wine and heart

[Bucko]

I sure am glad that Hotsie isn't a doctor! [img]http://wines.com/ubb2/biggrin.gif[/img]

PSVT is pretty common but it can scare the bejesus out of you. It usually beats at 150-190 bpm, starts suddenly, then self-converts after a short time. Anything lasting longer than 2-3 minutes should be seen in the ER. PSVT can certainly be caused by too much caffeine -- I've seen a few myself.

Of more serious note, the conduction from the atria to the ventricles normally occurs via the atrioventricular node (AV node). Patients with a preexcitation syndrome have an additional or alternative pathway, known as an accessory pathway, which directly connects the atria and ventricles and bypasses the AV node. In the Wolff-Parkinson-White (WPW) syndrome, AV conduction is through an AV bypass tract (the bundle of Kent). This results in earlier activation (preexcitation) of the ventricles than if the impulse had traveled through the AV node. If this is the case, ablative therapy, either surgical or with a catheter using radiofrequency energy, offers a cure for patients with symptomatic WPW by ablating the accessory pathway responsible for the arrhythmias. Although both techniques are highly effective, radiofrequency ablation has largely replaced the surgical approach.

There are many others, e.g. Focal atrial tachycardia, Repetitive focal (automatic) atrial tachycardia, Incessant atrial tachycardia, Multifocal atrial tachycardia, Macroreentrant atrial tachycardia.... blah, blah, blah.

If cutting back on caffeine doesn't resolve the issue, I'd be seeing a cardiologist if it was me. Electrophysiologic studies often help to identify the mechanism responsible for the atrial tachycardia.

[hotwine]

Glad ol' Bucksnort chimed in. He's right, I'm sure as hell no doctor.

Think about this, Georgie..... 30% of heart attack victims don't survive the first one.

[Drew]

Great notes, Bucko...BTW, what year was that Wolff-Parkinson-White and is it a blend? [img]http://wines.com/ubb2/biggrin.gif[/img]

Drew

[quijote]

Georgie, I can't believe you had the patience to wait for the parents to leave! I hope the news from the physician is not too drastic. And with some luck (and wishful thinking), s/he'll prescribe port as a cure.


[This message has been edited by quijote (edited 03-04-2004).]

[Georgie]

Thanks everyone, particularly you, Bucko.. I'm cutting out even my precious morning cup of coffee. I've already cut out junk food and alcohol, now coffee..not much left.. [img]http://wines.com/ubb2/frown.gif[/img]

[Bucko]

Non-vintge German, Drew. We'll get you a case.

I see no need to stop alcohol as long as it is kept to two drinks per day. Alcohol is a depressant, caffeine is a stimulent. You need to avoid stimulents. Even one cup of coffee per day should be pretty safe.

I had a patient come in with PSVT. After exam and history, I "cured" him without a cardiologist. He was drinking a triple shot mocha every morning! He went to one regular coffee and voila, no more PSVT.

Other common stimulents are things like Sudafed, diet pills, ephedra, etc.

[Georgie]

OK! Two drinks a day and one cup of coffee! Doctor's orders! Yes! Life is good!