one more, once?

Honey, it happened again! Last night I was watching the brouhaha following the James Comey firing and I felt my heart pounding. I quickly took my pulse with my oximeter and recorded a 160 bpm. Jan was at a book club session. I tidied up around me and prepared to drive myself to the ER--about a 12-min shot--and took one more reading. 174 bpm! So I got in the car started down the road and called Jan who met me at the hospital.

The ER was somewhat busy. A life flight helicopter was on the pad spooling down and an ambulance was in the loading bay. People were standing in the seating area. The admit-person always alerts when one presents with a high HR, but no one came to get me for a good 5 min. Once in the room I joked how they better hurry with the ECG otherwise they could miss the event. The ECG cart was there quickly and they wired me up. A joke happened. I don't know whether I cracked it or someone else did. But I had a good laugh and my heart rate came crashing down to normal. They all gasped because it happened quickly. And once again the ECG missed most of the event. 

The rest was routine: heart in normal sinus rhythm; blood draw; wait for labs; find out labs are perfect; wait for paperwork; go home.

They label this presentation PSVT for Paroxysmal Supra-Ventricular Tachycardia. That = above the ventricles; high HR. I think it is a post-endocrine dump event.  The interesting thing is that it appears to occur sometime after the stress that produces the endocrine dump, almost like a rebound effect. The dumper here is undoubtedly the adrenal system. Can I point to stress before both of these events? Oh yes. Let me count yesterday's ways.

1. Yesterday (Tu) was a day after my work out on Mon--which was the same sequence in the prior event. In fact, the day of the week was the same. The event occurred in the evening in both occurrences. Both times I was sedentary when the event began. Last night's was earlier in the evening. During the day I did some lifting of boxes. I practiced my piano for several hours. I had lunch with my same buds as the prior event. (What is it about them?)

2. Psychological stress is high right now. The famous scale that shows the levels of stress in uncommon human environments ranks death of a close family member as first, divorce as second, and moving as third. WE ARE MOVING.

We have accepted an offer on our home and the deal will close August 1, all else equal. We have chosen a lot and a home to build. All of this took much mental energy. The home will require at least 5 months of construction. We will be homeless for several months. We have been looking for an apartment in an extremely tight market. We have been working our finances hard.  We are packing daily and moving non-essentials to a storage unit. There are discussion tensions between Jan and me owing to the known unknowns. Many plates are spinning in the air.

Yesterday, the contractor resolved many financial questions when he offered to build the home for us on spec. We will make a down payment to get construction going with the remainder of the home's cost due when our house closes. Our down payment will be returned to us if our house fails to sell.  This is all win-win. I think we felt immense relief. We are accepting this deal. Tension should should decrease, no?

3. I got engrossed in the drama of the Washington Follies, ie, the James Comey firing, yesterday late afternoon and was still watching the analysis when the attack occurred. I was highly stimulated by what was occurring, especially by the thought that our democratic system was being tested, and had been so stimulated for several hours. 

This is different from the prior event as there was concurrent stimulation, so this might have been a direct response to a high adrenalin flow, rather than some sort of rebound effect.
I will have to reflect: I don't recall the prior time, but last night there was no pre-prandial alcohol. One wonders. It may have been ameliorative.

Wiki says that stimulants such as caffeine and nicotine and psychological stress may be involved. So, I am at least one out of three. I  did drink quite a bit of tea yesterday--a couple cups with breakfast and several at a sushi lunch. One can apparently try the valsalva maneuver which is pressing down as though trying to have a bowel movement. Or pretend to blow up a balloon. Quickly, pass me a trumpet! Next time I will try one of these methods to see if they have any effect. Because if this continues the rhythm docs will want to get involved again with their cardio-versions  (shocks) and ablations.

Probably not the end of this.....