Re: RE: [NP-Clinical] Incidental asymptomatic cardiac finding

Mon Jan 8 12:52:21 PST 2007

Thaks, Priscilla, for the explanation. This is what I love about this group - I am always learning something new that is useful! Thank you again.

Patti Np

>From: Priscilla Merrill <prispunnyfnp at metrocast.net>
>Date: 2007/01/07 Sun AM 07:44:39 CST
>To: 'NP Clinical' <np-clinical at nurse.net>
>Subject:  RE: [NP-Clinical] Incidental asymptomatic  cardiac finding

>Lyme causes many cardiac arrhythmias, trigeminy being one possibility.  You
>may recall a pt. I mentioned this summer that presented in complete block
>and now has pacemaker after IV abx x over a month.  We look for it around
>here in NH since its' so prevalent.  I'm suspicious since she had no other
>identifiable risk factors.  Will post as FYI if +
>Priscilla
>
>-----Original Message-----
>From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
>On Behalf Of pattinp at verizon.net
>Sent: Saturday, January 06, 2007 9:01 PM
>To: NP Clinical
>Subject: Re: [NP-Clinical] Incidental asymptomatic  cardiac finding
>
>Priscilla,
>Forgive my ignorance...does Lyme disease cause trigeminy? I did not know
>this.
>
>Thanks.
>
>Patti NP
>
>>From: Priscilla Merrill <prispunnyfnp at metrocast.net>
>>Date: 2007/01/06 Sat PM 04:49:44 CST
>>To: 'NP Clinical' <np-clinical at nurse.net>
>>Subject: [NP-Clinical] Incidental asymptomatic  cardiac finding
>
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>><P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2
>FACE="Arial">One of my 10 minute</FONT></SPAN><SPAN
>LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT SIZE=2
>FACE="Arial">“</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN
>LANG="en-us"><FONT SIZE=2 FACE="Arial">quick sicks</FONT></SPAN><SPAN
>LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2
>FACE="Arial">”</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN
>LANG="en-us"><FONT SIZE=2 FACE="Arial"> this week was a 30ish healthy woman
>presenting w/ c/o sinusitis.  No cardiac hx.  She admitted to some usual
>fatigue attributed to her sinusitis.  No cardiac sx</FONT></SPAN><SPAN
>LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2
>FACE="Arial">’</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN
>LANG="en-us"><FONT SIZE=2 FACE="Arial">s.  When I was checking her HR while
>listening to her lungs, I was amazed at the pauses.  I got a routine EKG
>with her permission and she was in trigeminy.  No hx Lyme or anything at
>all.</FONT></SPAN>!
> <SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2 FACE="Arial"> 
>You might say my heart skipped a beat!</FONT></SPAN><SPAN
>LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
>>
>><P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2
>FACE="Arial">I scheduled her with a Holter and cardiac consult but wondered
>if any of your cardiac gurus had run into this before?  Totally asymptomatic
>trigeminy.  I got a lab panel including Lyme and TSH, CBC and CMP.  My
>colleague FP doc felt this was enough workup where asymptomatic but thought
>she should see cardiac where insured.  Normal weight and past lipids
>,etc.</FONT></SPAN></P>
>>
>><P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT SIZE=2
>FACE="Arial">Thanks for any thoughts.</FONT></SPAN></P>
>>
>><P DIR=LTR><SPAN LANG="en-us"><FONT SIZE=2 FACE="Arial">Priscilla Merrill
>FNP</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
>><BR>
>>
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>_______________________________________________
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>FnP Associates offers a complimentary continuing education program.
>Pain: Current Understanding of Assessment, Management, and Treatments
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