Holding the breath

That was an unusual complaint. She said every time she went for a walk she was forced to hold her breath. ‘You mean you were breathless? I asked. She said,’ no doc, I had to stop breathing for a few seconds and then I can proceed with normal breathing’. She said she had no chest discomfort or radiating pain. This 65 year old woman has been my patient for several years and not given to exaggeration though the unfeeling husband seemed to think that she was imagining a complaint! I knew that an exercise ECG and an angiogram [done for similar complaint?] two years ago were normal.

I did not like it despite her BP being normal and a regular pulse. I sent her to my cardiologist friend and forced him to do an exercise ECG. He called me from the hospital and said she had severe supraventricular tachycardia [very fast uncontrolled heart rate] and atrial fibrillation [another kind of serious rhythm disturbance] within two minutes of excercise! The stopping of her breath was due to inadequate perfusion from a heart which was in serious trouble. She was rescued with medication and another possible disaster avoided!