What would the MRI report of a patient with episodic cardiac arrhythmia suggest?

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I can understand your concern. I have reviewed the attachments (attachment removed to protect the patient's identity) the MRI (magnetic resonance imaging) is normal. Echo is also normal. Preserved means not reduced, which means normal. The right ventricle's slightly increased volume is not significant; it is also normal. Regarding arrhythmia or PVC (premature ventricular contractions), get a Holter monitoring done. In Holter monitoring, ECG is continuously recorded for 24 hours for a maximum of seven days. It will record any cardiac rhythm abnormality. Kindly revert for more queries. Thank you.

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Preserved biventricular geometry and function means both ventricle's structure and function are normal.Your arrhythmia is paroxysmal, it can be supraventricular Tachycardia or atrial fibrillation. It can be ventricular tachycardia but it is less common than former two.POTS is usually sinus tachycardia. Drink more water, avoid anxiety. POTS is formally assessed with tilt table test. Is there any family history of cardiac issue like cardiac arrest or sudden cardiac death? Has you ever had loss of consciousness?

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I am so sorry to hear about your concerns. I can only imagine how difficult this must be for you.

It takes a lot of courage to face a health challenge like this. These findings in the brain are not caused by the heart. POTS causes the only heart rate to increase upon standing from a lying position with symptoms. Orthostatic hypotension is when blood pressure drops when one stands from a lying or squatting position. A vagal reaction is when blood pressure drops and the heart rate decreases. All these can be assessed on the tilt table test. CSF leak is when fluid surrounding the brain leaks through the discontinuity of bone, and fluid dribbles from the nose. Your symptoms may be due to cardiac arrhythmia or non-cardiac causes. Even if it is cardiac, it is not high risk because the cardiac structure is normal. Cardiac arrhythmias can be paroxysmal SVT (supraventricular tachycardia) or atrial fibrillation. Ventricular tachycardia is also a possibility. It can also be the vasovagal response.

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Regarding brain imaging, differential diagnoses are mentioned in the report, like toxin exposure, substance abuse, and age-related brain changes. But these should cause persistent symptoms, not the episodic symptoms you have. A neurologist's expert advice will be more fruitful. Regarding cardiac workup, it depends upon symptoms. If you have symptoms of fast heart rate or dizziness, or blackouts only upon standing from sitting or lying position, have a tilt table test done. If you have episodic symptoms of palpitations, have long-term ECG (echocardiogram) monitoring like Holter or an event recorder. A cerebrospinal fluid (CSF) leak may not always appear on an MRI. Therefore, in some cases, a specialized imaging test such as a cisternography may be required to diagnose a CSF leak.

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This single-channel ECG shows a fast rate, but in SVT heart rate is even faster than this. No definite P waves are visible. Differentials include SVT, atrial flutter, and junctional tachycardia. If this is frequent, a cardiac electrophysiological study is done to differentiate and treat. Do you suspect a CSF leak? CSF leak occurs from the nose, called CSF rhinorrhea. In this, sudden fluid dribbles from the nose upon straining, coughing, etc. Fluid is clear, warm, and and is odorless. Regarding other tests, baseline tests are done if not done in the recent past. These tests include complete blood count (CBC), urea, creatinine, electrolytes, and TSH (stimulating thyroid hormone) levels.