Link: How Alabama’s Riley Norris Dealt with Heart Scare

RTR91 said:

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Purely a guess, but an educated one, is that this was Wolff-Parkinson-White syndrome.

Electrical activity in the heart flows from the SA node at the top and down through the center and around the the sides, atria first then ventricles. Between the top and bottom chambers is the AV node. In WPW, an extra pathway causes an electrical loop and in addition to the original pulse of electrical activity the second can loop back through again. This causes the heart to speed up and is called a reentry tachycardia or supraventricular tachycardia. The heart rate can go from less than 90 beats per minute to more than 200 bpm, which actually makes the cardiac output drop and results in poor oxygen perfusion in brain and other tissues. Though some opt for ablation for a number of reasons, most can be treated medically successfully with beta blockers or calcium channel blockers. The problem for athletes is that both classes of medication have side effects that may impact their ability to perform at their highest potential so they more often opt for ablation treatment. There is a small risk with ablation that the wrong pathway is severed and a permanent cardiac pacemaker will be needed.

Less often in young people there is an extra excitable area in the atrium that causes an paroxysmal (intermittent) atrial fibrillation. When the ventricles speed up too it is called atrial fibrillation with rapid ventricular response and this too can cause a drop in cardiac output. This can be treated in a similar manner but also requires blood thinners to prevent stroke unless/until any potential ablation therapy is successful.

Symptoms of either condition can include heart palpitations, fatigue, shortness of breath, and syncope (passing out) or presyncope (feeling like you will pass out).

Symptoms in either condition requires prompt assessment and treatment. A-Fib with RVR often requires cardioversion (CLEAR!), which "shocks" the heart back into a normal rhythm, while while cardioversion is a last resort when meds like adenosine or those mentioned above fail in WPW/SVT.

My wife has WPW/SVT and treats medically with a beta blocker. During her worst episode her heart rate was 240-260. I walked into the ER just as they were pushing the third and last dose of adenosine and were charging up the paddles to cardiovert. Fortunately, the medication worked and she was spared the trauma of anything worse.

Of note, adenosine has a half life of less than 10 seconds so a large saline bolus has to be pushed IV immediately after the adenosine. Very often this takes two nurses working together to get the medicine to the heart before the medicine just disappears.

Also, adenosine causes a "pause" for anywhere from 1-6 seconds that hopefully starts back on its own. Those were a long three seconds.

Prayers that all turns out well for Riley! My mom was diagnosed with Wolff-Parkinson-White syndrome. She passed away in her sleep at 59 years old. No autopsy was performed but we believe it was the cause.


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im4datide said:

Prayers that all turns out well for Riley! My mom was diagnosed with Wolff-Parkinson-White syndrome. She passed away in her sleep at 59 years old. No autopsy was performed but we believe it was the cause.


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I'm sorry to hear that. Thank you for sharing.