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From: George
I came across this site while I was trying to find out more about what may have caused an episode that a friend of mine, (David), had yesterday while visiting my house.
David was visiting my wife & I and suddenly slumped to his left, and then his head tilted back. I first thought he was goofing around, like: "Oh, man, I've had a rough day.." But the way he slumped just wasn't right. (I should mention that I have over 14 years experience in Sports Medicine as an Athletic Trainer. I am retired, now.) As I spoke David's name, I moved towards him realizing that with the eyes wide open, blank stare on his face, he was not responsive.
As I reached David, I found that he had stopped breathing. I checked his pulse & it was normal. With a normal pulse, I decided to move him to the floor & give him artificial respiration, if needed. I thought it might be possible that he would restart respiration, on his own, if I got him into a supine position.
I got him to the floor, re-checked his pulse, (OK) and rechecked his respiration - still not breathing. He was limp, showing no signs of seizure and still unconscious. I then checked to make sure his tongue had not closed off his airway - it had not.
I proceeded to give Dave a breath of air from my lungs. I closed off his nose, pulled his chin down & gave him a full respiration from my lungs. I felt his lungs fill, and as they filled, he coughed & exhaled on his own. At the same time, he began to 'flail' his arms and kick his legs wildly. He also involuntarily contracted his torso, lifting his buttocks off the floor. This continued for about 5-10 seconds and then he began to regain consciousness.
He had a confused, blank look on his face as he looked at me. It was another 5 seconds or so before he 'connected w/ the world' and began to apologize.
(The compulsion to apologize immediately following a seizure is something I had witnessed before, so I didn't think anything of it.)
Within 15-20 seconds Dave had re-gained full consciousness and was starting to ask questions about what had happened. The entire episode lasted little more than 90 seconds, at the most.
I questioned David about pain, any history of seizures, how he was feeling, etc, etc, and got nothing from him other than he hadn't eaten much today and had worked out this afternoon. (It was about 4:00pm at the time.) The only thing he reported was feeling hungry.
I continued to talk with him, reassuring him & getting him to relax. After 3-4 minutes, I got him to sit up.
My wife got him a glass of water & several pieces of cheese & he readily ate them. He started to perspire heavily and 'felt warm' about 2-3 minutes after he began to eat/drink.
I called his personal physician to see if he wanted to see Dave or if I should take him to the ER. I gave a complete description of the episode to his physician & he suggested I take him to the ER and then have David see him for a follow-up.
By about 6:00pm we had seen an ER Doc. They had done an ECG, which appeared normal. David was on a heart monitor & was showing an irregular heart beat about every 10-12th beat. The physician considered this 'normal', but without seeing what a 'true' normal was for Dave's heart, I wouldn't agree. I watched the monitor for 4-5 minutes & recognized a consistent, irregular beat.
Dave's wife arrived at the ER, & I left before the blood work returned, but I spoke with Dave's wife later in the evening & the ER doc had attributed the entire event to dehydration. I don't know how they determined David was dehydrated or why dehydration brought on the episode. Dave showed no outward signs of dehydration, nor did he every mention being thirsty. If it was based on his electrolyte blood levels, there are things other than dehydration that could cause abnormal electrolyte levels.
The diagnosis was still bothering me this morning; leading me to do some research on the Internet. After spending some time reading about VVS on this forum & seeing your post, Ted, I feel that VVS may be responsible for David's episode.
I was concerned yesterday that David's episode was related to his heart. He's 45 and used to be active at an above-average level, but until 2 months ago, he had been inactive, working a sedentary job & not watching his diet. He's about 15% overweight, and moderately under-toned. He also smoked until 8-10 years ago.
Given his history, arteriole disease, cholesterol-related plaque &/or an ill-conditioned heart must be expected. With these factors, a myocardial incident is not outside of consideration in a 45 year old male.
Unfortunately, everything combined could be the basis for a 'classic example' of an early 40's, first episode, terminal heart attack. Observing David's physical reaction yesterday, the abrupt cessation of respiration, the eyes wide-blank & perplexed stare on his face reminded me of the outward signs of life leaving a body.
Any comments, observations or similar experiences to David's episode that anyone reading this forum may have would be greatly appreciated. I would like to contact Dave's regular physician & make sure Dave gets in to see him for a more definitive diagnosis.
Thanks.
George