On Wednesday evening, I made an unexpected trip to the emergency room at Columbia-Presbyterian. I’d like to say I was just doing a dry run, but in fact I had been having heart palpitations for two days straight and I wanted some reassurance that this was nothing to worry about.
I’ve had palpitations before. I’m pretty sure you have too. It feels like your heart skipped a beat or did a somersault or a small flutter. However, this time it was different. It was skipping every other beat, and I mean EVERY. OTHER. BEAT. It felt like my heart was not only doing somersaults, but a routine on the uneven bars. While heart palpitations on their own are usually nothing serious, my doctor said it couldn’t hurt to get it checked out and recommended that I visit the ER to get an EKG.
This was easier said than done at first. There was a substantial line for the triage nurse at the ER, so substantial that my friend Nancy had to stand in it for me, because by this point, I was exhausted from the worrying. When it was finally my turn, I had to rally myself to even stand up and walk over to the nurse’s desk.
Lesson Learned #1: Say the words “ascending aortic aneurysm” and you become a whole lot more interesting to the ER staff. This was quite hilarious to note because they couldn’t believe a person of my age, weight, and health could have one as big as I said mine was. Moreover, I overheard more than one conversation about me between the staff that weren’t even on my case referring to me as the “AAA” girl, which is totally going to be my next tattoo.
I don’t think the attending fully believed my reported rate of palpitations until he stood next to me and watched them show up on the monitor for three straight minutes. But he was definitely a believer after that. Nancy and I began to make a game of it where she would watch the monitor and then catch my eye every time she saw the telltale signature and I would just smile because my chest just told me the same thing. We quickly learned that my palpitations were actually something called premature ventricular contractions, or PVCs for short.
Normally, each heart beat pumps blood out of the ventricles and into the body (to the lungs from the right ventricle and to the arteries from the left ventricle). Between beats, the atria fill the ventricles with blood that has been returned from either the lungs or the veins. During PVCs, the ventricles contract before they have been refilled by the atria, resulting in little to no blood has really been pumped out of the heart. Consequently, the first heartbeat to follow a PVC feels a little stronger than usual because the ventricles have now had more than one heartbeat to refill and pump out a higher volume of blood than usual. The best way I can describe the sensation (other than with the gymnastics reference above) is that it feels like: regular beat, mini beat, BIG beat. Repeat ad infinitum.
As you might imagine, it’s not so fun. And that’s why I wanted someone to tell me nothing serious was wrong. Which they pretty much did, but only after they said they wanted to keep me overnight for observation.
Lesson Learned #2: The best hospital food is in the ER. I was there long enough for the adrenaline to die down and the hunger to return. Luckily there was a lovely lady with a snack cart who gave me a turkey sandwich and some Snackwells cookies somewhere around midnight. Little did I know this was the best I’d have it over the next 15 hours. It really hit home the next morning when I realized I still had one of the cookies left and b’fast was still hours away. [Note to self for surgery: bring snacks.]
I was finally transferred to a real hospital room around 2 am. This was probably the highlight of my stay as I was wheeled in my ER bed from the first floor of one of the medical buildings to the ninth floor in another building through eerily quiet corridors by an orderly who had cornering skills that would make the guys on Top Gear drool. Imagine trying to wheel one of those Ikea or Home Depot lumber carts through a maze and you’ll have some idea of what this guy could do with a gurney.
Lesson Learned #3: The ball always gets dropped by someone. As a newly admitted patient, I was met by the P.A. on duty who took a full history and said that they would be reattaching me to a heart monitor to record my heartbeats and examine them closely for anything out of the ordinary. That was at 4 am. At 8 am when the attending came to see me, I was still “unmonitored” much to his and my dismay. He had assumed that everything was showing up normal as he hadn’t been notified of any abnormalities, but it turned out no abnormalities had been noted because no heartbeats at all had been noted! Where is Christina Yang when you need her? I was finally hooked up to a monitor again around 9 am which meant I was stuck there for at least another couple of hours while they accumulated some data.
I was also stuck in other ways…namely with needles to run more blood tests than I can remember. And I fear this is just a fraction of the pin-cushion effect I can look forward to in July. Fortunately, everything came back negative for scary, serious stuff.
Finally, around noon, the attending informed me that there was nothing abnormal on my EKG or in the data they had been monitoring other than the PVCs. And unfortunately, PVCs can often occur spontaneously and with no obvious cause. Not exactly the answer a scientist likes to hear. They could be related to stress (who me?), medication (check), or nothing at all (blerg). Regardless though, it at least meant I was cleared to go home, which I was more than happy to do having only gotten one and a half hours of sleep and a few bits of some pretty bad food. Despite the discharge orders being given at noon, it took over two hours for them to actually make their way from the attending’s mouth to the nurse’s paperwork. Gotta love bureaucracy.
So I changed out of my glamorous hospital gown and back into the clothes I left my apartment in 30 hours earlier and I made a bee-line for a cheeseburger and my bed, in that order.
As I write this, those friendly PVCs are keeping me company once again, but now I just picture them as little nerdy overachieving ventricles instead of terrifying ventricles of DOOM.
Thus endeth the adventures in heart palpitations…for now.