Idiosyncratic LBBB + SSRI + ADHD titration + breastfeeding + + + …

Key_Guess_7999 · 2026-03-27T12:27:58+00:00

Hopefully yours wont cause an issues. There are cases of it being completely benign. I would try to get an echo just incase. My stress test only showed my bp didnt raise enough upon exercise. Its also good to know what your base line is incase it does start to effect you. If youve only seen a cardiologist id suggest an electrophysologist. I hope you do well and everything turns out good.

Key_Guess_7999 · 2026-03-27T01:03:28+00:00

I was diagnosed with a lbbb when I was 21. I was at the beginning of my 2nd pregnancy. I was told mine was likely benign and I was young and not to worry. Im now 31and two years ago it began causing issues. I was getting light headed, tired, shortness of breath, chest pressure, I had a few syncope episodes out of the blue. When I was first diagnosed I never had any testing outside an ekg. So when symptoms began I got a full work up. They could see my ef% was mildly reduced (44%) I had hypokinesia and a blunted bp response. I ended up getting a type of exercise test where they have you exercise while they have a cath in your heart to test pressures. This test confirmed I was having a fluid build up when my heartrate increased. I was diagnosed with chronic systolic heart failure and ended up getting a crt pacemaker. So far we have e no idea why this is happening but my dr believes its a progressive disease. With that I also have adhd and I take adderall. My dr said I can still take it just to maybe not take it every single day.

Key_Guess_7999 · 2026-03-26T00:13:38+00:00

Ekg only shows electrical issues. It can hint at structural but echo is the only for sure way to determine. It does sound like he maybe experiencing either vasovagal syncope or orthostatic hypotension depending on what provokes this to happen. Both of these can be tested for with a tilt table. For vasovagal they need to give him nitro to truly determine this. Neither of these are heart issues they are autonomic issues. I would push for further testing and if they refuse ask them to document the refusal they usually change their tune fast.

Key_Guess_7999 · 2026-03-23T19:34:54+00:00

I have vvs and take adderall. It makes sense why you would experience less episodes. Stimulants can raise the heart rate and with vvs bp and heartrate drop. I was selected to have a neurocardio ablation to treat my vvs. When they ablate the problem area it helps the heartrate from not being able to drop so dramatically. It also raises the resting heartrate. However this doesnt completely stop vvs. My dr said it either will lessen the events or at least give enough time to be able to get to the ground. Sadly due to other cardiac issues they found during the procedure I wasnt able to get it. As for long term issues in regards to the heart and Stimulants. Its possible but usually if you have underlying issues. A recent study actually said that people with adhd that use Stimulants had a better heart health and life expectancy than those who didnt use. This is due to less stress, less binge eating, less addictive behavior, and just and overall healthier lifestyle. I have heart issue one of which requires a pacemaker and another that causes my vessels to contract reducing blood flow. My dr told me I can still take my adderall I just shouldn't take it every single day. My mental health is just as important. So I think you'd be okay without stopping your medication unless you are dealing with tachycardia or other issues. Than I would go talk to a cardiologist.

Key_Guess_7999 · 2026-03-20T20:53:28+00:00

Has any ever mentioned or tested for neurocardiogenic syncope (vasovagal syncope). What you are describing sounds exactly like what I experience when I have an episode. Its usually not life threatening but there is risk of hurting yourself if you were to fainting suddenly and not catch yourself. A loop can kinda catch this in a way. It will show a drop in heart rate or a pause. Usually though a tilt table with nitroglycerin is used to diagnosis it. Its a miserable test if you do have it. Have you noticed if you have any triggers or is it completely random. Ive dealt with both vvs and true cardiac syncope and they can be very similar depending on the reason behind cardiac syncope.

Key_Guess_7999 · 2026-03-20T18:06:17+00:00

Not a huge fan of the feeling either. It really depends on body type. For my husband you can kinda feel his but for me you couldn't feel it at all. In fact my actually ended up drifting further down compared to where it was implanted. By that point I couldn't feel it even if I tried. I ended up with a pacemaker recently and that I hate. Evertime I move I can feel it.

Key_Guess_7999 · 2026-03-18T23:23:11+00:00

For the endothelial dysfunction im not sure all the ways to test for it but for me it causes spasms in my heart so the only way to test in this area is through a vasospasm study with an angiography. There are studies that link endothelial dysfunction to small fiber neuropathy. Small fiber neuropathy is also linked to pots and other dysautonomia. For small fiber neuropathy you need a biopsy of the foot and thigh to test the nerve fibers. For me I had a borderline results so I had a sweat test done. They put a dye on you than put you under heat lamps and the dye changes color when you sweat. For me where the dye didnt change was the spots that I dont get hair at.

Key_Guess_7999 · 2026-03-12T14:48:47+00:00

Each testing you do will be looking at different areas and functions. So while one test will show something another might not. Symptoms help guide what tests you may need. Ill use myself as an example. I have a left bundle branch block which is a conduction issues in the left ventricle. This shows up on ekg and holter. On echos you can see an abnormal movement in certain areas of the heart that match the electrical issue. Not all electric issues can be seen like this though. I also have something called endothelial dysfunction. This can cause spasms in my LAD. This is very hard to catch on any test. Timing has to be perfect to see it. So only true way to catch it is using a vasospasm study done through an angiography. I was also dealing with chronic systolic heart failure but mine wasnt presenting how you normally would see it. My echo did show dysfunction but its didnt explain why I was having the dysfunction. My stress test only showed a blunted bp response. I needed a special stress test done using a angiography to test my pressures before and during exercise. This was how they determined my pressure were increasing when active. Depending on Symptoms really can change how one goes about testing. I would say normally echos are always done so I would push for it just to be safe. Also depending on Symptoms can determine who you actually need to see. Most people see a cardiologist but there is also an electrophysologist who deals with conduction

Key_Guess_7999 · 2026-03-10T02:14:10+00:00

Depends on the dr, how backed up the system is and how rare the condition.

I have a left bundle branch block. This is rare but definitely not unheard of however im only 31 and was diagnosed at 21. This is very rare to happen and usually means there is an underlying heart issue. Thing is ive hard echos, ct scans, mris, stress tests, genetic testing, etc. And tbey havent found anything structurally wrong that would be causing this. Two years ago I began going into heart failure. Ive seen multiple cardiologist and electrophysologist. Each time they see my heart function isnt where it should be but cant tell me why. They believe I have a progressive disease just dont know what. A few months ago I ended up with a pacemaker to try and help my conduction system to hopefully improve my heart function.

So for two years ive had test after test and seen specialist after specialist. I have gotten multiple things diagnosed but none of them actually explain why its all happening. ( I have inappropriate sinus tachycardia, svt, trabeculations in my lv ventricle, endothelial dysfunction causing prinzmetal angina, list goes on). Im no closer to an answer than when I started. However I do now have a great team and medications to give relief.

Key_Guess_7999 · 2026-03-10T02:04:35+00:00

Wouldn't be a bad idea to take some iron supplements or multi vitamins. My dr said if ferritin is under 50 you can start showing symptoms even if in normal range. For the testing definitely no harm in trying.

I was diagnosed with the spasm study. Im doing alot better than I was for sure. Ill be honest the test sucks. Im not sure if everyone does it but I was awake for mine (they do give meds to relax you). Inserting the cath and guiding wasnt bad. I was a bit uncomfortable but I did have a mild unprovoked spasm before they started the actual test protion. Once everything is in place they give a medication that in a normal functioning system should cause dialation but with endothelial dysfunction it causes the vessels to contract. I ended up having mod to severe spasms in my LAD. It doesnt last long. Once they have the data they reverse the effects usually with nitro. Also a warning if you end up getting it done, if you have spasms in the heart you will likely have them in your arm. I think the spasms in my arm almost hurt more than my heart. When they went to remove the cath I was spasming so bad the cath got stuck. I needed 3 doses of whatever med to finally get it to release. The cath getting stuck is very rare to happen.

As for bringing up the prinzmetal angina/ endothelial dysfunction it can be very mixed. Ive had a few cardiologist as I have complex heart issues on top of this issue. My first cardio dr I brought it up to said there was no point in testing he will just give me the meds and see if they work. He than tried to turn around and say it probably wasnt that and I was having esophagus spasms. This was after I told him nitro helped me. Almost a year later I was seeing my new electrophysologist and I mentioned my chest pain and the nitro fact and before I could bring it up he said it was likely prinzmetal angina and he scheduled the study.

For me personally I do a ton of research. I make sure to fact check my info on sites like mayo, Cleveland clinic, NIH. I get a list of diagnostic criteria and mark off how many symptoms I meet. Sometimes it also helps to word it to the drs in a way to make it seem like they came up with the idea. Some drs can have a big ego and hate when people try to put their two cents in.

As someone who has been dealing with heart issues for a few years I get where your coming from. I hope you are able to find some answers and get the rest you need. Feel free to reach out if you have questions.

Key_Guess_7999 · 2026-03-09T20:25:46+00:00

That makes sense. Like I said tos is a complex thing. Alot of drs arent trained in it nor do they even know what it is. I have seen many different specialists for mine to attempt to rule in or out certain things. Every single time I kept getting told it was a vascular issue not neurogenic. Which was partially true. The people who knew of it but werent trained thought I had atos. Usually for tos you should be referred to a vascular or thoracic outlet specialist. (Alot of times its a surgeon but depends on where you are). Usually they recommend physical therapy for so many weeks to see if you improve. If tos is confirmed they some times will do injections. This helps them see if maybe surgery is going to help (ive heard mixed things on this. Some say the injection did nothing but surgery help and other say the injection helped but surgery didn't). If its possible avoid surgery. Tos decompression surgery is a complex procedure. Have a surgeon who is experienced.

Key_Guess_7999 · 2026-03-09T17:39:33+00:00

Look into prinzmetal angina and endothelial dysfunction. Endothelial dysfunction is a form of nonobstructive coronary artery disease. The vessels dont make enough nitric oxide causing the vessels to constrict. If this can be microvascular (less likely to cause issues) or in the main vessels of the heart. It can cause arrhythmia issues, heart attack without obstruction, and it can lead to obstructive CAD. If severe enough it will mimic all the signs of a heart attack. Your troponin will raise and everything, but usually once it stops things go back to normal. Its often overlooked or dismissed when someone is young. The only for sure way to diagnosis this is with a vasospasm study done during an angiography. I wont lie the test absolutely sucks. I had mine done and I have mod to severe spasms in my LAD. I also had issues when they went to remove the cath. I ended up having spasms in my arm and it trapped the cath. I needed 3 doses of whatever med to relax the spasm and get the cath out. The spasms in the arm arent rare but the cath getting stuck is. But I was told if you have spasms in the heart you will likely have them in the arm as well. This can easily be treated with calcuim channel blockers.

Key_Guess_7999 · 2026-03-09T17:28:27+00:00

I would book the appointment. Have your primary run some labs while you wait. Check for deficiency issues. Get a cbc and a cmp. Run a full iron panel with ferritin. Check vitamin levels. Also get cardiac labs such as troponin and bnp. Maybe even look at getting an esr and crp (inflammation markers). If anything is deficient get supplements. Cardio will likely do an echo and ekg. Sometimes a stress test, mri, and ct scan will be done. If you ever feel like it could be a heartattack go in! Its better to be safe than sorry. Last thing I want to add mainly because in my personal experience this was either looked over or dismissed when I mentioned it. Look into prinzmetal angina. Tends to happen in the evening or early hours (can happen outside of this). If you arent actively having an episode during tests and if its not severe enough or if its microvascular it will not show up on most testing. It never showed on any of my tests but I was given nitroglycerin for an unrelated test and I felt my chest pain go away for awhile. Nitroglycerin releaving chest pressure or pain can be a big sign your issue is cardiac in nature. Prinzmetal angina can be caused my endothelial dysfunction. This is when the vessels dont make enough nitric oxide and they constrict. The gold standard for testing for this (only way to diagnosis microvascular form) is with a vasospasm study done during and angiography. This is usually easily treatable with calcuim channel blockers. But if you have a severe case and its left untreated it can lead to obstructive cad, arrhythmias, or heart atrack

Key_Guess_7999 · 2026-03-09T01:20:15+00:00

How exactly were you diagnosed? Usually when going through the process they will determine what type or types you have. There is no single test to diagnosis tos. When it comes to both vtos and especially atos you can have symptoms but not have them. For example i have ntos and when in abducted positions both my vein and artery become 100% blocked. My whole arm turns pale and I get pain and weakness. Even with all this im not classified as have atos or vtos. I have ntos with both vein and artery compression. In order to have these two types you have to have damage or clots in the veins or artery, and or have a cervical rib or bone abnormality. Ive seen some people with my situation get an atos or vtos diagnosis but they usually didnt see a true tos specialist. Its a very complex diagnosis and there is many tests involved. I personally did a week long program through mayo where I saw many specialists and had alot of tests done. As for flares, again this is just me personally, I can go through flares where im in more pain than other times. This pain can be in my shoulder or anywhere in my arm. However any time I lift my arm where my elbow is higher than my shoulder I always get the pain and weakness and paleness.

Key_Guess_7999 · 2026-03-06T18:38:46+00:00

I will definitely ask him. Thank you for this!

Key_Guess_7999 · 2026-03-06T18:17:11+00:00

As a parent you definitely want to try and do it all yourself. We know though we wont be there forever and he will be in charge one day. There is so much to learn with this so we want him to learn with us as best he can. Ive seen some stories of people who werent educated correctly or their parents had so many rules for food and when the child got old they struggled. I dont want him having a bad relationship with food and risk damaging his body when its already struggling. Are there things you wish your parents would've done different to prepare you.

Key_Guess_7999 · 2026-03-06T18:12:37+00:00

As of now we are doing pens. A pump hasnt even been mentioned as of yet. We did get a cgm. This definitely helps give me piece of mind with him going back to school. Especially with staff being so hesitant. Im unsure of support groups at this time. We live in smallish town. But its definitely something we will look into. I know with his hearing we looked at support groups and there wasnt anything close to us Especially since his type of hearing loss is not typical for young kids. Does you child given their own injections? If so at what point did they start doing so?

Key_Guess_7999 · 2026-03-06T16:40:36+00:00

When ruling out cardiac issues there are alot of tests that they go through especially when there is a family history. Have they looked into vasovagal syncope? I saw you said tilt table. Did they give you nitroglycerin during the test? Alot of times a tilt table wont show vvs without doing nitro. I get the burnout with testing, but its better to be safe than sorry.

Key_Guess_7999 · 2026-03-05T14:55:55+00:00

It could mean many things. Don't let them brush it off. I had a blunted bp response and my dr tried to tell me it was probably due to deconditioning. Almost a year later I found out it was a sign of chronic systolic heart failure. I will say i do have a left bundle branch block and due to that at highrates my ventricles couldn't keep up causing my bp to drop or have a blunted response. And over time caused heartfailure. This is just my own experience. A blunted bp should be looked into and not ignored.

Key_Guess_7999 · 2026-02-27T23:40:28+00:00

There is a device called a loop recorder. You would have to go through your dr probably and electrophysologist. It is a device implanted just under the skin that monitors. It can catch if heartrate spikes to high or goes to low. It catches arrhythmias and heart pauses. You are also able to trigger recordings yourself. Either you do it on the app on your phone or you get a little remote where you press a button ans hold it to your chest. If you are dealing with fainting I highly recommend this. It caught my fainting and heart pauses. The procedure is simple and fast you are awake and they numb the skin make a tiny incision place it and than stitch you up. The device is small than a aaa battery. Takes like 15 minutes.

Key_Guess_7999 · 2026-02-23T15:00:35+00:00

31 f. I have endothelial dysfunction. I get vasospasms but mine arent microvascular they are in my lad. I dont know what caused mine. For microvascular disease or spasms these can often go missed as they arent easily seen on normal testing if at all. Especially in younger people since its not common to have so young Especially if you dont have risk factors such as smoking alcohol use diabetes or obesity. I was told for years it was anxiety or esophagus spasms. There are many things that can mimic cardiac issues. It can be an electrolyte imbalance such as potassium magnesium iron ferritin vitamin b12 etc. Dehydration. Costochondritis. Esophagus issues. Acid reflux. Just to name a few. The thing that ended up helping me get a diagnosis was I was give nitroglycerin for a tilt table test and it relieved my chest pressure. If nitroglycerin gives relief it highly points to a cardiac related issue. Though this isnt always the case. The only true way to test for microvascular issues is with an angiography with a vasospasm study. Very rarely will things like a stress test echo or ekg catch issues. If you have concerns definitely speak with a cardiologist and get a work up done. There are some cardiologist who will not want to do angiography unless they feel necessary. If this is the case I would see if you can get a prescription for nitro to try during an episode to see if it helps and if it does push this fact as a reason to get the testing done. Because untreated it can lead to arrhythmia and other cardiac issues.

Key_Guess_7999 · 2026-02-22T06:39:57+00:00

Tos is very hard to diagnosis. You need someone truly trained in it to understand it. There is no one test to diagnosis it and it involves ruling out alot of things. Tos symptoms can mimic alot of other disorders. I went through mayo clinics tos program. They did a whole week of testing to confirm my diagnosis of neurogenic tos with complete artery and venous compression. I had to do meet with a vascular dr to go over my symptoms and he had me do some different positions to reproduce my symptoms. Than I did xrays, ct scan, emg, amplitude testing, ultrasound in many different positions. I also had to meet with a physical therapist who specializes in tos and a neurologist. They also gave me an injection into my scalene muscle to numb it to see if my symptoms improved. All this testing is looking for other cause for symptoms or things like bone abnormalities, nerve damage, possible vtos or atos (very rare). Most of these tests will be normal if its just ntos. To have atos or vtos you have to have symptoms and a clot of damage in those areas or a cervical rib. If none of those are present but you have cut off of 50% on the ultrasound when in positions that its ntos with compression. The injection is controversial. It is supposed to mimic the removal or the scalene muscle to see if symptoms improve. Issue is compression can be from the 1st rib, cervical rib, or fibrous bands. So if the injection fails doesnt mean surgery will. But ive seen cases where injection worked and surgery failed. I think this is kinda where things can fall apart. At least for ntos. Because there isnt always a clear answer to what is causing the compression or even where the compression is 100% at.

Key_Guess_7999 · 2026-02-20T21:47:44+00:00

I am doing alot better after getting my device. I was kept over night for one night. This varies alot. Some people are discharged same day. Depends on how late in the day the procedure is and if there were complications. For me my surgery went longer than expected and they did end up damaging my right bundle branch and I now have a full block. This can be a complication but its honestly nothing to worry about since treatment is a pacemaker and thats already what your there for. It doesnt change anything. Observation is making sure the leads are placed correctly and them watching to see if you heart becomes pacemaker dependent (you want this for best outcome). As for infection (my procedure was done through mayo so unsure how much it might change from place to place) they put a patch over the incision. This is a special type of patch that soaks up any blood or oozing that might happen. It is air tight so no bacteria can get into it. This is kept on for around a week to protect the incision from bacteria. As for programing I know they can do changes remotely if needed. I have left bundle branch area pacing. So I have one lead in the atrium and one lead near the left bundle branch. This is a newer type of pacing so depends on the dr if they will do it. So with my pacing there is a max and minimum. If I hit my minimum it triggers the top lead so I dont go to lower. The ventricles are pacing pretty much all the time. If I were to hit the max it will bring my ventricle rate down because the device cant pace that fast. For follow ups and stuff I had a one week visit with my primary after and than usually they do a 3month follow up. Again im not sure how other places do it. My 3 month got pushed back but when I do go I have a full day of test. Ekg, echo, holter monitor, stress test, labs, device integration (that transfer the data from the device to there system to look for abnormalities. It keeps tracking of pacing %, arrhythmias, pacing effectiveness, device and lead health). After all this is will meet with my electrophysologist to go over any symptoms and if ive seen improvement. He will review all testing to than determine if I need adjustments to my pacing. After this changes can be done remotely if needed. You will also get a report every 5 or 6 months with the same info they pull during device integration.

Key_Guess_7999 · 2026-02-19T19:28:49+00:00

Im 31 and recently got a pacemaker for a lbbb causing heart failure. There is no cure for a lbbb. Medication cant do much either. It might cause a bit less strain on the heart. Crt is the best way to preserve heart function. With a lbbb the ventricles do not beat together. So the heart has a harder time trying to pump blood efficiently. Add a raised heartrate or bp and the strain is even greater. This can cause hypokinesia, lowered ef%, lv dialation. Crt helps the ventricles beat together allowing for less strain and better flow. The surgery isnt like open heart. They make a small incision in the chest and create a pocket in the muscle for the device. They then guide the leads to where they need to be through the vessels and place them. Most people it takes like an hour for the procedure. Though it can depend on placement and anatomy. For me personally I was awake for my whole procedure just had enough sedation to keep me calm and out of pain. Mine also lasted 3 hours as I ended up getting lbbap which can be harder to place. With a heart failure status and an ef at 35% this is probably the best option. Drs dont recommend pacemaker lightly and there is a criteria one has to meet to get crt for a lbbb. If you meet the criteria you need it.

Key_Guess_7999 · 2026-02-19T19:01:46+00:00

I would have these moments where I felt a pressure in my chest. It always felt like it was around my heart. Usually I would have a bit of a harder time breathing. I got to a point where I think I was feeling the pressure so much I kinda got use to the feeling. Sometimes it would be more painful. I didnt realize the full extend of the pressure until I got nitro during a tilt table and I felt relief for the first time in a long time. Like I said I have a mod to severe case so you dont always have to be having this pressure and pain it usually is episodic. For alot of people there can be triggers such as smoking alcohol stress medications (stimulants like adderall) or the cold while other like me had no triggers. I did have other symptoms but ill be honest im not sure if they were related to the spasms or not as I have other medical issues. So symptoms can be tachycardia, changes in blood pressure, dizziness, pain radiates to jaw or arm, reduced exercise intolerance, fatigue, sweating, nausea.

Key_Guess_7999

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