Instruction: Cardiac incidents are complicated. You mention that he had plaque (calsium deposit) in his heart, which can cause heart attacks, he might have been revived at first and then suffered another attack later causing him to pass away. Having plaques in the arteries of the heart is one of the main causes of heart attacks, and if a piece of this build up breaks off a blood cloth might form around it, blocking the blood flow to the heart starving it for oxygen which is a potentially life threatening condition.That's a question better fit for a Cardiologist, as an EMT it's a little outside my job description to know the fine details about the tests. I know they use duplex ultrasonography which is an imaging tool that uses sound waves to check the flow of blood in the veins. It can detect blood clots and blockages in the deep veins. But I'm not sure how much/little build up there has to be for it to detect it. They also use a blood screening called "D-dimer" which is a substance that is released when a blood clot breaks up. Again, I'm not sure how sensitive the test is.

Output: Im sorry this happened to you. My father died In A similar manner, playing tennis. He was in great health, it was a terrible shock to our family and left me fatherless at a young age. Your father likely had a cardiac arrhythmia, it could be related to the Covid virus as it can settle on your heart. If there is no cause of death found at the autopsy it will fall under the category of sudden cardiac death. Resuscitation is not like in the movies and has a low likelihood of good outcomes especially in the field (outside of the hospital). Sometimes despite everyones best efforts people still pass, do not blame yourself or anyone else as these are just acts of nature or God.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Cardiac incidents are complicated. You mention that he had plaque (calsium deposit) in his heart, which can cause heart attacks, he might have been revived at first and then suffered another attack later causing him to pass away. Having plaques in the arteries of the heart is one of the main causes of heart attacks, and if a piece of this build up breaks off a blood cloth might form around it, blocking the blood flow to the heart starving it for oxygen which is a potentially life threatening condition.That's a question better fit for a Cardiologist, as an EMT it's a little outside my job description to know the fine details about the tests. I know they use duplex ultrasonography which is an imaging tool that uses sound waves to check the flow of blood in the veins. It can detect blood clots and blockages in the deep veins. But I'm not sure how much/little build up there has to be for it to detect it. They also use a blood screening called "D-dimer" which is a substance that is released when a blood clot breaks up. Again, I'm not sure how sensitive the test is.. ### Response: Im sorry this happened to you. My father died In A similar manner, playing tennis. He was in great health, it was a terrible shock to our family and left me fatherless at a young age. Your father likely had a cardiac arrhythmia, it could be related to the Covid virus as it can settle on your heart. If there is no cause of death found at the autopsy it will fall under the category of sudden cardiac death. Resuscitation is not like in the movies and has a low likelihood of good outcomes especially in the field (outside of the hospital). Sometimes despite everyones best efforts people still pass, do not blame yourself or anyone else as these are just acts of nature or God..


Instruction: I (22F) found out I have a pulmonary embolism on november 2nd. It is in the posterior basilar segmental pulmonary artery of the right lower lobe. Its acute (d-dimer at 1,170), I wasnt really concerned honestly. I have been in and out of hospitals my whole life (Im not very lucky when it comes to my health) and ive gotten to the point that I dont stress out whenever I get diagnosed with something new. The ER doctor suspects it was caused by my BCP (combined) along with post-covid stuff (I had covid in july/august of this year).I work as a phlebotomist and recently added an MA type position to my job role at a preventive cardiology office. So I am in the medical field but I dont know a lot about medical stuff - moreso just what I learn from patient situations and what I hear around the office.The first day back at work, a lot of co-workers were extremely concerned and worried about me, some said things like im so glad youre alive!. I appreciated all of the kind words from everyone but it got me a little nervous about how serious this is??Should I take this more seriously? And be more aware of my symptoms? I can take my vitals daily at work and do little things like that. I am so lucky that this happened while working at a cardiology office as the doctors there are keeping an eye on me and basically just told me to monitor my d-dimer at the office and refill my own prescription for eliquis etc etc. Obviously giving them the blood work results if there is anything concerning.The only thing I have changed in my life is that Im constantly wearing a mask in public as I really dont want to risk getting sick right now. When I started eliquis while I was in the 2 weeks of 10mg twice daily, I sneezed and got a nose bleed (I havent had a nose bleed in a good 10+ years so thats not normal for me), so I really dont want to be constantly coughing or sneezing. I used to try to wear a mask out in public whenever I remembered to bring a mask with me and I avoided large crowds as I am immunocompromised anyway, but I wasnt extremely strict with it. Ive also been wearing compression socks since I started this recent BCP.Should I be more careful in other places? Is this something I should be really worried about? I feel like Im doing enough but the comments I get whenever I mention my PE to someone kind of scare me.Medical info : 22 Female 5ft8 ~155lbs White. Diagnosed with psoriatic arthritis at age 2 (arthritis, psoriasis, and uveitis). PCOS, endometriosis, and a septate uterus (the main reason Im on BC). Hypermobility (probable EDS). Frequent concussions (recently got a referral to see a neurologist for this). Guillan-barr episode in October 2020 due to an insect bite on my neck. Paralyzed from the neck down, was in the ICU for a week for precautionary reasons but never needed a ventilator. GB isnt reoccurring and not on any medications for it. ADHD (along with depression and anxiety) and PTSD.Humira bi-weekly for uveitis. Eliquis 5mg twice daily. Falmina (BCP). Prazosin for PTSD (nightmares). Cymbalta for depression. Vyvanse for ADHD (not taking currently due to concussion and PE. Vyvanse makes me extremely tired and Im already tired from my PE so I dont want to make myself even more tired). Pred-forte eye drops for uveitis (SIG changes constantly, currently on twice daily in both eyes).Extremely light drinker (last drink I had was sometime in September). Occasional marijuana use for humira side effects and pain (~4 nights a month).

Output: PEs are like car wrecks. Some are horrible and kill you instantly, more often they are a semi big deal, and a lot of the time they happen and are lame but you werent really at risk of dying on the spot. But regardless, if you tell someone youre in a wreck theyll gasp and ask if you were ok.Sounds like you had a small subsegmental PE which as you said couldve been provoked by your medication. Take your eliquis which will prevent new clot formation and your old clot will dissolve with time

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I (22F) found out I have a pulmonary embolism on november 2nd. It is in the posterior basilar segmental pulmonary artery of the right lower lobe. Its acute (d-dimer at 1,170), I wasnt really concerned honestly. I have been in and out of hospitals my whole life (Im not very lucky when it comes to my health) and ive gotten to the point that I dont stress out whenever I get diagnosed with something new. The ER doctor suspects it was caused by my BCP (combined) along with post-covid stuff (I had covid in july/august of this year).I work as a phlebotomist and recently added an MA type position to my job role at a preventive cardiology office. So I am in the medical field but I dont know a lot about medical stuff - moreso just what I learn from patient situations and what I hear around the office.The first day back at work, a lot of co-workers were extremely concerned and worried about me, some said things like im so glad youre alive!. I appreciated all of the kind words from everyone but it got me a little nervous about how serious this is??Should I take this more seriously? And be more aware of my symptoms? I can take my vitals daily at work and do little things like that. I am so lucky that this happened while working at a cardiology office as the doctors there are keeping an eye on me and basically just told me to monitor my d-dimer at the office and refill my own prescription for eliquis etc etc. Obviously giving them the blood work results if there is anything concerning.The only thing I have changed in my life is that Im constantly wearing a mask in public as I really dont want to risk getting sick right now. When I started eliquis while I was in the 2 weeks of 10mg twice daily, I sneezed and got a nose bleed (I havent had a nose bleed in a good 10+ years so thats not normal for me), so I really dont want to be constantly coughing or sneezing. I used to try to wear a mask out in public whenever I remembered to bring a mask with me and I avoided large crowds as I am immunocompromised anyway, but I wasnt extremely strict with it. Ive also been wearing compression socks since I started this recent BCP.Should I be more careful in other places? Is this something I should be really worried about? I feel like Im doing enough but the comments I get whenever I mention my PE to someone kind of scare me.Medical info : 22 Female 5ft8 ~155lbs White. Diagnosed with psoriatic arthritis at age 2 (arthritis, psoriasis, and uveitis). PCOS, endometriosis, and a septate uterus (the main reason Im on BC). Hypermobility (probable EDS). Frequent concussions (recently got a referral to see a neurologist for this). Guillan-barr episode in October 2020 due to an insect bite on my neck. Paralyzed from the neck down, was in the ICU for a week for precautionary reasons but never needed a ventilator. GB isnt reoccurring and not on any medications for it. ADHD (along with depression and anxiety) and PTSD.Humira bi-weekly for uveitis. Eliquis 5mg twice daily. Falmina (BCP). Prazosin for PTSD (nightmares). Cymbalta for depression. Vyvanse for ADHD (not taking currently due to concussion and PE. Vyvanse makes me extremely tired and Im already tired from my PE so I dont want to make myself even more tired). Pred-forte eye drops for uveitis (SIG changes constantly, currently on twice daily in both eyes).Extremely light drinker (last drink I had was sometime in September). Occasional marijuana use for humira side effects and pain (~4 nights a month).. ### Response: PEs are like car wrecks. Some are horrible and kill you instantly, more often they are a semi big deal, and a lot of the time they happen and are lame but you werent really at risk of dying on the spot. But regardless, if you tell someone youre in a wreck theyll gasp and ask if you were ok.Sounds like you had a small subsegmental PE which as you said couldve been provoked by your medication. Take your eliquis which will prevent new clot formation and your old clot will dissolve with time.


Instruction: male/ 37 years old/ 230lbs/ 6 feet tall/ non-smokerI've had chest pain since my late-20s. For about 12 years, I've had high cholesterol due to a rather poor diet. My total cholesterol is "borderline" high according to the ranges, at around 230 mg/dL, my LDL is usually around 160 mg/dL and my HDL is around 50 mg/dL. My blood pressure is always pretty good at around 115/78.Due to the chest pain not going away, I was sent to a cardiologist who did a whole cardiology workout: echocardiogram, loop monitor, EKG and a calcium CT scoring test. Everything came back fine and my calcium score then was "Zero" , which the cardiologist said is a perfect exam.Since then, I've been diagnosed with a hiatal hernia and anxiety. I've started Zoloft, which has made my chest pain 85% better. I still get it at times, and my doctors are convinced it's my hiatal hernia creating pressure in my chest and/or pushing on my vagus nerve.Fast forward 6-7 years to today, I just really started getting my diet in gear about 2 weeks ago but just at that time before I started, I wanted to get a baseline blood work to compare. My cholesterol was the same as it usually was for the last 12 years but my primary care physician said my C Reactive Protein is 5.5 mg/L , whereas when I had it drawn years ago , it was around 3.0 mg/L. He said "you really need to focus on lowering your cholesterol. That CRP could be due to your arteries starting to narrow and atherosclerosis starting to happen.". Would the calcium score test from 6 years ago change that much in that time?I am not "fat" and have really wide shoulders so I carry my weight differently but I know I should definitely lose weight and eat better, which I definitely have been. Hearing that my CRP is now high, I am worried that there is now narrowing in my heart. Should I go back to my cardiologist and see if I can have a repeat calcium scoring test or even a CTCA?

Output: More than anything you need treatment for your cholesterol. Are you on a statin? Poor diet does not by itself lead to an LDL of 160 in a 37 year old.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: male/ 37 years old/ 230lbs/ 6 feet tall/ non-smokerI've had chest pain since my late-20s. For about 12 years, I've had high cholesterol due to a rather poor diet. My total cholesterol is "borderline" high according to the ranges, at around 230 mg/dL, my LDL is usually around 160 mg/dL and my HDL is around 50 mg/dL. My blood pressure is always pretty good at around 115/78.Due to the chest pain not going away, I was sent to a cardiologist who did a whole cardiology workout: echocardiogram, loop monitor, EKG and a calcium CT scoring test. Everything came back fine and my calcium score then was "Zero" , which the cardiologist said is a perfect exam.Since then, I've been diagnosed with a hiatal hernia and anxiety. I've started Zoloft, which has made my chest pain 85% better. I still get it at times, and my doctors are convinced it's my hiatal hernia creating pressure in my chest and/or pushing on my vagus nerve.Fast forward 6-7 years to today, I just really started getting my diet in gear about 2 weeks ago but just at that time before I started, I wanted to get a baseline blood work to compare. My cholesterol was the same as it usually was for the last 12 years but my primary care physician said my C Reactive Protein is 5.5 mg/L , whereas when I had it drawn years ago , it was around 3.0 mg/L. He said "you really need to focus on lowering your cholesterol. That CRP could be due to your arteries starting to narrow and atherosclerosis starting to happen.". Would the calcium score test from 6 years ago change that much in that time?I am not "fat" and have really wide shoulders so I carry my weight differently but I know I should definitely lose weight and eat better, which I definitely have been. Hearing that my CRP is now high, I am worried that there is now narrowing in my heart. Should I go back to my cardiologist and see if I can have a repeat calcium scoring test or even a CTCA?. ### Response: More than anything you need treatment for your cholesterol. Are you on a statin? Poor diet does not by itself lead to an LDL of 160 in a 37 year old..


Instruction: thank you. I am not on a statin. My doctor said given the fact that I got my LDL down to 118 a few years ago when I tried eating more fish (salmon), he said I can do try the diet route again if I stick to it. He also knows I don't exercise much due to the pressure I feel from the hiatal hernia.

Output: It is worth considering. While you are young your elevated lipids and hsCRP are enough to at least consider it

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: thank you. I am not on a statin. My doctor said given the fact that I got my LDL down to 118 a few years ago when I tried eating more fish (salmon), he said I can do try the diet route again if I stick to it. He also knows I don't exercise much due to the pressure I feel from the hiatal hernia.. ### Response: It is worth considering. While you are young your elevated lipids and hsCRP are enough to at least consider it.


Instruction: 79M approx.. 6 195 lbs. asthma (we have no idea what meds he is on or prescribed at ER)My FIL (79M) was taken via ambulance to a small local community hospital on Tuesday and diagnosed in the ER with having had a TIA due to Afib. Heart issues is something that was unknown to them previously so he was not previously on any meds for that. My husband got up there in time to interact with the doctor at discharge and specifically heard the doctor tell FIL and MIL that he needed to take the meds he was being prescribed and see cardiology and neurology as soon as possible. This was a small local community hospital outside of San Diego but they are in an area with a large senior population where they probably see this a lot. My husband felt the instructions were clear and relayed succinctly.Because my own father has a long and fantastic experience with both cardiology and neurology at the large very well respected university medical center my husband asked me if I could make appointments for his father there as we figured inlaws were overwhelmed among other issues. I was surprisingly able to secure him appointments for this Monday and Tuesday respectively (6 days post ER visit). Husband told MIL that evening that appointments were secured for FIL at the university hospital.Now today my husband learns that MIL took FIL to their GP yesterday (day after he was released and before specialist visits) to their GP (whom my husband refers to as Dr. Quack due to his negligent care of his aunt resulting in her subsequent death due to melanoma so we may be biased here and this is why we are asking) told him he didnt need coumadin that he was just stressed and he just needed some Xanax to relax. So FIL told my husband today that he stopped the meds that ER doc overprescribed and am just taking the Xanax. I FEEL GREAT! FTR we have no idea what the other meds were and now they wont tell us.MIL is exploding at my husband and accusing him of a lot of wildly ridiculous things and FIL is trying to keep the peace and just shutting down. As a bit of background there are A LOT of issues with MIL and her behavior and this is pretty standard. Husbands basic rule is that we just need to prevent her from harming others and just tune her out otherwise. So our question is will this change of meds harm FIL and husband needs to intervene more strongly or is this something standard? TIATLDR: is it medically acceptable for a GP to remove someone from blood thinner (Coumadin?) less than 48 hours after a TIA and replace with Xanax even before they have seen cardiology or neurology?Edited to clarify timing

Output: Everything here is just odd. No way of knowing what's what without the hospital records. Please be sure to take them with you to the neurologist and cardiologist.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 79M approx.. 6 195 lbs. asthma (we have no idea what meds he is on or prescribed at ER)My FIL (79M) was taken via ambulance to a small local community hospital on Tuesday and diagnosed in the ER with having had a TIA due to Afib. Heart issues is something that was unknown to them previously so he was not previously on any meds for that. My husband got up there in time to interact with the doctor at discharge and specifically heard the doctor tell FIL and MIL that he needed to take the meds he was being prescribed and see cardiology and neurology as soon as possible. This was a small local community hospital outside of San Diego but they are in an area with a large senior population where they probably see this a lot. My husband felt the instructions were clear and relayed succinctly.Because my own father has a long and fantastic experience with both cardiology and neurology at the large very well respected university medical center my husband asked me if I could make appointments for his father there as we figured inlaws were overwhelmed among other issues. I was surprisingly able to secure him appointments for this Monday and Tuesday respectively (6 days post ER visit). Husband told MIL that evening that appointments were secured for FIL at the university hospital.Now today my husband learns that MIL took FIL to their GP yesterday (day after he was released and before specialist visits) to their GP (whom my husband refers to as Dr. Quack due to his negligent care of his aunt resulting in her subsequent death due to melanoma so we may be biased here and this is why we are asking) told him he didnt need coumadin that he was just stressed and he just needed some Xanax to relax. So FIL told my husband today that he stopped the meds that ER doc overprescribed and am just taking the Xanax. I FEEL GREAT! FTR we have no idea what the other meds were and now they wont tell us.MIL is exploding at my husband and accusing him of a lot of wildly ridiculous things and FIL is trying to keep the peace and just shutting down. As a bit of background there are A LOT of issues with MIL and her behavior and this is pretty standard. Husbands basic rule is that we just need to prevent her from harming others and just tune her out otherwise. So our question is will this change of meds harm FIL and husband needs to intervene more strongly or is this something standard? TIATLDR: is it medically acceptable for a GP to remove someone from blood thinner (Coumadin?) less than 48 hours after a TIA and replace with Xanax even before they have seen cardiology or neurology?Edited to clarify timing. ### Response: Everything here is just odd. No way of knowing what's what without the hospital records. Please be sure to take them with you to the neurologist and cardiologist..


Instruction: Thank you for responding. Right now they are saying he is not going to cardiology and neurology because GP told him he doesn't need it. (again husband and I do NOT trust this GP and believe the ER). Husband had me call the university and make sure the appointments cannot be cancelled unless they call my husband's number. Our question is will he be fine like this until Monday or should husband intervene with the nuclear option and go collect FIL when MIL is out and take him to urgent care?

Output: Unless FIL is cognitively incompetent, they should be able to make their own decisions. They have all the information from the ER and GP to go on. This is a complicated situation and your question is not answerable without more detailed/nuanced information and discussion of pros/cons. Being on Coumadin is either a necessity or a huge liability (quite often both) depending on factors we do not know here on Reddit.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you for responding. Right now they are saying he is not going to cardiology and neurology because GP told him he doesn't need it. (again husband and I do NOT trust this GP and believe the ER). Husband had me call the university and make sure the appointments cannot be cancelled unless they call my husband's number. Our question is will he be fine like this until Monday or should husband intervene with the nuclear option and go collect FIL when MIL is out and take him to urgent care?. ### Response: Unless FIL is cognitively incompetent, they should be able to make their own decisions. They have all the information from the ER and GP to go on. This is a complicated situation and your question is not answerable without more detailed/nuanced information and discussion of pros/cons. Being on Coumadin is either a necessity or a huge liability (quite often both) depending on factors we do not know here on Reddit..


Instruction: 34 female 5'9" 230lbsNon drinker, light smoker but almost completely quit since the heart problems started. Had covid 6 weeks ago with no complications. No history of heart problems or high BP.It started less than 2 weeks ago with drops and spikes ranging from 90/60 to 180/110Now it's sustained high BP and elevated HR. I did go to the ER Monday just to make sure it wasn't something acute as there is accompanying chest pain but the entire time I was at the ER my BP was very low as was my HR.I have a cardiology appointment next Friday but every day since Monday I've been waking up with systolic in the 150s. I feel physically panicked all the time and it's starting to affect my sleep. I've already doubled my propranolol from 40 to 80, I take klonopin and prazosin daily as well, and I've added clonidine and antihistamines to also try to keep it lowered. Even taking all of those at once it barely makes a difference.I have a good life right now i can't think of any stressors other than being in love, but I feel like I can't do anything or be there for anyone because my body is fucking panicking 24-7 nowI can't do this much longer. It's obviously not an emergency but I feel awful not at all being in control of my body. It's like something flipped the fight or flight switch and it's stuck on high. This does not reflect my mental state at all.

Output: How regularly are you taking the clonidine? That frequently causes rebound hypertension.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 34 female 5'9" 230lbsNon drinker, light smoker but almost completely quit since the heart problems started. Had covid 6 weeks ago with no complications. No history of heart problems or high BP.It started less than 2 weeks ago with drops and spikes ranging from 90/60 to 180/110Now it's sustained high BP and elevated HR. I did go to the ER Monday just to make sure it wasn't something acute as there is accompanying chest pain but the entire time I was at the ER my BP was very low as was my HR.I have a cardiology appointment next Friday but every day since Monday I've been waking up with systolic in the 150s. I feel physically panicked all the time and it's starting to affect my sleep. I've already doubled my propranolol from 40 to 80, I take klonopin and prazosin daily as well, and I've added clonidine and antihistamines to also try to keep it lowered. Even taking all of those at once it barely makes a difference.I have a good life right now i can't think of any stressors other than being in love, but I feel like I can't do anything or be there for anyone because my body is fucking panicking 24-7 nowI can't do this much longer. It's obviously not an emergency but I feel awful not at all being in control of my body. It's like something flipped the fight or flight switch and it's stuck on high. This does not reflect my mental state at all.. ### Response: How regularly are you taking the clonidine? That frequently causes rebound hypertension..


Instruction: Age: 8Height/weight: Average, not sure exactly but last i was told, she's within normal rangeFemaleCaucasian/ HispanicNo previous medical history, no prior surgeriesnon-smoking householdWe all had covid in December 26th. It was rough but we all recovered. Me and my husband were vaccinated. My kids weren't because their clinic wasn't providing the vaccines yet.I'm going to try to be thorough as possible because it's just so much going on with her and i don't know where to start and her symptoms are all over the place... Last summer she was in someone's house that had a rabbit. The rabbit was filthy and it scratched the top part of her hand. Her hand began looking infected because even though i washed it and put neosporin on it, kids are kids and she couldn't keep it clean and soon it began looking red. She got a fever roughly around that time and was complaining of headaches and that her "throat feels tight". I took her to her clinic and they drew blood to test her for "rabbit scratch fever" It came back negative..They figured she just caught a virus and nothing became of it. The scratch eventually healed with an ointment they gave her. That same summer she..again...being a kid, didn't listen to me and was rolling in grass in her grandmother's yard which we have found ticks in. She ended up with a tick in her head which by the time we noticed it amongst her hair was engorged. I pried it off her. My daughter again, began complaining of headaches and her body hurting, "tight" throat. I took her to the ER and had her get tested for lyme disease it came back negative..It's now almost a year later and her headaches "tight throat" and body pain just come and go sporadically. I would chalk it up to growing pains which is what everyone was telling me. Her doctor never seems concerned...But sometimes the headaches are so intense she will cry and lay down and ask for a cold towel for her head...she's 8. And now on top of it all she's got new symptoms. She came to me about a week ago saying her butt felt weird like it had "dots". I tell her to show me and all over her butt and upper thigh area she is covered in what look to be pimples. Its so odd. My mind automatically went to "bed bugs!" So i checked the beds from top to bottom but found nothing. She still has trouble sleeping some nights and comes to sleep on our bed so if it was bed bugs why is she the only one with the dots? I'm checking her daily and it's as if she's got a new "pimple" everyday...again, she's 8...wth..Another new symptom she has is she's been getting heart palpitations. One minute she's playing on the floor or on the sofa, and the next she will come to me saying her heart is beating rapidly. I put my head on her heart and i feel her heart beating quickly. It scares her and i have to scoop her up and hold her for a while. She has also started hypervenilating when she's upset. Something she's NEVER done in her life. We aren't strict with her and she's a happy child, why would she start doing that? She says she can't help it.I took her to her doctor roughly two-three weeks ago because i had enough, i told her doctor everything from the summer to now. From the body pain to the heart pain and showed him her butt pimples and asked him to please help because we are at our wits end. He checked her out and said her heart sounds fine to him. He also was dismissive towards her skin problem. He did however notice the lymph nodes around her neck were really swollen. He ordered her to get blood work done and it came back last week. She has covid anti-bodies in her blood. She tested negative again for lyme (im guessing he just wanted to double check in case the other one was a false negative) and showed what he thinks might be her in "Recovering" state of cat scratch fever? ...ok? We have cats so i guess that's possible. He sounded so unsure with himself. Sighing a lot and kept going "eh...i don't really know what to tell you..." and stumped with her blood work. He sent her a prescription for Azithromycin just to be safe. She has to take this every day after dinner.Thing is, she's still complaining about her various symptoms. And it's been days since she got the medicine and now she's more frequently telling me her hearts beating quickly. So im afraid to continue giving her the medicine in case that's whats causing the palpitations. I have sent various messages to her doctor two days ago but he isn't calling me back. I'm tired of waiting for him and already went ahead and made her an appointment for both pediatric cardiology and dermatology. I also found a new pediatrician because i've had it with this guy. Both appointments are next week. But until then i'm just a bundle of nerves. I hate when she comes to me saying her heart hurts or her head hurts. Can anyone here please tell me whats wrong with my baby girl?Edit: were at the ER now. She started complaining of heart pain and palpitations and Im done waiting. Will update depending on what they say

Output: Time for a new doctor. Its not typical for 8 year olds to get heart palpitations

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Age: 8Height/weight: Average, not sure exactly but last i was told, she's within normal rangeFemaleCaucasian/ HispanicNo previous medical history, no prior surgeriesnon-smoking householdWe all had covid in December 26th. It was rough but we all recovered. Me and my husband were vaccinated. My kids weren't because their clinic wasn't providing the vaccines yet.I'm going to try to be thorough as possible because it's just so much going on with her and i don't know where to start and her symptoms are all over the place... Last summer she was in someone's house that had a rabbit. The rabbit was filthy and it scratched the top part of her hand. Her hand began looking infected because even though i washed it and put neosporin on it, kids are kids and she couldn't keep it clean and soon it began looking red. She got a fever roughly around that time and was complaining of headaches and that her "throat feels tight". I took her to her clinic and they drew blood to test her for "rabbit scratch fever" It came back negative..They figured she just caught a virus and nothing became of it. The scratch eventually healed with an ointment they gave her. That same summer she..again...being a kid, didn't listen to me and was rolling in grass in her grandmother's yard which we have found ticks in. She ended up with a tick in her head which by the time we noticed it amongst her hair was engorged. I pried it off her. My daughter again, began complaining of headaches and her body hurting, "tight" throat. I took her to the ER and had her get tested for lyme disease it came back negative..It's now almost a year later and her headaches "tight throat" and body pain just come and go sporadically. I would chalk it up to growing pains which is what everyone was telling me. Her doctor never seems concerned...But sometimes the headaches are so intense she will cry and lay down and ask for a cold towel for her head...she's 8. And now on top of it all she's got new symptoms. She came to me about a week ago saying her butt felt weird like it had "dots". I tell her to show me and all over her butt and upper thigh area she is covered in what look to be pimples. Its so odd. My mind automatically went to "bed bugs!" So i checked the beds from top to bottom but found nothing. She still has trouble sleeping some nights and comes to sleep on our bed so if it was bed bugs why is she the only one with the dots? I'm checking her daily and it's as if she's got a new "pimple" everyday...again, she's 8...wth..Another new symptom she has is she's been getting heart palpitations. One minute she's playing on the floor or on the sofa, and the next she will come to me saying her heart is beating rapidly. I put my head on her heart and i feel her heart beating quickly. It scares her and i have to scoop her up and hold her for a while. She has also started hypervenilating when she's upset. Something she's NEVER done in her life. We aren't strict with her and she's a happy child, why would she start doing that? She says she can't help it.I took her to her doctor roughly two-three weeks ago because i had enough, i told her doctor everything from the summer to now. From the body pain to the heart pain and showed him her butt pimples and asked him to please help because we are at our wits end. He checked her out and said her heart sounds fine to him. He also was dismissive towards her skin problem. He did however notice the lymph nodes around her neck were really swollen. He ordered her to get blood work done and it came back last week. She has covid anti-bodies in her blood. She tested negative again for lyme (im guessing he just wanted to double check in case the other one was a false negative) and showed what he thinks might be her in "Recovering" state of cat scratch fever? ...ok? We have cats so i guess that's possible. He sounded so unsure with himself. Sighing a lot and kept going "eh...i don't really know what to tell you..." and stumped with her blood work. He sent her a prescription for Azithromycin just to be safe. She has to take this every day after dinner.Thing is, she's still complaining about her various symptoms. And it's been days since she got the medicine and now she's more frequently telling me her hearts beating quickly. So im afraid to continue giving her the medicine in case that's whats causing the palpitations. I have sent various messages to her doctor two days ago but he isn't calling me back. I'm tired of waiting for him and already went ahead and made her an appointment for both pediatric cardiology and dermatology. I also found a new pediatrician because i've had it with this guy. Both appointments are next week. But until then i'm just a bundle of nerves. I hate when she comes to me saying her heart hurts or her head hurts. Can anyone here please tell me whats wrong with my baby girl?Edit: were at the ER now. She started complaining of heart pain and palpitations and Im done waiting. Will update depending on what they say. ### Response: Time for a new doctor. Its not typical for 8 year olds to get heart palpitations.


Instruction: Yes, but I was just told by a pediatric cardiologist that this is happening with children who had Covid and were t vaccinated. Im going through similar with my 8 year old.Edit: werent vaccinated, not were.The reason I stated what I did and kind of barged in here to comment was just to bring light to this issue.Theyre monitoring her for now. They had to her a holter monitor for a few days, then some testing. She was fainting and her lips were turning blue when she would have her palpitations. I also have them and get dizzy but never blue finger tips or blue lips.I hope all ends up okay. I know how scary this is for both of you.

Output: How long does it last? If it lasts 15+ minutes, it might be worth your peace of mind to get her on a monitor in the ER. If its only a few minutes then she probably needs a holter monitor or evaluation with a pediatric cardiologist.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yes, but I was just told by a pediatric cardiologist that this is happening with children who had Covid and were t vaccinated. Im going through similar with my 8 year old.Edit: werent vaccinated, not were.The reason I stated what I did and kind of barged in here to comment was just to bring light to this issue.Theyre monitoring her for now. They had to her a holter monitor for a few days, then some testing. She was fainting and her lips were turning blue when she would have her palpitations. I also have them and get dizzy but never blue finger tips or blue lips.I hope all ends up okay. I know how scary this is for both of you.. ### Response: How long does it last? If it lasts 15+ minutes, it might be worth your peace of mind to get her on a monitor in the ER. If its only a few minutes then she probably needs a holter monitor or evaluation with a pediatric cardiologist..


Instruction: 29F, non-smoker with history of NSVT. Diagnosed in 2011. NSVT was then changed to PSVT in patient records without my knowledge until recently.Diagnosis would present with palps, lightheadedness and tunnel vision. It occurs randomly with no clear trigger.I had a new holter applied for rapid pounding heart with dizziness and angina.Holter findings were reported normal with low burden PVC and sinus tachycardia. (sinus tachycardia is expected culprit for rapid heart and associated symptoms)However, VT was also noted?https://imgur.com/a/S2rMmmEThe comment states AIVR. And Im just curious if this is actually AIVR or PSVT? Or something else entirely.I do have an appointment with Cardiology in a few weeks.

Output: Characterized as AIVR because rate is <110 with widened QRS.PSVT is usually in the setting of tachycardia so rate goes from normal to very high. Had a few more beats (like those shown) at a faster rate happened, it may have been called PSVT.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 29F, non-smoker with history of NSVT. Diagnosed in 2011. NSVT was then changed to PSVT in patient records without my knowledge until recently.Diagnosis would present with palps, lightheadedness and tunnel vision. It occurs randomly with no clear trigger.I had a new holter applied for rapid pounding heart with dizziness and angina.Holter findings were reported normal with low burden PVC and sinus tachycardia. (sinus tachycardia is expected culprit for rapid heart and associated symptoms)However, VT was also noted?https://imgur.com/a/S2rMmmEThe comment states AIVR. And Im just curious if this is actually AIVR or PSVT? Or something else entirely.I do have an appointment with Cardiology in a few weeks.. ### Response: Characterized as AIVR because rate is <110 with widened QRS.PSVT is usually in the setting of tachycardia so rate goes from normal to very high. Had a few more beats (like those shown) at a faster rate happened, it may have been called PSVT..


Instruction: That makes sense, thank you!Do you know if PSVT and AIVR have a habit of appearing hand in hand?

Output: Not typically. My best guess is this was a small run of soon to be PVST that corrected before becoming tachycardic.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: That makes sense, thank you!Do you know if PSVT and AIVR have a habit of appearing hand in hand?. ### Response: Not typically. My best guess is this was a small run of soon to be PVST that corrected before becoming tachycardic..


Instruction: 29M 62 181lbs Hypertension (20mg olmesartan qd) and recently recovered from mild COVID infection, otherwise no significant medical hx. I do also take melatonin nightly and use an occasional ginger root supplement.I was on a beach trip over the weekend and we stopped to grab some brunch around 10am before my girlfriend and I drove back home. I drank a cup of coffee at brunch, and felt a skipped beat kind of feeling, so I took an Apple Watch ECG. To my surprise, I noticed that I was popping anywhere from 2-10 PVCs/minute, which I have no history of.I rode it out on the way home and tried to forget about it. I took a few more random Apple Watch ECGs, and the frequent PVCs have been consistent all day. Finally a little after we got home, I decided to go to urgent care just to get seen. They did an ECG, which didnt capture any PVCs on the 10 second strip of lead II. But the NP said she auscultated a few after they took the ECG. Confirmed on my Apple Watch theyre still happening.The NP basically told me shed give me a cardiology referral and to do nothing in the meantime, but to go to the ER immediately if I started having any chest pain or SOB. She basically said that there was nothing she could do in the urgent care setting and that I need a further cardiology work up.Is this solid advice? Am I safe? Or do I need to go to the ER? Besides the initial skipped beat feeling, I havent been symptomatic at all.I will also say, I had a good bit of alcohol this weekend, more so than usual. Could it be alcohol and caffeine?12 lead ECG from urgent careApple Watch strip with PVCs

Output: Yup wait to follow up with cardiologist. ER if SOB or chest pain. Caffeine and alcohol can certainly contribute

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 29M 62 181lbs Hypertension (20mg olmesartan qd) and recently recovered from mild COVID infection, otherwise no significant medical hx. I do also take melatonin nightly and use an occasional ginger root supplement.I was on a beach trip over the weekend and we stopped to grab some brunch around 10am before my girlfriend and I drove back home. I drank a cup of coffee at brunch, and felt a skipped beat kind of feeling, so I took an Apple Watch ECG. To my surprise, I noticed that I was popping anywhere from 2-10 PVCs/minute, which I have no history of.I rode it out on the way home and tried to forget about it. I took a few more random Apple Watch ECGs, and the frequent PVCs have been consistent all day. Finally a little after we got home, I decided to go to urgent care just to get seen. They did an ECG, which didnt capture any PVCs on the 10 second strip of lead II. But the NP said she auscultated a few after they took the ECG. Confirmed on my Apple Watch theyre still happening.The NP basically told me shed give me a cardiology referral and to do nothing in the meantime, but to go to the ER immediately if I started having any chest pain or SOB. She basically said that there was nothing she could do in the urgent care setting and that I need a further cardiology work up.Is this solid advice? Am I safe? Or do I need to go to the ER? Besides the initial skipped beat feeling, I havent been symptomatic at all.I will also say, I had a good bit of alcohol this weekend, more so than usual. Could it be alcohol and caffeine?12 lead ECG from urgent careApple Watch strip with PVCs. ### Response: Yup wait to follow up with cardiologist. ER if SOB or chest pain. Caffeine and alcohol can certainly contribute.


Instruction: 40M 5'8 160 pounds. As part of my team of doctors (3 cardiologists, primary care doc, endocrinologist, neurologist, etc.), we've been hunting down some autonomic issues that I have been having. I haven't had blood work in a couple of years because I have been pending Disability since last year and had a work injury the year before that. My autonomic issues worsened over that time.If TLDR, can a Cardiology office request the same type/amount of blood work as a primary care doc, for instance?I don't have a primary care doctor presently because I had a good one and he moved away back to his home state a while ago. Most primary care doctors are unfamiliar with specific autonomic dysfunction conditions, so my third cardiologist is the specialist in autonomic issues. They want to do blood work. Of course, I'm asking their office what kind of blood work they can do, as well. But since it may be days before they can get around to that general question, this is a two-part question:I'm wondering if any doc can explain the difference between which offices (primary care, cardiology, endocrinology, etc.) can do what types of blood work and if they are 'limited' in what types they can request.Also, is that that limitation solely based on the provider themselves being medically unable to request beyond specific blood work related to their specialty or is it just because they're not familiar with other blood values? For instance, I asked my neurologist one time about blood work values from a cardiology tilt table test and he said he "didn't know how to read those blood gas levels". So that told me that of course that's not his specialty, and I knew that, but he was the one who asked about blood work to begin with.

Output: Any doctor can order any kind of blood work, but the limitation as you've found is the ability to properly interpret it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 40M 5'8 160 pounds. As part of my team of doctors (3 cardiologists, primary care doc, endocrinologist, neurologist, etc.), we've been hunting down some autonomic issues that I have been having. I haven't had blood work in a couple of years because I have been pending Disability since last year and had a work injury the year before that. My autonomic issues worsened over that time.If TLDR, can a Cardiology office request the same type/amount of blood work as a primary care doc, for instance?I don't have a primary care doctor presently because I had a good one and he moved away back to his home state a while ago. Most primary care doctors are unfamiliar with specific autonomic dysfunction conditions, so my third cardiologist is the specialist in autonomic issues. They want to do blood work. Of course, I'm asking their office what kind of blood work they can do, as well. But since it may be days before they can get around to that general question, this is a two-part question:I'm wondering if any doc can explain the difference between which offices (primary care, cardiology, endocrinology, etc.) can do what types of blood work and if they are 'limited' in what types they can request.Also, is that that limitation solely based on the provider themselves being medically unable to request beyond specific blood work related to their specialty or is it just because they're not familiar with other blood values? For instance, I asked my neurologist one time about blood work values from a cardiology tilt table test and he said he "didn't know how to read those blood gas levels". So that told me that of course that's not his specialty, and I knew that, but he was the one who asked about blood work to begin with.. ### Response: Any doctor can order any kind of blood work, but the limitation as you've found is the ability to properly interpret it..


Instruction: Im 20F with a long standing family history of heart failure. Ive had intermittent chest pains due to chronic Tachycardia but last night it was unbearable and I went to the ER because I thought I might be having a heart attack. I waited approximately 2 hours after initial onset to leave work bc another manager needed to be present. My mistake but I eventually shut down the store out of fear and went. My ECG was flagged abnormal for nonspecific T wave abnormalities on the inferior leads. But thats always on my ECG. However the hr recorded was 72. My avg resting hr is 98. Could I have had a cardiac event that ended before I got to the hospital? negative D Dimer low average Lactase and high PT (12) and PTT (54) INR 1.1. Chest X Ray clear. Should I push for a cardiology referral given family history? or was it likely a fluke?

Output: >Should I push for a cardiology referral given family history?No, they would probably decline the referral given your normal investigations.>Could I have had a cardiac event that ended before I got to the hospital?Incredibly unlikely.Also:>Ive had intermittent chest pains due to chronic TachycardiaI doubt these two things are related.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Im 20F with a long standing family history of heart failure. Ive had intermittent chest pains due to chronic Tachycardia but last night it was unbearable and I went to the ER because I thought I might be having a heart attack. I waited approximately 2 hours after initial onset to leave work bc another manager needed to be present. My mistake but I eventually shut down the store out of fear and went. My ECG was flagged abnormal for nonspecific T wave abnormalities on the inferior leads. But thats always on my ECG. However the hr recorded was 72. My avg resting hr is 98. Could I have had a cardiac event that ended before I got to the hospital? negative D Dimer low average Lactase and high PT (12) and PTT (54) INR 1.1. Chest X Ray clear. Should I push for a cardiology referral given family history? or was it likely a fluke?. ### Response: >Should I push for a cardiology referral given family history?No, they would probably decline the referral given your normal investigations.>Could I have had a cardiac event that ended before I got to the hospital?Incredibly unlikely.Also:>Ive had intermittent chest pains due to chronic TachycardiaI doubt these two things are related..


Instruction: 34, male, 5'9", 260lbsnon-smoker, rarely consumes alcohol (1 or 2 a month, if at all), tried a friend's THC vape once, no other recreational drug use.medications: effexor 150mg, concerta 54mg, advair 2 puffs daily, albuterol rescue inhaler as neededhealth conditions: anxiety, depression, ADHD, moderate asthma (all very well controlled on current meds)medical history: knee surgery 2012, initial 2 COVID vaccines March and April 2021 + booster November 2012, had COVID February 2022.Background of Current IssueHad a mild case of COVID-19 in February. Main symptoms were swollen lymph nodes on the left side on my neck and armpit and frequent heart palpitations.Symptoms went away until April, when I started having sudden heart palpitations randomly throughout the day. When the palpitations end, my the same neck and armpit lymph nodes swell up painfully for several hours.Symptoms got bad enough that I thought I was dying and went to the ER. Not dying, just something that can happen post-covid. Minor abnormalities on ECG, Doctor explained why they weren't concerning in my case.After a couple months of reducing caffeine intake as much as possible ( about 2 cups of coffee before work, no more canned coffees or caffeinated tea at work), it seemed to have gone away.About two days ago, it came back. Didn't recognize the symptoms for what they were and went to the ER again. Slightly different abnormal but not concerning ECG. Blood pressure was high, went back down to normal by the time I was discharged. Negative COVID-19 test. Same left side lymph nodes painfully swollen.My Question for AskDocs:I plan to see a cardiologist about the heart palpitations since they have been so frequent after coming back.Is there any other specialty that might be able to help me? Or would making sure my heart is okay be enough?

Output: Cardiology will handle the palpitations.Without seeing your ekgs I can't tell you much more. There are many causes of palpitations, if the ER discharged you then the palpitations we're probably due to PACs or PVCs which can be treated by your PCP or cardiologist to reduce your symptoms, but like I said, can't say much more without the ekgs or more info.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 34, male, 5'9", 260lbsnon-smoker, rarely consumes alcohol (1 or 2 a month, if at all), tried a friend's THC vape once, no other recreational drug use.medications: effexor 150mg, concerta 54mg, advair 2 puffs daily, albuterol rescue inhaler as neededhealth conditions: anxiety, depression, ADHD, moderate asthma (all very well controlled on current meds)medical history: knee surgery 2012, initial 2 COVID vaccines March and April 2021 + booster November 2012, had COVID February 2022.Background of Current IssueHad a mild case of COVID-19 in February. Main symptoms were swollen lymph nodes on the left side on my neck and armpit and frequent heart palpitations.Symptoms went away until April, when I started having sudden heart palpitations randomly throughout the day. When the palpitations end, my the same neck and armpit lymph nodes swell up painfully for several hours.Symptoms got bad enough that I thought I was dying and went to the ER. Not dying, just something that can happen post-covid. Minor abnormalities on ECG, Doctor explained why they weren't concerning in my case.After a couple months of reducing caffeine intake as much as possible ( about 2 cups of coffee before work, no more canned coffees or caffeinated tea at work), it seemed to have gone away.About two days ago, it came back. Didn't recognize the symptoms for what they were and went to the ER again. Slightly different abnormal but not concerning ECG. Blood pressure was high, went back down to normal by the time I was discharged. Negative COVID-19 test. Same left side lymph nodes painfully swollen.My Question for AskDocs:I plan to see a cardiologist about the heart palpitations since they have been so frequent after coming back.Is there any other specialty that might be able to help me? Or would making sure my heart is okay be enough?. ### Response: Cardiology will handle the palpitations.Without seeing your ekgs I can't tell you much more. There are many causes of palpitations, if the ER discharged you then the palpitations we're probably due to PACs or PVCs which can be treated by your PCP or cardiologist to reduce your symptoms, but like I said, can't say much more without the ekgs or more info..


Instruction: Age: 21. Weight: 160. Gender: male. Height: 5'7". Diagnosed with asthma.I had a cardiology appointment today. I was told that I had a heart murmur and I had a bunch of tests scheduled..the soonest being A WEEK OUT. With my echo being months out. Seems like a heart murmur could easily kill me. What's up.

Output: Many heart murmurs are caused by non-life threatening things. Unless you are having signs or symptoms of life threatening things (passing out, chest pain, severe shortness of breath, etc) doctors will investigate things in an outpatient setting. For example, most cancer work ups (arguably more life-threatening) are done in an outpatient setting.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Age: 21. Weight: 160. Gender: male. Height: 5'7". Diagnosed with asthma.I had a cardiology appointment today. I was told that I had a heart murmur and I had a bunch of tests scheduled..the soonest being A WEEK OUT. With my echo being months out. Seems like a heart murmur could easily kill me. What's up.. ### Response: Many heart murmurs are caused by non-life threatening things. Unless you are having signs or symptoms of life threatening things (passing out, chest pain, severe shortness of breath, etc) doctors will investigate things in an outpatient setting. For example, most cancer work ups (arguably more life-threatening) are done in an outpatient setting..


Instruction: Mandatory info: 30M, 6'3", 185lbs, white, near syncope with heart pains for the past week, EKG abnormality. Don't smoke or use any recreational drugs, have used Ambien (5-10mg) to treat insomnia intermittently for the past 3 years. No preexisting conditions.Last week I had back-to-back instances of severe chest pain, followed by a hot flash / sweating and dizziness that persisted for about 60s. This occurred at the airport, and resulted in me getting transferred to the ED for evaluation. Paramedics conducted a few EKGs, and I heard them say there appeared something anomalous with "B3". At the ED, had an additional EKG, chest x-ray, and ultrasound with no acute findings. No bloodwork done. Cleared to fly, completed my work travel, returned home with a PCP appointment scheduled for this morning. The intermittent pain / palpitations / weakness / dizziness has persisted since the first episode.At PCP visit today, another EKG was done and compared to my past EKGs done at that office. My primary found an anomaly in Lead 3 (which I assume is what I misheard the medics identify), and ordered bloodwork (troponin and lipid panel, amongst others). Gave me an urgent referral for cardiology, wants me to get a Holter monitor and stress test at a minimum.My question for all you wonderful people: what is the pathophysiology that leads to an anomalous Lead 3 finding on an EKG? How worried should I be?

Output: Impossible to say without seeing the ECG and exploring. Lead 3 (in conjunction with others) corresponds to the inferior portion of the heart. But there are many things that could be showing in this lead on your ECG.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Mandatory info: 30M, 6'3", 185lbs, white, near syncope with heart pains for the past week, EKG abnormality. Don't smoke or use any recreational drugs, have used Ambien (5-10mg) to treat insomnia intermittently for the past 3 years. No preexisting conditions.Last week I had back-to-back instances of severe chest pain, followed by a hot flash / sweating and dizziness that persisted for about 60s. This occurred at the airport, and resulted in me getting transferred to the ED for evaluation. Paramedics conducted a few EKGs, and I heard them say there appeared something anomalous with "B3". At the ED, had an additional EKG, chest x-ray, and ultrasound with no acute findings. No bloodwork done. Cleared to fly, completed my work travel, returned home with a PCP appointment scheduled for this morning. The intermittent pain / palpitations / weakness / dizziness has persisted since the first episode.At PCP visit today, another EKG was done and compared to my past EKGs done at that office. My primary found an anomaly in Lead 3 (which I assume is what I misheard the medics identify), and ordered bloodwork (troponin and lipid panel, amongst others). Gave me an urgent referral for cardiology, wants me to get a Holter monitor and stress test at a minimum.My question for all you wonderful people: what is the pathophysiology that leads to an anomalous Lead 3 finding on an EKG? How worried should I be?. ### Response: Impossible to say without seeing the ECG and exploring. Lead 3 (in conjunction with others) corresponds to the inferior portion of the heart. But there are many things that could be showing in this lead on your ECG..


Instruction: F30. Ive had these transient episodes of PSVT for some years now, following an Epstein Barr infection when I was 22. Ive had a cardiology referral before, with a 3 day monitor. It caught nothing, so they diagnosed me with Anxiety and sent me away with a low dose of Propanolol if I wanted it.These heart episodes are making my life a living hell. They are destroying my relationships and my ability to function in my daily life. I used to work, but now I dont. Ive had to give up my job because I couldnt cope with the interrupted sleep (they specifically wake me up from a sound sleep, usually around 3am). This is obviously very frustrating for both myself and my partner.Went to ER with chest pain after the last episode, and the ER doc wanted to get me a 21 day heart monitor - which would definitely catch it as my episodes appear in clusters, a few times a month. There appears to be a hormonal component to it.Ive completely cut out caffeine but the effect that has had on it has been minimal.Now, the NHS is saying that they will refer me to cardiology when my anemia is sorted. But, its never sorted - at least, not without iron infusion therapy (I have IBS and dont tolerate oral tablets well).I did have an iron infusion months ago, which picked my Hb levels to no longer anemic - but didnt get the referral then either. On the contrary, I heard nothing from my GP, for months, and now Im back to being anemic again - its so hard to maintain my iron levels without routine IV iron, and the only time I get it is if Im in hospital for another reason (last time was Gynae related).Im beginning to lose hope that this will ever be resolved and worry that Im just going to drop dead of an unidentified cardiology issue.Is there any way I can get the cardiology appointment and have my cardiologist take me seriously instead of attributing it to anemia like last time, because my resting HR is 60bpm, these SVT episodes are a very distinct and immediate jump to a hr of about 170-200bpm, and they arent anxiety related at all. They also definitely arent anemia related because even when I am no longer anemic, I still get them. Twice monthly, around the times I ovulate and right before my period. Predictable as clockwork.I just want them to stop because they make me afraid to sleep at night and as a result I have developed pretty terrible insomnia, and depression due to the constant fear of wondering if something is severely wrong with me.

Output: I dont understand why you had to give up your job if they only happen twice a month like you say? Do the beta blockers work?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: F30. Ive had these transient episodes of PSVT for some years now, following an Epstein Barr infection when I was 22. Ive had a cardiology referral before, with a 3 day monitor. It caught nothing, so they diagnosed me with Anxiety and sent me away with a low dose of Propanolol if I wanted it.These heart episodes are making my life a living hell. They are destroying my relationships and my ability to function in my daily life. I used to work, but now I dont. Ive had to give up my job because I couldnt cope with the interrupted sleep (they specifically wake me up from a sound sleep, usually around 3am). This is obviously very frustrating for both myself and my partner.Went to ER with chest pain after the last episode, and the ER doc wanted to get me a 21 day heart monitor - which would definitely catch it as my episodes appear in clusters, a few times a month. There appears to be a hormonal component to it.Ive completely cut out caffeine but the effect that has had on it has been minimal.Now, the NHS is saying that they will refer me to cardiology when my anemia is sorted. But, its never sorted - at least, not without iron infusion therapy (I have IBS and dont tolerate oral tablets well).I did have an iron infusion months ago, which picked my Hb levels to no longer anemic - but didnt get the referral then either. On the contrary, I heard nothing from my GP, for months, and now Im back to being anemic again - its so hard to maintain my iron levels without routine IV iron, and the only time I get it is if Im in hospital for another reason (last time was Gynae related).Im beginning to lose hope that this will ever be resolved and worry that Im just going to drop dead of an unidentified cardiology issue.Is there any way I can get the cardiology appointment and have my cardiologist take me seriously instead of attributing it to anemia like last time, because my resting HR is 60bpm, these SVT episodes are a very distinct and immediate jump to a hr of about 170-200bpm, and they arent anxiety related at all. They also definitely arent anemia related because even when I am no longer anemic, I still get them. Twice monthly, around the times I ovulate and right before my period. Predictable as clockwork.I just want them to stop because they make me afraid to sleep at night and as a result I have developed pretty terrible insomnia, and depression due to the constant fear of wondering if something is severely wrong with me.. ### Response: I dont understand why you had to give up your job if they only happen twice a month like you say? Do the beta blockers work?.


Instruction: I was training as a student nurse, but the stress from this has been too much for me to cope with tbh.Im reluctant to take BB because my resting heart rate sits at 60bpm, and tbh theres nothing wrong with my resting hr. I would prefer to have an ablation than take daily unnecessary medication for the rest of my life?

Output: Im sure the cardiologist assessed your pulse before giving you beta blockers, have you tried them?

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I was training as a student nurse, but the stress from this has been too much for me to cope with tbh.Im reluctant to take BB because my resting heart rate sits at 60bpm, and tbh theres nothing wrong with my resting hr. I would prefer to have an ablation than take daily unnecessary medication for the rest of my life?. ### Response: Im sure the cardiologist assessed your pulse before giving you beta blockers, have you tried them?.


Instruction: That was when I was 25, and Im 30 now, so its been a while since my last cardiology review (during which time these episodes have gotten more frequent and last longer) and the cardiologist hadnt ever actually seen an ecg tracing of this issue, which I think is a pretty important piece of diagnostic information. Id personally advocate for my patients that abnormal ecgs are reviewed, so why not mine?Ill ask my GP about trying a low dose BB, but I dont expect it to do a great deal other than lower my BP a smidgen.

Output: Id be surprised if a cardiologist ordered a 3 day monitor without reviewing an ECG first.If I was you Id go back and take the beta blockers, give them a go. If they fail then go back and say I did what you said doc whats the next steps. The outcome will either be finding a treatment that works in primary care or youll be referred back to cardiology.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: That was when I was 25, and Im 30 now, so its been a while since my last cardiology review (during which time these episodes have gotten more frequent and last longer) and the cardiologist hadnt ever actually seen an ecg tracing of this issue, which I think is a pretty important piece of diagnostic information. Id personally advocate for my patients that abnormal ecgs are reviewed, so why not mine?Ill ask my GP about trying a low dose BB, but I dont expect it to do a great deal other than lower my BP a smidgen.. ### Response: Id be surprised if a cardiologist ordered a 3 day monitor without reviewing an ECG first.If I was you Id go back and take the beta blockers, give them a go. If they fail then go back and say I did what you said doc whats the next steps. The outcome will either be finding a treatment that works in primary care or youll be referred back to cardiology..


Instruction: I have also been having infrequent runs of (possibly) SVT, which also seem to be hormone related, although Sods Law they have never appeared when hooked up to hospital machines, only a 6 lead home device.I also have a resting HR of 50-60 but have found beta blockers insanely useful. I take a super low dose of bisoprolol and it seems to be just enough to stop my heart going into these fast rhythms but not so much that my heart feels too slow. I was sceptical at first too, but Im glad I gave it a go. I drink a tin of coke each day and take stimulant medication and I will only get a brief run of SVT once in a blue moon. Whenever Ive stopped the beta blocker the issue has come back so it must be doing something.I hope you manage to get to the bottom of things and find a solution!

Output: Meds are helpful as mentioned and usually pretty well-tolerated unless you have AV block or hypotension.Depending on frequency, length of the episodes and preference cardiologists generally use either chronic preventive therapy with a beta-blocker or calcium channel blocker, or pill-in-the-pocket with flecainide or beta-blocker. If you have a favorite vagal maneuver those can sometimes work too.These are very rarely life-threatening. Ablation is effective but can't help you negotiate the NHS system. Fixing the iron deficiency will also help. Our hematologists do have some patients with chronic iron deficiency anemia who can't catch up with oral supplements who have scheduled IV infusions, but only after every possible source of ongoing blood loss or iron malabsoprtion is addressed (celiac, heavy menses etc).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I have also been having infrequent runs of (possibly) SVT, which also seem to be hormone related, although Sods Law they have never appeared when hooked up to hospital machines, only a 6 lead home device.I also have a resting HR of 50-60 but have found beta blockers insanely useful. I take a super low dose of bisoprolol and it seems to be just enough to stop my heart going into these fast rhythms but not so much that my heart feels too slow. I was sceptical at first too, but Im glad I gave it a go. I drink a tin of coke each day and take stimulant medication and I will only get a brief run of SVT once in a blue moon. Whenever Ive stopped the beta blocker the issue has come back so it must be doing something.I hope you manage to get to the bottom of things and find a solution!. ### Response: Meds are helpful as mentioned and usually pretty well-tolerated unless you have AV block or hypotension.Depending on frequency, length of the episodes and preference cardiologists generally use either chronic preventive therapy with a beta-blocker or calcium channel blocker, or pill-in-the-pocket with flecainide or beta-blocker. If you have a favorite vagal maneuver those can sometimes work too.These are very rarely life-threatening. Ablation is effective but can't help you negotiate the NHS system. Fixing the iron deficiency will also help. Our hematologists do have some patients with chronic iron deficiency anemia who can't catch up with oral supplements who have scheduled IV infusions, but only after every possible source of ongoing blood loss or iron malabsoprtion is addressed (celiac, heavy menses etc)..


Instruction: 40M 5'18 160 pounds. Over the past few years, some weird symptoms either developed or got worse. I was lightheaded back in 2018 and a neurologist found nothing wrong with me. Late December, symptoms sent me to the ER with elevated blood pressure, white blood cell counts at 14.5, stomach and intestinal pain, rapid heartbeat, etc. My heart rate and blood pressure rapidly fluctuate. My heart rate varies by at least 20 beats per minute from the base line. So I'm sitting and the base is 70, it will go 72, 75, 78, 80, 82, 85, 87, 90...88, 86, 84, 83, 0, 78, 75, 72, 70 and sometimes do that whole course twice in a minute. I am not known to have ever had Covid and I am presently fully vaccinated, as well.Over the past few years, I've been seen by primary care, neurology, gastroenterology, endocrinology, had head/abdominal scans with nothing noted, saw 3 cardiologists, wore 2 Holters for a month, had lots of blood work and such. Stress Echo via treadmill showed a healthy and strong heart.Diagnosis of Postural Orthostatic Tachycardia Syndrome by primary care, neurology and cardiology. Dysautonomia/autonomic dysfunction got thrown vaguely into the mix, as well. Tilt table test would have been negative for POTS. I didn't faint or have the rapid rise in heart rate. They gave my sublingual nitroglycerin and I fainted within a short time. BP went down to 97/56 and pulse to 40, possibly only because of the nitro. I am lightheaded 24/7. Even just lying on the bed at night, I feel little sharp "zaps" of lightheadedness. I'm familiar with BPPV and it's not that. The POTS no longer applies - I am rarely tachycardic. Also, my blood pressure is now more so low on a daily basis. For instance, earlier today it was 99/57 after a meal that was quite heavy in salt. I seem to always crave salt and can't seem to get enough of it. I am completely exhausted every day, have no energy and my entire body is hyperreflexic.I have hundreds of tiny little red bumps all over my upper and lower back and the backs of my arms. They do not itch. Back in 2020 an EGD showed an inflamed stomach lining with negative biospies. 6 months of Prisolec 40mg twice daily at that time didn't help. He put me back on the 40mg twice daily again. It was after that point that I ended up chasing the POTS/autonomic dysfunction stuff and had not seen the gastro doc since because I later lost my job due to a work injury. I just saw my gastro doc again recently. After reviewing my symptoms, he asked if I have ever seen an allergist. Then when I told him about the horrific lower colon pain that I get at times, constipation on average of 2-3 days at a time due to inflammation preventing a bowel movement, the feeling of inflammation and severe burning/clawing pain for hours even after a bowel movement and such...he feels that I may have something else going on in my colon. He brought up Crohn's and said it was sneaky sometimes. I showed him photos of my pie crust-like tongue that seems to swell at times and I get canker sores in various areas of the mouth and have for a long time. I showed him a photo that looked like I was pregnant - considerable lower colon swelling and abdominal bloating. Also, what makes me think some of my other symptoms like the low blood pressure and such may be related is because when I press on my lower colon area or rub it, my ears immediately ring and at times I get nauseous. There's no way that's a coincidence given how often it happens.I'm always hungry for big meals even after I just ate a big meal recently. I get considerable postprandial hypotension. I haven't worked in 2 years, pending Disability. Gastro doc requested CBC, Comprehensive Metabolic and Thyroid/TSH panels. All within normal range except the thyroid panel:T3 UPTAKE 24 Reference Range: 22-35 %T4 (THYROXINE), TOTAL 10.9 High Reference Range: 4.9-10.5 mcg/dLFREE T4 INDEX (T7) 2.6 Reference Range: 1.4-3.8TSH 2.25 Reference Range: 0.40-4.50 mIU/LThe only flag was the T4 Thyroxine and it's only 0.4mcg/dL higher than the highest normal reference range. All other blood work was fine. This reference range seems normal and also what is 'normal' seems to vary considerably depending on what source you compare it against.Severe burning/clawing sensation in the lower colon just below the navel. Worse at night, but moderate pain 24/7. Full-body malaise, jitteriness and rare spikes in blood pressure with full-body tremors as if freezing cold for 15-20 minutes. I get even more colon pain during this time and at times feel feverish. I have had unexplained blood pooling in my hands and feet since I was a teenager. Heavy nausea immediately after lightly pressing or lightly rubbing the lower colon area below the belly and middle abdomen. No vomiting. Frequent bright yellow or greenish stools with some worm-like mucus in them. No visible bleeding. Upper body jolt-like 'tics' that feel at times as if they are originating from the lower abdominal area and cause my upper body to jump randomly in certain movements. With the lightheadedness, it feels like even when I'm sitting or lying down an djust move one arm or leg, I get a brain "zap" of lightheadedness. What in the world could cause that?I'm trying to get a colonoscopy to see for sure. Due to low income, the Colorectal Cancer Alliance has me on a list for funding for a colonoscopy locally when it becomes available, quoting possibly in February when more programs open.What are my chances of Crohn's/IBD with the above issues going on? Could it also be the cause of my blood pressure and heart rate fluctuations? I'm puzzled at the normal white blood cell counts given that my lower colon was absolutely hurting/inflamed during the blood draw.

Output: There's nothing here that suggests IBD, though that doesn't mean you can't have it.It's possible that you have IBD but your symptoms are pretty vague and not classically IBD

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 40M 5'18 160 pounds. Over the past few years, some weird symptoms either developed or got worse. I was lightheaded back in 2018 and a neurologist found nothing wrong with me. Late December, symptoms sent me to the ER with elevated blood pressure, white blood cell counts at 14.5, stomach and intestinal pain, rapid heartbeat, etc. My heart rate and blood pressure rapidly fluctuate. My heart rate varies by at least 20 beats per minute from the base line. So I'm sitting and the base is 70, it will go 72, 75, 78, 80, 82, 85, 87, 90...88, 86, 84, 83, 0, 78, 75, 72, 70 and sometimes do that whole course twice in a minute. I am not known to have ever had Covid and I am presently fully vaccinated, as well.Over the past few years, I've been seen by primary care, neurology, gastroenterology, endocrinology, had head/abdominal scans with nothing noted, saw 3 cardiologists, wore 2 Holters for a month, had lots of blood work and such. Stress Echo via treadmill showed a healthy and strong heart.Diagnosis of Postural Orthostatic Tachycardia Syndrome by primary care, neurology and cardiology. Dysautonomia/autonomic dysfunction got thrown vaguely into the mix, as well. Tilt table test would have been negative for POTS. I didn't faint or have the rapid rise in heart rate. They gave my sublingual nitroglycerin and I fainted within a short time. BP went down to 97/56 and pulse to 40, possibly only because of the nitro. I am lightheaded 24/7. Even just lying on the bed at night, I feel little sharp "zaps" of lightheadedness. I'm familiar with BPPV and it's not that. The POTS no longer applies - I am rarely tachycardic. Also, my blood pressure is now more so low on a daily basis. For instance, earlier today it was 99/57 after a meal that was quite heavy in salt. I seem to always crave salt and can't seem to get enough of it. I am completely exhausted every day, have no energy and my entire body is hyperreflexic.I have hundreds of tiny little red bumps all over my upper and lower back and the backs of my arms. They do not itch. Back in 2020 an EGD showed an inflamed stomach lining with negative biospies. 6 months of Prisolec 40mg twice daily at that time didn't help. He put me back on the 40mg twice daily again. It was after that point that I ended up chasing the POTS/autonomic dysfunction stuff and had not seen the gastro doc since because I later lost my job due to a work injury. I just saw my gastro doc again recently. After reviewing my symptoms, he asked if I have ever seen an allergist. Then when I told him about the horrific lower colon pain that I get at times, constipation on average of 2-3 days at a time due to inflammation preventing a bowel movement, the feeling of inflammation and severe burning/clawing pain for hours even after a bowel movement and such...he feels that I may have something else going on in my colon. He brought up Crohn's and said it was sneaky sometimes. I showed him photos of my pie crust-like tongue that seems to swell at times and I get canker sores in various areas of the mouth and have for a long time. I showed him a photo that looked like I was pregnant - considerable lower colon swelling and abdominal bloating. Also, what makes me think some of my other symptoms like the low blood pressure and such may be related is because when I press on my lower colon area or rub it, my ears immediately ring and at times I get nauseous. There's no way that's a coincidence given how often it happens.I'm always hungry for big meals even after I just ate a big meal recently. I get considerable postprandial hypotension. I haven't worked in 2 years, pending Disability. Gastro doc requested CBC, Comprehensive Metabolic and Thyroid/TSH panels. All within normal range except the thyroid panel:T3 UPTAKE 24 Reference Range: 22-35 %T4 (THYROXINE), TOTAL 10.9 High Reference Range: 4.9-10.5 mcg/dLFREE T4 INDEX (T7) 2.6 Reference Range: 1.4-3.8TSH 2.25 Reference Range: 0.40-4.50 mIU/LThe only flag was the T4 Thyroxine and it's only 0.4mcg/dL higher than the highest normal reference range. All other blood work was fine. This reference range seems normal and also what is 'normal' seems to vary considerably depending on what source you compare it against.Severe burning/clawing sensation in the lower colon just below the navel. Worse at night, but moderate pain 24/7. Full-body malaise, jitteriness and rare spikes in blood pressure with full-body tremors as if freezing cold for 15-20 minutes. I get even more colon pain during this time and at times feel feverish. I have had unexplained blood pooling in my hands and feet since I was a teenager. Heavy nausea immediately after lightly pressing or lightly rubbing the lower colon area below the belly and middle abdomen. No vomiting. Frequent bright yellow or greenish stools with some worm-like mucus in them. No visible bleeding. Upper body jolt-like 'tics' that feel at times as if they are originating from the lower abdominal area and cause my upper body to jump randomly in certain movements. With the lightheadedness, it feels like even when I'm sitting or lying down an djust move one arm or leg, I get a brain "zap" of lightheadedness. What in the world could cause that?I'm trying to get a colonoscopy to see for sure. Due to low income, the Colorectal Cancer Alliance has me on a list for funding for a colonoscopy locally when it becomes available, quoting possibly in February when more programs open.What are my chances of Crohn's/IBD with the above issues going on? Could it also be the cause of my blood pressure and heart rate fluctuations? I'm puzzled at the normal white blood cell counts given that my lower colon was absolutely hurting/inflamed during the blood draw.. ### Response: There's nothing here that suggests IBD, though that doesn't mean you can't have it.It's possible that you have IBD but your symptoms are pretty vague and not classically IBD.


Instruction: 28YO female, healthy and an avid lifter. Referred to cardiology for heart palpitations and fast heart rate. Placed on 7 day heart monitor. Was told that I am in ST majority of the day. There were some skipped beats as well. Placed on toporol for management. Cardiologist said borderline concerned, due to how high my HR is. Said if it gets worse, things would change. These strips are from the Holter monitor report.

Output: ST = Sinus Tachycardia. It means the heart is working down the normal electrical system, but its going faster than normal. Often there is an underlying cause (and not a primary problem with the heart), but sometimes peoples hearts just go fast and we need to slow them down with medications like your toprol.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 28YO female, healthy and an avid lifter. Referred to cardiology for heart palpitations and fast heart rate. Placed on 7 day heart monitor. Was told that I am in ST majority of the day. There were some skipped beats as well. Placed on toporol for management. Cardiologist said borderline concerned, due to how high my HR is. Said if it gets worse, things would change. These strips are from the Holter monitor report.. ### Response: ST = Sinus Tachycardia. It means the heart is working down the normal electrical system, but its going faster than normal. Often there is an underlying cause (and not a primary problem with the heart), but sometimes peoples hearts just go fast and we need to slow them down with medications like your toprol..


Instruction: Age: 36 years old Gender: Female Height: 5'4" Weight 160lbs Location: USA Smoking: Never Meds: xyzal 5 mg daily for chronic idiopathic urticaria and angioedema 200mg Zoloft (serteraline)I recently gave birth. I had pre-eclampsia with high blood pressure, protein in my urine, headache and chest pain. I was given an ECG, EKG, and chest x-ray while in the hospital. I was discharged a couple days later and they put a zio heart monitor on me for 2 weeks.This past Friday I had a follow up appointment with a cardiologist after my monitor results, the other tests, and one more ECG. The cardiologist told me (in a relatively relaxed and casual way) that I have a long QT interval and that can increase the risk of sudden cardiac death. She referred me to a geneticist who I'm waiting on for an appointment.At the time my brain stopped working when she said death but now I'm trying to gauge what is.me.being overly health anxious and what is justified worry. I am emailing the doctor but I suspect it willl take awhile for a response since it is the weekend.But given that I have no history of drinking, smoking, drugs, eating disorders, or any vitamin imbalances. How worried should I be?? Like should ainbe saying my goodbyes?! Or do I just ignore it and my life will be relatively normal??? I haven't had any fainting spells and I don't THINK either side of .y family has a history of SCD. But on both sides there is cardio history -- my maternal grandfather died of a heart attack and my maternal uncle has had a couple I think? My paternal uncle has had a heart attack and I think my paternal grandfather died from one as well? But that one I am really unsure about.Is this the sort of thing that everyone has and is NBD?? Or is this the sort of thing where I need to 100% commit to completely devoting myself to Cheerios and heart healthy choices if I want to live???I really appreciate any help or advice you can give. I really know SO LITTLE about cardiology it's like I don't even know what I don't know.

Output: I'm sorry you're going through this. I don't think you need to say you're goodbyes at this point. There are varying degrees of prolonged QT intervals. Without actually knowing how prolonged it is it's hard to really guess. Depending on how prolonged it is it may be nothing to worry about but it sounds like you're in good hands with seeing a cardiologist and moving forward with workup.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Age: 36 years old Gender: Female Height: 5'4" Weight 160lbs Location: USA Smoking: Never Meds: xyzal 5 mg daily for chronic idiopathic urticaria and angioedema 200mg Zoloft (serteraline)I recently gave birth. I had pre-eclampsia with high blood pressure, protein in my urine, headache and chest pain. I was given an ECG, EKG, and chest x-ray while in the hospital. I was discharged a couple days later and they put a zio heart monitor on me for 2 weeks.This past Friday I had a follow up appointment with a cardiologist after my monitor results, the other tests, and one more ECG. The cardiologist told me (in a relatively relaxed and casual way) that I have a long QT interval and that can increase the risk of sudden cardiac death. She referred me to a geneticist who I'm waiting on for an appointment.At the time my brain stopped working when she said death but now I'm trying to gauge what is.me.being overly health anxious and what is justified worry. I am emailing the doctor but I suspect it willl take awhile for a response since it is the weekend.But given that I have no history of drinking, smoking, drugs, eating disorders, or any vitamin imbalances. How worried should I be?? Like should ainbe saying my goodbyes?! Or do I just ignore it and my life will be relatively normal??? I haven't had any fainting spells and I don't THINK either side of .y family has a history of SCD. But on both sides there is cardio history -- my maternal grandfather died of a heart attack and my maternal uncle has had a couple I think? My paternal uncle has had a heart attack and I think my paternal grandfather died from one as well? But that one I am really unsure about.Is this the sort of thing that everyone has and is NBD?? Or is this the sort of thing where I need to 100% commit to completely devoting myself to Cheerios and heart healthy choices if I want to live???I really appreciate any help or advice you can give. I really know SO LITTLE about cardiology it's like I don't even know what I don't know.. ### Response: I'm sorry you're going through this. I don't think you need to say you're goodbyes at this point. There are varying degrees of prolonged QT intervals. Without actually knowing how prolonged it is it's hard to really guess. Depending on how prolonged it is it may be nothing to worry about but it sounds like you're in good hands with seeing a cardiologist and moving forward with workup..


Instruction: Thank you for your reply.I feel so ignorant about how hearts work I feel like my brain can't even comprehend the risk or understand. I'm not a particularly stupid person but this is all just beyond my capacity.

Output: Don't feel that way! It's a complex organ and no one would expect you to fully understand. You should reach out to your cardiologist and just see if they can explain it better to you, that may be helpful before seeing the geneticist and answer some of your questions.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you for your reply.I feel so ignorant about how hearts work I feel like my brain can't even comprehend the risk or understand. I'm not a particularly stupid person but this is all just beyond my capacity.. ### Response: Don't feel that way! It's a complex organ and no one would expect you to fully understand. You should reach out to your cardiologist and just see if they can explain it better to you, that may be helpful before seeing the geneticist and answer some of your questions..


Instruction: F49, 55, 143 lbsI had a severe allergic reaction and I almost died on Tuesday. I got stung 2-3 times by a yellow jacket while cutting the grass. I came inside to get some Benadryl and saw all these black spots (probably 4 minutes later). Then I was profusely diaphoretic, dry heaves, had copious amount of phlegm from my mouth and nose, couldnt breathe, weakness and was blacking out. It was so so fast.My husband (hero #1) happened to be coming from the airport so he called 911 and My 13 year old gave me one of her epipens in the thigh (she is anaphylactic to shellfish and buckwheat). First responders came (maybe 4.5 minutes) and I couldnt open my eyes, they put me on a blood pressure monitor and then it was alarming, so they turned the alarm off. Then advanced life support I think or Ems literally picked me up and ran me out to the ambulance. I think I blacked out and woke up and I barely remember the ambulance ride with sirens and lights and them laying on the horn. I could hear them saying we got gotta get her pressure up, we got nothing here. I remember trying to talk to them and my tongue wouldn't work. When I was conscious and realized the lights and sirens were on, i saw the seriousness. When I heard them say ETA 3-5 and BP of 40/20 - I 'm like , that's not compatible with life. The paramedics worked on me the entire time. At hospital had me in a trauma room and called all staff over loudspeaker. Thankfully they got my pressure up and gave me another epipen and steroids and Benadryl. The epipen and lack of blood flow gave me some cardiac issues and Im following up with cardiology.That said, I dont feel right. Im weak. I keep waking up with nightmares about not being able to breathe and I keep replaying the incident in my head. I have little appetite. Do you think I would benefit from some counseling? Did I almost die? I feel like I certainly came close. Would I be a candidate for venom therapy? I feel like this if my only chance at a normal life.Is there any way I have some sort of Mast Cell Disorder for this to come on so suddenly?

Output: Sounds like a pretty traumatic experience and I'm sorry you had to go through that. It is normal not to feel completely yourself this quickly after such an event, and it may take some time to feel back to normal again.Medically, it is good that you have recovered. I must emphasize you need to have an epi-pen with you at all times in the event you do have another sting at some point. The strength will come back. It's hard to tell how bad off you are, but can say a BP of 40/20 is pretty bad.Counseling is up to you. It sounds like you are having an acute stress reaction to a traumatic experience (think PTSD, but happening essentially immediately after). This may improve on its own, or may need some help to get through.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: F49, 55, 143 lbsI had a severe allergic reaction and I almost died on Tuesday. I got stung 2-3 times by a yellow jacket while cutting the grass. I came inside to get some Benadryl and saw all these black spots (probably 4 minutes later). Then I was profusely diaphoretic, dry heaves, had copious amount of phlegm from my mouth and nose, couldnt breathe, weakness and was blacking out. It was so so fast.My husband (hero #1) happened to be coming from the airport so he called 911 and My 13 year old gave me one of her epipens in the thigh (she is anaphylactic to shellfish and buckwheat). First responders came (maybe 4.5 minutes) and I couldnt open my eyes, they put me on a blood pressure monitor and then it was alarming, so they turned the alarm off. Then advanced life support I think or Ems literally picked me up and ran me out to the ambulance. I think I blacked out and woke up and I barely remember the ambulance ride with sirens and lights and them laying on the horn. I could hear them saying we got gotta get her pressure up, we got nothing here. I remember trying to talk to them and my tongue wouldn't work. When I was conscious and realized the lights and sirens were on, i saw the seriousness. When I heard them say ETA 3-5 and BP of 40/20 - I 'm like , that's not compatible with life. The paramedics worked on me the entire time. At hospital had me in a trauma room and called all staff over loudspeaker. Thankfully they got my pressure up and gave me another epipen and steroids and Benadryl. The epipen and lack of blood flow gave me some cardiac issues and Im following up with cardiology.That said, I dont feel right. Im weak. I keep waking up with nightmares about not being able to breathe and I keep replaying the incident in my head. I have little appetite. Do you think I would benefit from some counseling? Did I almost die? I feel like I certainly came close. Would I be a candidate for venom therapy? I feel like this if my only chance at a normal life.Is there any way I have some sort of Mast Cell Disorder for this to come on so suddenly?. ### Response: Sounds like a pretty traumatic experience and I'm sorry you had to go through that. It is normal not to feel completely yourself this quickly after such an event, and it may take some time to feel back to normal again.Medically, it is good that you have recovered. I must emphasize you need to have an epi-pen with you at all times in the event you do have another sting at some point. The strength will come back. It's hard to tell how bad off you are, but can say a BP of 40/20 is pretty bad.Counseling is up to you. It sounds like you are having an acute stress reaction to a traumatic experience (think PTSD, but happening essentially immediately after). This may improve on its own, or may need some help to get through..