Imagine working in an Emergency Department and a male patient in their early 20's comes in complaining of lightheadedness. You see him get registered and call him over to check some vitals. He slowly walks to you and seems calm. As you put the pulse oximeter over his finger and walk back to your computer, you hear the beeps of the machine wailing with an alarm. As you turn, you see his pulse is in the 170 bpm range. You rush over to get an EKG and call the charge nurse to secure a room for him. The patient isn't complaining of anything other than the lightheadedness. As you do the EKG it shows signs of supraventricular tachycardia (SVT). You bring the patient back to a room, to where the physician tells the nurse to get 6mg of Adenosine. While waiting for the medication, the physician tells the patient to bare down as if he was going to have a bowel movement and is changed from a sitting position to a Trendelenburg position. The monitor's sporadic movement and noise slowly diminish, and just like nothing the patient's heart rate went into normal range without the use of medication.
This is a common occurrence when dealing with an arrhythmia such as supraventricular tachycardia. SVT is a type of arrhythmia that is caused by an issue with electrical conduction, making the heart not fill up correctly with blood, making the heart speed up to compensate for its lack of perfusion. Patients under SVT will usually have heart rates over 150bpm without doing any physical activity. Most are symptomatic with lower blood pressure, lightheadedness, diaphoretic, and palpitations. Some do present asymptomatically, but can be caught quickly when triaging the patient. For many young adults, causes usually come from excessive caffeine or drug use.
To help combat this arrhythmia physicians will use Valsalva maneuver, Adenosine, and or cardioverting the patient. Valsalva maneuver is usually used first during SVT as a noninvasive alternative. It requires the patient to bare down as they would be when trying to have a bowel movement. This technique increases vagal parasympathetic tone which in turn causes the baroreceptors in your brain to increases parasympathetic output (an example is added below) (Neihues & Klovenski, 2024). Adenosine is used to block the conduction of the AV node allowing the heart to reset. If nothing has been successful, cardioverting is used to shock the heart to reset its electrical activity.
Next time you're cramming for your next midterm, maybe don't reach for another Celsius and grab a tea instead.
Valsalva Maneuver:
https://www.youtube.com/watch?v=NVFAr9-THKo
As I am well aware of the dangers in consuming too much caffeine, I am also a person who take in quite a bit of it, and I am a pretty big advocate for the amount of good it is doing for me. I believe that if you are having a healthy amount of intake ( and by that I mean not drinking multiple red bulls in a day) The pros of caffeine are very worth the risk.
ReplyDeleteCaffeine is known to increase alertness, increase memory, having an elevated mood and you guessed it, not feeling tired. The FDA does not recommend more than 400mg of caffeine daily. Which is just about around the average jo drinker is at. Making sure you are well hydrated and have a decent meal in your belly is going to be the most important thing to negate some of the unwanted affects.
https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much
Alsunni A. A. (2015). Energy Drink Consumption: Beneficial and Adverse Health Effects. International journal of health sciences, 9(4), 468–474.
I have always had complexed feelings about caffeine-intake and I definitely understand both sides of the argument. I am someone who LOVES caffeine and often treat myself to an energy drink or coffee early in the morning and later in the evening (I know, probably not the best idea). and definitely have seen the positive effects of it during the day. However, I have noticed that when I have more than 400mg of caffeine in a day, I do feel somewhat of a "sugar-crash" at the end of the day. So, I will definitely keep this in the back of my head when reaching for another energy drink and explore some different options to possibly help my energy levels throughout the day.
ReplyDeleteLike many of us I cant imagine my day without a caffeine to boost my mood and energy throughout the day. I often see myself drinking coffee at late hours of the night and never imagine any possible consequences of my bad caffeine habits. I had a friend who also once was hospitalized due to high consumptions of caffeine, I find it interesting to see how a change in position can have such a strong impact definitely something to remember if im ever in a situation which calls for it.
ReplyDeleteAlthough I often feel anxious when drinking too much caffeine, I struggle to not use it when studying. After reading your blog I was curious as to why I may struggle to feel relaxed when drinking caffeine (even in small amounts) and found that it also slows down heart rate autonomic recovery, which would correlate with why you would want to increase parasympathetic output.
ReplyDeletehttps://pubmed-ncbi-nlm-nih-gov.dml.regis.edu/34274079/
I definitely learned something new today. It is interesting that the Valsalva maneuver can active baroreceptors in the brain to induce the parasympathetic nervous system. Are there other applications for the noninvasive Valsalva maneuver? I wonder if this technique would be benefit individuals with panic attacks, or other cardiac events?
ReplyDeleteI am also one that relies on caffeine to get through a long day of classes. But like anything in life too much of one thing can have negative impacts. As long as students stay informed on the negative effects of consuming too much caffeine, I find these drinks to bring a much needed boost to our day. A coffee in the morning, and an energy drink in the afternoon is how I continue to crush Dr. Campisi's physiology exams.