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I was in a doctors office today and experience severe chest ...
Sent to Health Experts March 24 10:10 PM

I was in a doctors office today and experience severe chest pain right under my sternum. I had a ekg done and the physicians asst. wrote paraxysmal idioventricular rhythm on the ekg reading.. what does this mean? and should i be worried.?

 

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Female, Age: 41, North Carolina

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March 24 11:02 PM (52 minutes and 26 seconds later)
         
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Daniel Nelson, MD -- Doctor (MD)100% Positive Feedback on 254 Health Accepts
Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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March 24 11:36 PM (33 minutes and 49 seconds later)
         
What other things could cause this? Is pain one of the symptoms? what about jaw and face pain? all evening i've had some soreness still in my chest with slight jaw pain...could this have been a heart attack? i am going to see a cardio doc on thursday... and will call my regular doc tomorrow.. I have so much concern right now,, that it's hard to "wind down" for the night. what would have made my chest hurt like that? all week i have felt sudden racing of my heart.. and then it would calm down. no vomiting or sweating. please write back. thanks.
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March 25 6:14 AM (6 hours and 37 minutes and 35 seconds later)
         
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Causes of the "Escape Rhythms" mentioned above are failure of the upper pacemaker to fire or to conduct its electrical activity successfully to the rest of the heart. This can occur in conditions like Sinus Bradycardia (slow heart rate - which is an opportune time for a lower heart pacemaker to dominate, as in accelerated idioventricular rhythm), Sinus Pause or Sinus Arrest, Sino-Atrial Exit Block, and Sick Sinus Syndrome.

The exact and underlying causes of these conditions is far beyond the scope of this discussion, because the rhythm you described the PA writing down isn't used as such, as it's not proper EKG Interpretation Terminology. Thus, we do not have an appropriate rhythm disturbance name to work with in your situation.

If you have ongoing chest pain, jaw/face pain, in the setting of an abnormal EKG you should be seen in the ER now and evaluated for heart attack. As I mentioned before, the terminology used by the PA is not appropriate and does not make sense. Regardless, chest pain with jaw/face pain and an abnormal EKG need to be immediately investigated for heart attack or other life-threatening problems.

I would strongly favour your being seen in the ER and being evaluated as soon as possible. They will put you on a monitor, draw blood tests, repeat the EKG, and evaluate you for both heart attack and the exact nature of the abnormal EKG.

Your PA has complicated this scenario by using terminology that is not used in as such in medicine. "Paroxysmal Idioventricular Rhythm" is not proper terminology. The EKG can show paroxysms of "Accelerated Idioventricular Rhythm" or a "Ventricular Escape Rhythm" ... both of which in the setting of the presence of chest pain and jaw/facial pain should be evaluated emergently.

If you were one of my patients, I would recommend that you go to the Emergency Room RIGHT NOW.

Kindest Regards,
Daniel Nelson, MD



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1 Other Expert Agrees with this!
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Daniel Nelson, MD -- Doctor (MD)100% Positive Feedback on 254 Health Accepts
Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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March 26 11:52 AM (1 day and 5 hours later)
         
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Daniel Nelson, MD -- Doctor (MD)100% Positive Feedback on 254 Health Accepts
Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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March 26 5:42 PM (5 hours and 49 minutes and 56 seconds later)
         
Thanks for your imput.... I agree,, i need to be seen as soon as possible because on a scale of one to ten... the last 24 hours ,, i've been at a 3-4... off and on.. i hope there's nothing to worry about.
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March 26 5:46 PM (3 minutes and 46 seconds later)
         
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Daniel Nelson, MD -- Doctor (MD)100% Positive Feedback on 254 Health Accepts
Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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