Earlier this year, my 85 year-old mom called me while I was in San Francisco attending the JP Morgan Healthcare Conference, to let me know that “everything’s fine” and that after wearing a Holter monitor for 24 hours, “they found nothing wrong” with her heart.
So why was she wearing a monitor? My mom was wearing the Holter monitor because, apparently (and I say apparently because I only found out about it afterward) my mom experienced rapid heartbeat several times over the last few months. It was strong enough to wake her at night and lasted long enough to keep her at home on 2 occasions “feeling lousy”. This is a woman who is rarely home alone during the day: she volunteers at a woman’s shelter, teaches my friends how to cook, drives patients for their chemotherapy appointments and even dishes out lunch at the Cummings Centre in Montreal. I never heard my mother say she was “feeling lousy” before.
When I found out about the rapid heartbeat, I asked why she had not called an ambulance or at least call me? I know that my mom does not panic – she was a registered nurse and has had a lot of experiences in her life. She figured that either a) she was having a heart attack or b) she wasn’t. If yes, she would feel worse and go to the hospital, if not, she would get better. After this happened 3 or 4 times, she decided to see her doctor. Needless to say, I was relieved that there was nothing functionally wrong with her heart but I was not at all surprised that they were not able to diagnose the cause of the tachycardia or rapid heartbeat. I believe that my mother had experienced paroxysmal supra-ventricular tachycardia (PSVT), an electrical disorder of the heart that, while not “dangerous”, can have a major impact on a person’s quality of life.
Why am I posting about this now? I’m writing the blog now having been inspired by a recent post from Lisa Suennen, an advisor for our fund, detailing her own enlightening experience with rapid heartbeat that resulted in an emergency trip to the hospital.
The reason I’m even aware of such a condition as PSVT is because our fund has an investment in Milestone Pharma, a company that is developing a convenient therapy for PSVT, an intra-nasal administration of a modified version of a well-known heart medication, designed to provide a convenient, rapid, safe and effective therapy for patients to take at the onset of an episode in an “at-home” setting. Kind of like a “puffer” for asthmatics only through the nose and for PSVT! Patients with PSVT, like my mom, often go undiagnosed for the first episode(s). The episode may last several hours (like my mother’s case) to days with unresolved rapid heartbeat. One of the problems is that there is no way to diagnose this condition unless the person is actively experiencing the symptoms while under medical monitoring
Once diagnosed however, there are treatment options. Doctors are able to terminate a PSVT episode but this requires that the patient go to hospital for what sounds to me like a “rebooting” of the heart. This was how it was described to me by a diagnosed patient who experiences PSVT “3 or 4 times a year”. In hospital, the patient receives drug via intravenous to terminate the PSVT episode. The side effect profile has been reported to include flushing, dyspnea, headache, cough, chest pain, sinus bradycardia, atrial fibrillation and ventricular arrhythmias. Talk about feeling really lousy! If the episodes are frequent enough the patient may be put on chronic heart medication, along with all its side effects, to prevent recurrence of the PSVT. If PSVT is even more disruptive to the patient, they might choose to have an ablation; a quite safe and permanent solution for many patients. One issue with ablation however, is that it involves a procedure where a catheter is guided through blood vessels in order to scar small areas of the heart that prevent the abnormal electrical signals from moving through the heart. Not all patients wish to undergo this procedure and those who do, certainly do not enter that decision lightly.
Milestone’s product is intended to be used only when an episode occurs and if shown to be a safe and effective treatment for PSVT, should provide patients with an alternate option. In the meantime, my mother has agreed to call me the next time it happens so I can accompany her to hospital and so she is properly diagnosed – as long as I agree to follow her lead and not panic.