stuff i named above were low or high

i have

POTS

GERD

GILBERTS SYNDROME

1ST DEGREE AV BLOCK

any 1 have an experience like this ?

keep in mind the heart rate did not come upon standing as usual it came when i was lying down which was fairly odd because my HR only tends to go up when i stand

i have no clue what happen but i never want to feel that way again

they did not admit me and told me to follow up with cardio pcp and neuro

they said x rays and blood test did not show anything alarming so they let me go

but i have no idea why my HR went to 190

i have had many many blood test urine test and just recently skin biopsy and ct scans which could not find anything conclusive just here and there minor things

they did ct scans on chest abdomen and pelvis said all was normal

did NCV AND EMG NORMAL

i am not quite sure were to go or what to do because no 1 has been able to tell me what has caused my POTS

and last night my HR went to 190 and it was the worse i have felt in my life

any help ?

[Tobiano]

That does sound like a horrible day . A HR of 190 does feel terrible. I have no idea about your test results but I do hope you get some answers. Thinking of you - hang in there!

[Achilles2323]

yea it really does

=/

thank you so much

just want answers =/

[looneymom]

Follow up with whoever is treating you for your POTS. Maybe they can get it figured out by your test results. Hope it helps you figure out what might be causing your POTS. Hang in there and keep yourself hydrated.

[Guest Alex]

Sorry you had such a bad experience but if it's any consolation I had a similar episode while in the hospital. The only good thing was the fact that they captured it on the monitor - I was told it was an episode of atrial tachycardia (my HR was 220 bpm) and I shouldn't worry about it as it could have happened to anyone. (kind of hard to do that though) The only thing they did for me aside from taking some blood was to give me a bag of saline IV. Also, all my blood work from back then came back fine.

Just so you see how unpredictable things can be - the very next morning I had a tilt table test meant to evaluate the effectiveness of my meds (so I was on meds when this happened) and I tested negative for POTS. According to my dr my treatment was helping!

Later on I spoke to an electrophysiologist who suggested I may have an extra pace maker in my heart. I didn't follow up on that.

Hang in there.

Alex

[issie]

I had something similar and I think it was connected to Mast Cell Activation disorder. They kept me over night and gave me IV's and nitroglycerin. I had taken massive antihistamines before I went to the hospital because I suspected it to be an allergic reaction. The final thought was Kounis Syndrome - that is connected to MCAS (mast cell activation syndrome) that hits the heart. It is very scary and when nitro works - even more scary. I felt totally worn out when it was all over and it took days to feel better. Hope you get it figured out. I never want another episode like that again either. I now have two epi pens in case this happens again. And I'm on daily H1 and H2's and mast cell stablizers.

Issie

[Katybug]

Sorry you had such a miserable episode. Your white count being high could indicate on oncoming infection and that is known to mess with our POTSie bodies. Whatever it was, I hope it's gone and never comes back. Take care.

[Achilles2323]

potassium was low 3.2

glucose was high 118

biliribun high 1.8

Wbc count high 11.1

hematocrit low 36.9

auto neutrophil high 8.5

are those really to high or to low ?

or just minimal ?

[Guest Alex]

reference ranges:

potassium 3.5 - 5.1 I'm symptomatic when my potassium is as low as yours. I took supplemments though and now I'm OK

glucose - the ADA recommends a postprandial glucose level no higher than 180. Given you did have dinner that evening, I'd say your number is well within range

total bilirubin 0-17

direct bilirubin 0-5 ....yours looks fine(?)

hematocrit 40-50% don't know what units yours is expressed in

wbc 4.0 - 11.0 yours seems borderline high - do you have any cavities maybe? Probably nothing to worry about though.

auto neutrophil 1.8 - 7.7 a bit high

For info on what these tests may mean go to http://labtestsonline.org or better yet check with your dr.

Sometimes drs disregard values that are slightly off as they may be due to all sorts of errors or factors we don't take into consideration.

I'm sure that if your numbers were concerning, the ER dr would have told you to follow up.

For your own peace of mind, see your family dr and ask him/her if there is anything abnormal there.

Hang in there.

Alex

[Achilles2323]

Yea I guess I will fax all the results

[Guest Alex]

Achilles,

here is an article I posted on dinet last night

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046107/

the following quote might be relevant to you: (in particular the text I 'highlighted' for you.

Postural tachycardia syndrome (POTS) is characterized by orthostatic tachycardia accompanied by multi-system complaints including chronic fatigue, exercise intolerance, and pain mainly in Caucasian pre-menopausal women. The disorder seems increasingly common [106]. Consistent with recruitment of sympathetic outflows during orthostasis, POTS patients have high plasma NE levels when upright [40].

POTS also entails neurocirculatory abnormalities during supine rest. These include relatively fast mean heart rates and increased NE, DA, and EPI concentrations and increased cardiac NE spillover [40, 44,52], indicating increased sympathetically mediated exocytosis and adrenomedullary hormonal system activation in POTS patients even while they are supine.

A sub-group of POTS patients are thought to have partial sympathetic denervation and compensatorily increased cardiac sympathetic outflow [76]. A family with inherited POTS was found to have a hypofunctional mutation of the gene encoding the cell membrane NET [112]. These findings have the common feature of decreased NET activity. Although acute administration of NET inhibitors produces hemodynamic and neurochemical alterations reminiscent of POTS [108], most POTS patients seem to have normal NET function [44].

Maybe it's worth printing the article and sharing it with your POTS dr.

Hope this help some.

Just know you're not alone in this.

Best,

Alex

[Achilles2323]

Thank you for the article but what exactly is it saying as I am not familiar with all the medical terms

[Achilles2323]

I am so thankful for all the help on here my fiancé and mother took a video of my heart going from 60 to 110 just upon standing and they also said j think that I have ortho hypertension

[Guest Alex]

I am still learning and trying to make sense of a lot of the medical/scientific terms in most of the dysautonomia related articles, (most times it's all Greek to me), but here is my best interpretation of that one paragraph that I highlighted:

POTS also entails neurocirculatory abnormalities during supine rest. These include relatively fast mean heart rates and increased NE, DA, and EPI concentrations and increased cardiac NE spillover [40, 44,52], indicating increased sympathetically mediated exocytosis and adrenomedullary hormonal system activation in POTS patients even while they are supine.

With POTS it is possible to get abnormal neurocirculatory findings even when lying down, resting. These include episodes of tachycardia as well as an increased levels of norepinephrine, dopamine and epinephrine (adrenaline), as well as a cardiac overflow of norepinephrine (noradrenaline). That indicates that it's possible for the hormones produced by the cortex of the adrenal glands (epinephrine and norepinephrine) to reach high levels even when patients are lying down.

In other words, POTS is not limited to an increase in HR and/or the adrenaline, noradrenaline levels when going from lying down to standing.These 'spikes' can also occur when lying down. (probably something similar to what you have experienced the other day).

I'm quite sure your dr (should you decide to share this article with him/her) will be able to make more sense of this.

Hang in there and try to stay positive.

Best,

Alex