Heart too funky to measure on CT?
August 18, 2022 8:59 AM   Subscribe

How can I minimize “ectopy”/fluctuating heart rate before a gated contrast CT-angio scan? Beta blockers didn’t work….

I’ve had two attempted gated CT angio scans (with contrast) in 2020 and 2022. Both were aborted after the calcium score but before contrast was added due to my heart rate fluctuating.

My Heart rate oscillated between 50bpm and 85bpm, when lying down prior to entering the scanner. My ECG and heart rate are “normal” (like ~60-70 bpm) when lying down outside the scanner in an office, so clearly this is a function of nerves or psychosomatic ( I don’t *feel* nervous, but obvs my heart belies this). I tried focusing on breathing, calming visualizations with my eyes closed, these didn't help....

I have a 3rd CT scheduled in a couple of weeks, at a hospital so the staff, if necessary, can try and stabilize my heart rate.

i) Are there practices I can do before/during the scan try and stop or minimize my heart rate from fluctuating?

ii) If not are there drugs we can recommend I have that will stabilize my heart rate so that they can do CT with contract.

Abbreviated notes from radiologist

Cardiac ectopy despite administration of beta blocker, the examination was terminated before the administration of iv contrast
Beta-blocker administered: 50 mg metoprolol by mouth x1

Due to difficulty to control heart rate, and "because of previous failure of Beta blockers", cardiac CT angiogram was discontinued before administration of contrast.
posted by anonymous to Health & Fitness (2 answers total)
I am not at all a health care professional. You can make sure you are well hydrated, which makes the heart's electrical system function more effectively.
I don't know the cause of the erratic heart rate, but I am usually able to resolve SVTs with the Valsalva maneuver, which stimulates the Vagus Nerve.
I'd consider Valium if it's due to anxiety. Valium is much less proscribed because of abuse, but it's really good at calming.
posted by theora55 at 9:33 AM on August 18, 2022

On my phone right now so cannot write a long comment but did you talk to the doctor who ordered the CT scan? I would talk to that person. It appears you only got a single dose of the betablocker and it didn't immediately stabilize your heart rate enough to perform the study but that is a problem your referring physician has most likely dealt with before. I'm reluctant to offer more concrete suggestions because it's the internet and only your clinician knows your specific situation but I'd encourage you to call your cardiologist or even your PCP for advice.
posted by M. at 2:22 PM on August 18, 2022 [1 favorite]

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