Paroxysmal Supraventricular Tachycardia (PSVT)

Paroxysmal: A sudden attack, recurrence, or intensification of a disease


Supraventricular: Located or occurring above the ventricles (the upper 2 chambers of the heart)


Tachycardia: a rapid cardiac rate


You guessed it.  More big medical terminology means more hospital fun for the Arav family.  Currently Elijah and I are in the Roanoke Carilion Memorial Hospital PICU due to his sudden attacks of rapid heart rate (above 300 in his case).  Other than the fact that we're in the hospital and I have to keep smothering my child with bags of ice to get his heart rate back down, we're doing well.  I'll try to make a long story short.


Shayna spiked a fever in the night Tuesday so I took her to see Dr. Berry in the morning.  Poor child had massive ear infections again, probably originated from last month's.  While we're waiting for her antibiotic shot, I notice Elijah is awake yet calm so figure it's a good time to check his heart rate like I'm supposed to 3x a day.  300+ so I grab the doc to listen too and he says, "pack up, we're going to the ER."  So I have a miserable, crying Shayna, a baby in PSVT, and Dr. Berry in the front seat directing us through the parking lot to the ER doors.  Dr. Berry stays with us for the next 3 hrs in ER directing Elijah's care, which was a blessing beyond belief as Dr. Berry knew what to do, how to do it, and what to monitor when it seemed the ER staff was overwhelmed and lost.  Vagal Maneuvers were used every time (3 ER episodes of PSVT) to get his heart rate down, the effective one being a bag of ice pressed to the face and head.  Becca came to help with Shayna and eventually took her home once it was clear that I would be allowed to ride down to Roanoke with Elijah.  (Shayna spent the rest of the day snuggling on the couch with Becca and watching Curious George or sleeping.  She's doing a lot better today.)  Since we got to the PICU yesterday afternoon, Elijah's had 8 more episodes so I've become quite a baby-smoothering-with-a-bag-of-ice expert.  (It was scary to watch Dr. Berry do it the first time but after he explained what he did to the transport crew so they could repeat it if necessary, it became fairly easy though still a little nerve racking for me to do.)  


In Elijah there appears to be an extra electrical circuit that originates above the ventricles that gets stuck in an infinite loop until either a vagal maneuver or iv drugs are used to stop it.  (Thankfully the iv drugs were never needed as they could have also stopped his heart (In the ER, he had little shock pads stuck to his front and back just incase he needed the drugs and the drugs stopped his heart, they could shock it back).)  Elijah is now on oral meds (flecaninide) 3x a day to control his heart rate.  Once he's bigger (20-25lbs), they can take a look inside to see what's wrong if we're still having issues.  At the end of the day, there's a 99% chance that he will simply out grow the PSVT around toddlerhood.  Until then, we will walk around with a stethoscope and 2 kids on drugs.  The good thing about Elijah's condition is it would take 12-24 hours to begin to kill him by just tiring out his heart.  This gives us plenty of time to get to the appropriate medical facility without much stress.  We should be able to go home Saturday or Sunday.

My day is going well as I got a visitor who brought real food and company.  Both beautiful blessings in my current state of living.  My friend even got to experience the thrill of 2 PSVT episodes.  She also has a good sense of humor so could laugh with me about our current situation. Tomorrow Becca will bring Shayna down for a visit so I can play with her & she can have some Ima time (I really missed holding her yesterday and just being with her in general).

Elijah getting himself to sleep.  We've been sharing the extra bed in the room as we both seem to sleep better next to each other.