• FAQ  • Search  • Memberlist  • Usergroups   • Register   • Profile  • Log in to check your private messages  • Log in 

arrythmia - palpitations


Goto page 1, 2  Next
 
Post new topic   Reply to topic    trumpetherald.com Forum Index -> Fundamentals
View previous topic :: View next topic  
Author Message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Thu May 10, 2012 3:07 am    Post subject: arrythmia - palpitations Reply with quote

are there hints
that trumpet playing could be associated with inducing cardiac arryhthmia ??
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
hvand
Veteran Member


Joined: 21 Jun 2006
Posts: 358
Location: Chapel Hill North Carolina

PostPosted: Thu May 10, 2012 10:02 am    Post subject: Reply with quote

As activities go, risks of trumpet playing are fairly small. There are a handful of case reports and series that link an increase in intrathoracic pressure to stroke-like events (CVAs), laryngoceles, and even raised intraocular pressure. You can damage your hearing by practicing in a closed room and you can catch a cold from playing an instrument that belongs to someone else. The serious events likely have a second factor involved (like a congenitally damaged blood vessel); the not so serious ones take only common sense to avoid.

Arrhythmias are quite common as we age. Singling out trumpet playing as a risk would be difficult if not impossible to do.

Controlling blood pressure makes a lot of sense, particularly since it probably increases while playing. For some, beta blockers both decrease performance anxiety and control BP.

Take care of yourself and if a doctor tells you not to play, I would get a second opinion.

Hank
_________________
Hank van Deventer, Durham Symphony
Back to top
View user's profile Send private message
trumpetninja
Veteran Member


Joined: 22 Jun 2008
Posts: 175

PostPosted: Thu May 10, 2012 10:48 am    Post subject: Reply with quote

Do you have a condition that causes arrhythmias? I have Wolff-Parkinson-White Syndrome which is a congenital heart condition that causes arrhythmias. The only thing regarding trumpet playing that has ever caused me to have an arrhythmia is the occasional performance anxiety that I get.

My doctor said that it wasn't the trumpet playing itself. There is actually an excercise that you can do during an arrhythmia that is not unlike trumpet playing.

PM me if you have any questions. I have been dealing with this for a few years now and after treatment I haven't had an arrhythmia.

Best,
Erika
Back to top
View user's profile Send private message Send e-mail
nieuwguyski
Heavyweight Member


Joined: 06 Feb 2002
Posts: 2335
Location: Santa Cruz County, CA

PostPosted: Thu May 10, 2012 10:48 am    Post subject: Reply with quote

I sometimes experience episodes of tachycardia (very rapid heart rate) while playing. It tends to happen when I'm over-heated and playing with excess tension.

I was thoroughly checked out by a cardiologist a few years ago and was told that I don't have a health problem -- I have a quality-of-life problem. Usually, if I relax, drink something cold, and take some deep breaths I will convert back to a normal rhythm in short order. Of course, it isn't always convenient to do all that when up on the stand -- but you do what you have to do. I had a bad episode a few months ago, when playing in a ballroom so stifling I was soaking through my tux jacket. I had to take a tune off and leave the room to cool down.

My "quality of life" problem seems to be getting worse as I age. At some point I will strongly consider cardiac ablative surgery.
_________________
J. Notso Nieuwguyski
Back to top
View user's profile Send private message Visit poster's website
Naharro
Regular Member


Joined: 07 May 2009
Posts: 12

PostPosted: Thu May 10, 2012 12:36 pm    Post subject: Reply with quote

Hi, I have had I have Wolff-Parkinson-White too, and my doctor said that the trumpet wasn't the trouble of tachycardia or palpitation. May be anxiety, but no W-P-W, but this syndome cause me the tachycardia.

I get??(sorry for my english) cardiac ablative surgery half and a year ago, and I haven't any problem now.

May be you can do an electroardiogram and check that it's all right.

My best,

Jose Carlos.
Back to top
View user's profile Send private message
hvand
Veteran Member


Joined: 21 Jun 2006
Posts: 358
Location: Chapel Hill North Carolina

PostPosted: Thu May 10, 2012 1:46 pm    Post subject: Reply with quote

I absolutely agree that if you have an accessory pathway like WPW, ablation is safe and quite effective. The risks may be higher with other supraventricular tachycardias.

Since the web is a bad place to do medicine, I won't go much beyond that. I do feel comfortable saying it's not the horn's fault.
_________________
Hank van Deventer, Durham Symphony
Back to top
View user's profile Send private message
TrumpetMD
Heavyweight Member


Joined: 22 Oct 2008
Posts: 2410
Location: Maryland

PostPosted: Thu May 10, 2012 2:19 pm    Post subject: Reply with quote

hvand wrote:
I absolutely agree that if you have an accessory pathway like WPW, ablation is safe and quite effective. The risks may be higher with other supraventricular tachycardias.

Since the web is a bad place to do medicine, I won't go much beyond that. I do feel comfortable saying it's not the horn's fault.

Hi Hank,

I agree that the web is a bad place to get personal medical advice. But under certain circumstances, it might be a good place to get general medical information.

Not sure if I understand the OP's original question, or the context he is considering. But if you include exercise-induced arrhythmia, then the answer is "yes". But this is extremely unlikely to happen in people without significant heart disease.

Mike
_________________
Bach Stradivarius 43* Trumpet (1974), Bach 6C Mouthpiece.
Bach Stradivarius 184 Cornet (1988), Yamaha 13E4 Mouthpiece
Olds L-12 Flugelhorn (1969), Yamaha 13F4 Mouthpiece.
Plus a few other Bach, Getzen, Olds, Carol, HN White, and Besson horns.
Back to top
View user's profile Send private message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Thu May 10, 2012 11:29 pm    Post subject: a Reply with quote

This subject is very interesting because:

We have every year more young people with atrial fibrillation, palpitations and/or arrhythmias. In former time this was troubling older people, mainly with pre-existing heart disease like ischemia, valve diseases and others; nowadays it beginns as serious problem with 30 years and earlier affecting otherwise healthy young people.

In former times this people went often to their practitioner or cardiologist, weekends in emergency departments, got different medications and were unhappy - but not well recognized.

Nowadays we see them for interventions like ablations or PV-isolations. And now this young healthy people appear and are recognized. And we see mainly people with:
- sleep apnea syndrome and obesity
- gastric reflux, late eating, alcohol
-
- and
-
- very sportive people over (30) 40 years
- young marathone runners and rowers
- singer
- trumpet player

It has obviously something to do with a overstimulated (fibration, swinging, strong movements) hyperactive vagal innervation of the gut, the esophagus and the heart (this is one big plexus, a huge network like a web which can develop irregular conductions). And as well something with mechanical compression of the small heart chambers. Probably the combination of being over 40 years, being very sportive (pressing, pumping, exhaustion) and singing or trumpet playing could be a risk constellation.


I am surprised and glad that in our trumpet player community here in the trumpetherald nobody seems to be affected

kind regards


peter
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
TrumpetMD
Heavyweight Member


Joined: 22 Oct 2008
Posts: 2410
Location: Maryland

PostPosted: Fri May 11, 2012 4:28 pm    Post subject: Reply with quote

Hi Peter,

I appreciate your question and interest, But I'm still not sure I understand what you are asking. And unfortunately, as a physician, I'm not sure I agree with your last reply. Let me clarify.

- Arrhythmias do not happen in people without underlying disease or congenital anomalies. I'm not considering certain benign arrhythmias that require no medical treatment at all.

- Arrhythmias are not on the rise in "otherwise healthy young people".

- No one is "unhappy" that cardiologists, emergency medicine physicians, and primary care physicians treat arrhythmias with medication.

- The ablations you mention are useful, but only for certain types of arrhythmias. The vast majority of arrhythmias are treated medically, and a large number of these arrhythmias require no treatment at all.

- The combination of being over 40, physically active, and a trumpet player in an otherwise healthy person is not "a risk constellation" for a cardiac arrhythmia.

Mike
_________________
Bach Stradivarius 43* Trumpet (1974), Bach 6C Mouthpiece.
Bach Stradivarius 184 Cornet (1988), Yamaha 13E4 Mouthpiece
Olds L-12 Flugelhorn (1969), Yamaha 13F4 Mouthpiece.
Plus a few other Bach, Getzen, Olds, Carol, HN White, and Besson horns.
Back to top
View user's profile Send private message
tptptp
Heavyweight Member


Joined: 25 Oct 2001
Posts: 1408
Location: Georgia

PostPosted: Fri May 11, 2012 6:41 pm    Post subject: Reply with quote

I agree with what you've said about arrhythmias, Mike. And, I suspect Peter is having a little trouble with English syntax.
Craig
_________________
Craig Mitchell


Last edited by tptptp on Wed Apr 02, 2014 6:51 pm; edited 1 time in total
Back to top
View user's profile Send private message
nieuwguyski
Heavyweight Member


Joined: 06 Feb 2002
Posts: 2335
Location: Santa Cruz County, CA

PostPosted: Sat May 12, 2012 1:49 am    Post subject: Reply with quote

The episodes of tachycardia I mentioned run in my family, spanning at least four generations. I piped up simply because there are specific circumstances involving playing the trumpet that will kick off an episode.
_________________
J. Notso Nieuwguyski
Back to top
View user's profile Send private message Visit poster's website
TrumpetMD
Heavyweight Member


Joined: 22 Oct 2008
Posts: 2410
Location: Maryland

PostPosted: Sat May 12, 2012 5:06 am    Post subject: Reply with quote

nieuwguyski wrote:
The episodes of tachycardia I mentioned run in my family, spanning at least four generations. I piped up simply because there are specific circumstances involving playing the trumpet that will kick off an episode.

Hi nieuwguyski. Sorry for any confusion. But I wasn't directing my comments toward you.

I think there may be a language barrier with the OP. My comments were directed toward the suggestion that arrhythmias in healthy people were on the rise, that playing the trumpet may be a contributing factor, that medical management of arrhythmias is incorrect, and that ablation therapy is the way to go.

Cheers,
Mike
_________________
Bach Stradivarius 43* Trumpet (1974), Bach 6C Mouthpiece.
Bach Stradivarius 184 Cornet (1988), Yamaha 13E4 Mouthpiece
Olds L-12 Flugelhorn (1969), Yamaha 13F4 Mouthpiece.
Plus a few other Bach, Getzen, Olds, Carol, HN White, and Besson horns.
Back to top
View user's profile Send private message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Sun May 13, 2012 12:04 am    Post subject: a Reply with quote

Hi Mike,
hi Craig,

thanks for your anser and your comments - it is great that you are arguing here

I think it is a good subject and worthwile to talk about in a trumpet forum. Especially if it could be that here could be one risk factor singing and trumpet playing.

Sorry, Mike - please donīt be angry; I appreciate that you are discussing here. If you say, that arrythmias only occur in underlying heart disease - this is simply wrong - please excuse me Mike & Craig. (If you want to know what I am doing - if you like per PM - I see more than a lot of acute patients since decades (as I was young I did 2 years surgery in Sydney and Denver - long ago).

Arryhtmias (SVES, episodes of A-fib) are often in otherwise healthy young (30 - 60 years) people Mike & Graig, that is exactly what we here are talking about.
And this is a problem that is increasing and pills are in most cases not the solution (efficacy, side effects)

It seems that we observe a cumulation with Marathone runners, singers, rowers and trumpet players (also a lot of caffeine, very late eating of huge meals and alcohol).

I am just curious in our trumpet playing community wether there are also others have this impression.

Never mind and donīt be cruel - it should be only a discussion and I am very interested in the feedbacks.

kind regards

Peter
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
tptptp
Heavyweight Member


Joined: 25 Oct 2001
Posts: 1408
Location: Georgia

PostPosted: Sun May 13, 2012 5:37 am    Post subject: Re: a Reply with quote

hien peter wrote:
Hi Mike,
hi Craig,

Arryhtmias (SVES, episodes of A-fib) are often in otherwise healthy young (30 - 60 years) people Mike & Graig, that is exactly what we here are talking about.
And this is a problem that is increasing and pills are in most cases not the solution (efficacy, side effects)

It seems that we observe a cumulation with Marathone runners, singers, rowers and trumpet players (also a lot of caffeine, very late eating of huge meals and

kind regards

Peter


Mike said he was excluding benign, common arrhythmias such as simple premature atrial and ventricular contractions. These are indeed common and exaserbated by caffeine, anxiety, fatigue, chocolate, other drugs, etc. Often, but not always, there is no underlying identifiable structural heart disease. Frequently there is unhealthy living involved.
There is no evidence that the more serious arrhythmias are increasing in frequency. Perhaps detection is better. Your category of "otherwise healthy" shouldn't be equated with "young", as many young folks are far from healthy these days. Some athletes are probably pushing themselves far beyond what God intended, and in some cases have undiagnosed disease. Current knowledge says that ventricular tachycardia, SVT, WPW, atrial fib and others are always accompanied by underlying heart abnormalities (bypass tracts, channelopathies, chamber enlargement, etc). OK, "always" is usually criticized, but that's my expert opinion.
Cardiologist
_________________
Craig Mitchell
Back to top
View user's profile Send private message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Thu Dec 13, 2012 9:51 am    Post subject: Reply with quote

Hi Mike,

sorry, but you are wrong.

I follow this subject now for a long time and cooperate with some cardiologic centers especially dealing with PVA (pulmonary vein ablation) in atrial fibrillation.

There is increasing incidence of SVES, runs and atrial fibrillation in:
- runner
- rower
- singer
- trumpet players

Common sense seems, that mechanical compression of the left atrium is an irritation that triggers sources of premature excitation. Also it induces influx of muscular growth of atrial tissue in the pulmonary veins with prematures and fibrillation.
(Probably also something to do with compression and irritation of the vagal plexus involving the stomach, kardia, esophagus and the heart and the ganglia of this plexus located around the left atrium - primarilly a problem of compression and mechanical irritation)

Also I know in the meanwhile some trumpet players stopped because of this (atrial fibrillation) in the age about 50 - 60 years.
Some professionals told me that they know a lot of colleagues getting this problem.

I just think this could be a subject worthwhile to look at it and to allow an open discussion with a lot of experiences and opinions.

Kind regards

Peter
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
TrumpetMD
Heavyweight Member


Joined: 22 Oct 2008
Posts: 2410
Location: Maryland

PostPosted: Thu Dec 13, 2012 10:25 am    Post subject: Reply with quote

hien peter wrote:
Hi Mike,

sorry, but you are wrong.

Hi Peter,

Let clarify that no one is angry. We're all just discussing your original question.

But let me also add that I am an Emergency Medicine and Internal Medicine physician, and that Craig (a Cardiologist) agrees with me. I stand by my earlier statements. And while I think there may be a bit of a language barrier adding to the confusion, I'm just not sure you understand this issue.

Mike
_________________
Bach Stradivarius 43* Trumpet (1974), Bach 6C Mouthpiece.
Bach Stradivarius 184 Cornet (1988), Yamaha 13E4 Mouthpiece
Olds L-12 Flugelhorn (1969), Yamaha 13F4 Mouthpiece.
Plus a few other Bach, Getzen, Olds, Carol, HN White, and Besson horns.
Back to top
View user's profile Send private message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Sun Nov 17, 2013 1:04 am    Post subject: a Reply with quote

For me ongoing a very interesting subject,
I am a little bit surprised no one else contributes.

In the meanwhile I have two more trumpet players with this arrhythmias,
one other who ist playing french horn,
(french horn players have a surprisngly high incidence of early dying or illness because of stroke in middle age (associated with arrhythmias).
A hungarian trumpet player (high end, very very good),
he plays sometimes in Dresden (Semper opera)
told me, he knows some collegues in big orchestras,
also his teacher in young years,
who had to stop their trumpet playing because of arrhythmias.

It has obviously also something to do with pressing, eating & drinkung
before&during playing and overstimulation of the vagal plexus.
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
ohiotpt
Heavyweight Member


Joined: 25 Jan 2008
Posts: 987

PostPosted: Sun Nov 17, 2013 1:41 am    Post subject: Reply with quote

The term arrhythmia covers a WIDE of range heart beats.

If you think of a "normal" heart rhythm as between 60 -> 100 bpm
Each beat fired off by the top of the heart (the atrium) sending a signal to the the bottom of the heart (the ventricles) with relatively slow changes in the heart rate to compensate for effort.

Then everything else is an arrhythmia (more or less).

So, which of the multiple arrhythmias are your referring to?
_________________
-fred
Lots of horns available to try and buy (or just try) in the Florida Treasure Coast area (Especially Kanstul trumpets) - PM if you'd like to stop by.
Back to top
View user's profile Send private message
hien peter
Veteran Member


Joined: 13 Apr 2007
Posts: 307

PostPosted: Sun Nov 17, 2013 1:59 am    Post subject: Reply with quote

For me ongoing a very interesting subject,
I am a little bit surprised no one else contributes.

In the meanwhile I have two more trumpet players with this arrhythmias.
one other who ist playing french horn,
(french horn players have a surprisngly high incidence of early dying or illness because of stroke in middle age (associated with arrhythmias).
A hungarian trumpet player (high end, very very good),
he plays sometimes in Dresden (Semper opera)
told me, he knows some collegues in big orchestras,
also his teacher in young years,
who had to stop their trumpet playing because of arrhythmias.

It has obviously also something to do with pressing, eating & drinkung
before&during playing and overstimulation of the vagal plexus.

Answer:
we talk about atrial premature beats,
first single, then becoming more, then runs,
in the end absolute arrhythmia by atrial fibrillation
(first paroxysmal and then onholding)

AND:
--> http://news.bbc.co.uk/2/hi/health/948374.stm
--> my opinion is:
--> it has nothimng to do with pressure
--> but with intermmittend absolute arrhythmia
_________________
playing trumpet is like meditation

Strad H37 & G 7s
martin committee 1946
Weimann C, Strad C
Conn V1 FH & MB6
Back to top
View user's profile Send private message AIM Address
ohiotpt
Heavyweight Member


Joined: 25 Jan 2008
Posts: 987

PostPosted: Sun Nov 17, 2013 7:48 am    Post subject: Reply with quote

This is not an uncommon problem among the older population.

As a coincidence, this thread popped up on my screen as I was calling the Electrophysiologist (Specialist in the cardiac conduction system) so I thought I'd ask his opinion.

Off the top of his head, he felt the the increased intrathoracic pressure over time could STRETCH the RIGHT ATRIUM. The pacemaker of the heart is located in the atrium. When a heart cell thinks that the pacer isn't doing it's job, it steps up to the plate to fire off itself. I'M NOW IN CONTROL. So with the atrium stretched a bunch of these cells could not "hear" the main pacer and try to take control (anarchy) FIRE FIRE FIRE FIRE FIRE. Thus kicking into Atrial Fib.

The next question was the valsalva maneuver of trumpet playing to kick one OUT of atrial fib. While that might control the RATE of RESPONSE, because it affects the pathway between the top of the heart and the bottom of the heart, it won't kick you out of Afib.

Now, let's talk trumpet playing and hernias...............
_________________
-fred
Lots of horns available to try and buy (or just try) in the Florida Treasure Coast area (Especially Kanstul trumpets) - PM if you'd like to stop by.
Back to top
View user's profile Send private message
Display posts from previous:   
Post new topic   Reply to topic    trumpetherald.com Forum Index -> Fundamentals All times are GMT - 8 Hours
Goto page 1, 2  Next
Page 1 of 2

 
Jump to:  
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot vote in polls in this forum


Powered by phpBB © 2001, 2005 phpBB Group