the case of the impatient heart
“Here’s what a normal EKG result looks like.” The cardiologist flipped over my printout and started sketching.
It’s always interesting when a medical professional starts with “Here’s what normal looks like.” Because I know the results they’re about to show me will be not-so-normal.
Like when an orthopedic surgeon pointed to an x-ray of my 14-year-old knee and said, “Over here is where your knee cap should be.”
And when a neurosurgeon pointed to the MRI results of my 19-year-old back and said, “These discs should be over here.”
Strange and abnormal results are nothing new to me. In fact, I’m probably more surprised when everything comes out in a normal range.
The cardiologist pointed to her sketch. “See this little bump here? That’s the P-wave, and the space between it and the next wave, the QRS, is called the PR interval.”
I nodded. “Okay.” So far, I was with her.
She flipped over the paper. “See here? On your results, your P-wave is right next to the QRS. You have an incredibly short PR-interval. So what that means is…” She paused to open a drawer. “Has no one explained this to you before? It’s been on your results since you were 16.”
I shook my head. No one had ever taken the time to explain anything besides “You have SVT.”
SVT. Supraventricular tachycardia. I was diagnosed when I was 16. It’s not life-threatening; it mostly just means sometimes my heart rate is freakishly high and other times I have chest pains or get light-headed. It’s just an occasional annoyance.
When I was first diagnosed, the doctors basically landed on the diagnosis through ruling out everything else. I wasn’t even sure they believed me, since my palpitations and tachycardia were only occasional, so I could never capture them on the heart monitor. They asked me if I’d been through a lot of stress lately. (Clearly they couldn’t remember high school.) Eventually they tagged me with the label SVT and told me I’d live. Later, I met an ex-paramedic who taught me some tricks for managing my symptoms. She was shocked the doctors had never told me how to manage my SVT.
I’m lucky, though. My symptoms have never been severe. I’ve never had to go to the ER to get my heart rate back to normal. And my chest pains, annoying though they can be, only happen occasionally. I guess part of me always wondered if I really had a heart problem.
The cardiologist pulled a mini heart model out of the drawer. “Basically, blood comes into the heart through the atrium.” She pointed to the top section. “And then it pushes the blood downward, gives it a moment to flow down into the ventricle, and then the ventricle contracts, pushing the blood out of the heart. That pause in the middle is the PR interval.”
She pointed back to my results. “Your heart doesn’t really provide that pause, that’s why you have a short PR-interval. There is likely a physical pathway connecting the upper and lower sections so that the electrical impulse just skips down and enervates the lower portion instead of waiting. You’ve had that defect since you were born and it’s why you have a heart murmur. It’s not causing any major symptoms now, but if it does in the future, there’s a simple surgery we can do to fix it.”
I stared at the mini heart model. I had a congenital heart defect? Most people would be floored by the news. But I was kind of thrilled. Because it meant my heart problems weren’t random or psychological. I wasn’t imagining it.
I didn’t know the whole story with my heart until that conversation two months ago. (I’m so grateful to finally have a cardiologist who takes time to explain!) And although the term “normal” is obviously rare for me, all my recent cardiology test results were “stable.” Meaning this wacky heart of mine is working just fine, in its own unique way.
I guess you could say I have an impatient heart. It’s supposed to be doing the waltz, but it’s doing the tango instead. Not that it knows what normal is. It doesn’t know what other hearts look and act like. It keeps forging on, beat after beat, performing a dance in its own special style.
Perhaps I was born with a heart that’s perfect for me.
Jennifer K. Hale
Feb 04, 2015 @ 20:36:06
Wowza, Halee. This post could not come at a crazier time for me!! I had an ekg TODAY for SVT. I’ve been having crazy-weird symptoms lately and they think that’s the culprit. Thanks for posting this. I’ll be messaging you later!! 🙂
Feb 04, 2015 @ 20:42:00
So glad for the crazy awesome timing! Yes, we can definitely chat.