Posted By Debbie on June 29, 2009

Where do I start?

                   First, I think it’s important to introduce a little prior knowledge about my life as it was at that time so you can see some of the big picture and not just the end result. I had a husband, a lovely man who happened to be born in the wrong century. He might have given up his cowboy hat and boots when he was ten but the Cowboy lives on. Along with two of the most wonderful, exceptional children (I am not being bias in this area I just know it to be a fact!!).

                   We had a mortgage, credit cards (those insidious little plastic pieces that will be the downfall of the monetary system as we know it) and all the stress and hoop-la that come with it. We lived in a fast busy world and both my husband and I worked hard and played hard. There was never enough time in the day or week or month to do the things that needed to be done. Priorities had to be set. It also meant that sleep was at a premium. A condition I am sure that still exists. With the majority of families having two working parents and those who have to make it on their own we all walk that fine line of sanity.

                   My children, who are truly my best friends, were my first priority. After all they didn’t ask to come into this world and they deserved the best that I could give them. Work for me was the second most important thing, for without that, the needs of my children could not be met. Except for the necessary absences from work, (usually for sick children), I was a dependable employee. There was room for advancement and I looked forward to these challenges. I was a lifer and I fully expected a long career and fruitful retirement. My relationship with my husband took the third cue, perhaps that wasn’t one of my wisest choices. My marriage was not exceptional but it was not unbearable either (however that did change in time).

                   I felt happy enough with the choices I had made and the commitment that bound me to them.

                     So, at thirty two I was healthy (or so I thought!) and strong and living the life.

                   It was the night of Wednesday, April 8, 1987.

 Continued……….

 QUOTATION:  “My life consists in my being content to accept many things.“

(Author Unknown)

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Category: My Heart Story | No Comments »
Tags: atrial ventricular, ejection fraction, failure, Heart Disease, icd, left coronary artery, myocardial infarc, tachycardia, wide complex

Posted By Debbie on February 23, 2010

Continued…….. They felt it was in my best interest to fly to London so Dr. Kostuk could oversee the administration of the drug.

 

          In the beginning my going to London seemed like a backward step in my recovery. The reality was I was scared that they wouldn’t be able to help me.  Having to travel on my own gave me way too much time to think about the consequences of not finding a medication to sustain a normal heart rhythm.  There are several reasons I could spurt about why it wasn’t possible for anyone to fly down with me but it would just be a bunch of poppycock, as my mother would say. Nobody volunteered or expressed interest in doing so. That is so “I’m feeling sorry for myself” but there you have it. I convinced myself it was for the best and “got on with it”. Another of my mom’s long list of popular quips. The flight was fine except for the fact that my heart rhythm would rise and fall on a whim. Staying calm under those circumstances was a challenge but my ever present denial kept me company and things in control.

 

          Have you ever had one of those moments when someone asked you how you were and you actually told them exactly what was going on? Well, I’m sure

I added a good story to my taxi drivers list of taxi tales. The ride to the hospital was quick. There was no question; my driver did not take any extra time to get more fare that day. He was glad to be rid of me. And then there it was. The last chance hotel.

 

          Just a reminder that I am a small town girl who’s nearest neighbor lives two miles down the road and you have to take the car to the corner store. It was an experience for me to walk through those doors. However, I could see immediately that this hospital knew how to make things easy on their out of town patients who lived with the wild dogs. Everything was clearly posted and after going through the initiation process, which was relatively painless, I was brought to the first waiting room where I found other somewhat nervous patients. By this time I’m relaxed. There were doctors here and if a passed out on the floor I was pretty sure someone would be there to take care of me. It took a relatively short period of time before I was brought to the second waiting room. There was a very long hallway and more doors to rooms than I could count. By this time I’m exhausted. I do not know how long it took the doctor to come in because I was fast asleep and he had to wake me up. Twenty minutes later I was on my way to admissions. An hour later I had eaten what was left over from the supper crowd and on my way to my first good sleep in a long time.

 

          Up at six o’clock for meds and breakfast and then a most interesting day began. The entire day was taken up by tests of many kinds. This hospital was fast and efficient. I would just get done with one test and I would be off for another. I had lunch in my wheel chair chatting with other heart patients and feeling well taken care of. Another long day and a long peaceful rest.

 

My stay lasted seven days. I was started on massive doses of Amiodarone. Sixteen hundred mg every eight hours just so I could get a good kick start. And it worked. By the time I left there I was feeling almost normal.

 

When all was said and done I was told that I was a very lucky girl. All week interns would come into my room and try to diagnose what was wrong with me. It was quite interesting and I began to have a lot of fun with it.

 

My diagnosis told me that I had massive tissue damage on the left side of my heart. Because of that my heart was enlarged and two of the electrodes were damaged. That was the cause of most of my tachycardia.  I was lucky that they were not life threatening at that time; however the heart would wear down if the tachycardia was not controlled. Thank you Amiodorone. I have now been taking the drug for twenty one years. The side effects weren’t pretty but I was more than happy to deal with them. My ejection fraction was thirty percent where a normal heart performs at one hundred percent. I have since discovered that a person can have a relatively normal life all the way down to thirteen percent. For the time being my tachycardia was more controlled and I was pleased with the outcome.

 

My next decision would be: do I get ready to live or get ready to die.

Quotation

The most powerful thing you can do to change the world is to change your own beliefs about the nature of life, people and reality to something more positive…and begin to act accordingly.

Author: Shakti Gawain

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Tags: atrial ventricular, ejection fraction, Heart Disease, Heart Failure, icd, left coronary artery, myocardial infarc, tachycardia, wide complex

Posted By Debbie on September 29, 2009

Continued………… It was official; I was an enigma and would be reminded of this often in the years ahead.

                   So now it was a waiting game and after two weeks they sent me home to convalesce until the other tests could be done. There was to be complete rest. That was easily accomplished. I was emotionally and physically weary from the events that had taken place. Eating became a chore all its own. I was unaware of the amount of energy needed to digest food. Maybe there was truth in the old adage “do not swim for at lease an hour after eating”. Cleaning house was never one of my favorite things to do. However, watching the dirt and grime build up was not all that uplifting either. Good days involved sitting on the deck with the sun pouring down on me. I read a lot of books and tried to be a good patient. My husband took some time off and we did a lot of staring at each other. Needless to say he was more than ready to go back to work after two weeks. Other than taking an overdose of pills the first day home and causing my blood pressure to drop to “60 over 40” everything went quite well.   

                   After my first of many angiograms and scores of other tests the doctor was ready to tell the bad and the good. Because of the substantial damage to the left ventricle at least two of the electrical sensors were damaged. My heart rhythm was erratic and would in all likelihood stay that way.  They discovered a collapsed artery witch they felt was the cause of the heart attack. Luckily all the other arteries were alive and well. It was nice to hear something positive for a change. It was mentioned that they had gone back in time to my father’s heart attack twenty seven years earlier and found a similar turn of events. He had died, I survived. Thanks to heart research and the new medications of my time.

                   The main problem now was finding a drug that would sufficiently control the tachycardia that persisted. Because the change of rhythm started in the lower chamber it wasn’t considered to be life threatening. Still, we needed to control them because in reality they could cause another attack at any given time.  

                   Erratic fluttering in my chest became a daily thing. It was unsettling at first. I would stop and find a resting spot, sit quietly and listen to my body.  These episodes lasted anywhere from five minutes to half an hour. Anything past that always led to a visit to emergency. They would administer oxygen and wait for it to pass. In the beginning I would wonder if this time would be the end. Was my time here finished? Would I be found by my children after a long school day? Although I always tried to stay calm shaking these thoughts from my mind was never easy. I would feel the anxiety building and it would intensify the feeling of my heart rate which soared to its own music. Panic always sat on my doorstep and for a long time all of my thoughts went to keeping it a bay. These episodes drained me of energy and I always felt like I had just run marathon.

                   Over time I learned to lie quietly and free my mind of thought. I would enter a dreamlike state. I concentrated solely on the reactions of my body to the unnatural rhythm. Sometimes I could visually view my heart as if it were separate from the other organs in my body. I would soothe it with soft whisperings, encouraging the muscle to settle back into a comfortable rhythm. The more relaxed I could make myself the easier the transition back to an acceptable heart rate occurred.      

                   We tried every arrhythmia medication available but the tachycardia persisted. At this rate my heart would eventually wear out. It was one of my long tachycardia attacks that enabled my doctor to finally map my heart to find out exactly what signals were being sent where and why. There was a relatively new drug on the market for arrhythmias that they had been testing at the research hospital in London, Ontario with great success. My doctor felt I could benefit from this treatment. He contacted his mentor, Dr. Kostuk, who at that time was in charge of the heart unit in London. They felt it was in my best interest to fly to London so Dr. Kostuk could oversee the administration of the drug. 

Continued………………

Quotation

“Let go of the notion that things shouldn’t be that way. They are that way!”

Wayne W. Dyer

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Tags: atrial ventricular, Heart Disease, Heart Failure, icd, left coronary artery, tachycardia, wide complex

Posted By Debbie on July 28, 2009

Continued………. The Grim Reaper went home alone. 

                   Unaware that four days had passed my first conscious thought when I awoke was “Where is everybody?” Apparently I had made it out of the critical part of the ordeal. I was feeling a little weary but that seemed logical after a battle of the body and mind with an unknown assailant. However, I also felt refreshed, like waking from a much needed rest. I took the liberty of sitting up and viewing my surroundings. The nurse, I would learn, was never very far away. She noticed me swing my legs to the side of the bed and came in to see what I was up to. It seemed odd to me that she wasn’t overtly happy to see me finally awake. And she lacked the normal concerned look that I might attempt standing so soon after awakening. She implied by her conversation that we were acquainted with each other. The grumbling in my stomach overruled my curiosity. Breakfast was here and I was famished. Eating exhausted me and I fell back into a deep sleep.

                   My sister in-law, who I thought to be my first visitor, arrived after my nap and I was glad to see a familiar face. “Feeling better today” were the first words out of her mouth. Because of the fact that I didn’t recall seeing her until before the heart attack I sat staring at her with what must have been a perplexed look.

                   We both seemed to clue in at the same time. Trying to figure out how much time had passed I asked her what day it was. Unknown to me it had been almost five days since the attack and according to her I had been awake and functioning for the last two days.

                   That was a couple of blank pages from my book that were never to be recovered.  Compared to the vast number of pages that disappear from our minds as time goes on it was inconsequential. However, it was more unsettling than I had originally thought when certain individuals were all too happy to tell me what I had ‘said’ while my alter ego was apparently in control of my conscious mind. For the first time I felt the true impact of losing time.  They mentioned things I can’t imagine me saying in ways unfamiliar to my real character. But what was I to do? I couldn’t remember and the nurses validated the truth of my unconscious exile. As time went on it seemed that those same people took liberties of quoting me from when I was absent from my own mind when it best suited there needs.  Some of which I could have said but lots that I couldn’t relate to. It recalled a memory from high school. I was very uncomfortable when one of the fads that popped up was being hypnotized. I had always been wary of putting myself in a situation which caused the loss of control of my own mind. This just confirmed my belief that you had better have implicit trust in any person you hand over your psyche to.

                   The doctor came to see me as soon as he heard I was awake. It was time to hear the about the aftermath of my attacks. They had done several electrocardiograms and a few ultrasounds which concluded the following.

                   My immediate problem was the large blood clot that had formed on my left ventricle. It was protruding at least two inches in diameter on the left side of my heart.  I was on blood thinners in hope that it would allow the blood to flow more freely to the rest of the body trying to avoid another attack. Along with the clot here was damage to the left ventricle but he wouldn’t know the extent until he could perform an angiogram. That couldn’t be done until the blood clot dissolved of its own accord. Trying to put the pieces together we concluded that the first attack had been minor and the second was what they called a “massive” heart attack. The third they had under control in a short period of time because they were there when it occurred. It was official; I was an enigma and would be reminded of this often in the years ahead.

Continued…………

                                                                                  Quotation

 “When you are told that you have some of kind of physical affliction, you can either prepare to suffer or prepare to heal.”

                                                                                 Author Wayne W. Dyer

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Tags: Heart Disease, Heart Failure, left coronary artery, tachycardia

Posted By Debbie on July 12, 2009

Continued………. I have no recollection of how I got undressed and in a hospital bed.

                   The pain in my chest persisted and it wasn’t long before I was awake again. At least it wasn’t long enough for me. There was a sense of urgency in the room, but except for my discomfort I felt safe and away from harm.  Everyone in the room was intent on their task at hand. They asked me some questions like I had the ability to answer them coherently. The pain in my chest was becoming so severe I actually pleaded with them to give me something to ease the assault on my body. I have always had a high tolerance for pain, but this was way out of my league.

                   They were busy hooking me up to all sorts of gadgets I knew nothing about and there was a heavenly relief when they finally put that needle into my arm and I slipped away into oblivion. I was not awake for the third attack and I can’t help but believe that was a good thing. I don’t think my psyche could have taken any more of that pain without driving me mad (incidentally, my daughter relates the same sentiment about her induced labour with twins).

                   When next I awoke I was in the heart unit and my family had set up vigil in the outer room. Now doesn’t that just tell you that something is wrong?  After all my family only got together at Christmas and funerals so this had to be a little more serious than I had hoped.  Taking that into consideration I felt good, pain free and safe. My doctor, who had been sitting next to me when I awoke, was intent on explaining just why I wasn’t safe. He seemed very solemn and there was a sense of urgency in his eyes. He leaned in quite close and told me what had happened. They had determined that two heart attacks had occurred. He was unaware at that time of the first one that had happened two days before but this seemed unimportant at this juncture.   

                   The doctor explained that because of the heart attacks I had developed several arrhythmias and a massive blood clot on the left ventricle of my heart. His biggest concern at that time was that blood clot may literally burst from the pressure of the blood.  I remember looking at him with this “what are you talking about” expression on my face.  Very seriously he leaned over me and expressed the importance that I needed to be perfectly still and rest in order for me to achieve my best chance for survival. An insidious, overpowering fear started to envelop me and he could see the disbelief in my eyes was being replaced by panic. It was at that time he confidently took my hand and held it, looking directly into my eyes. His touch was warm and self assured and his eyes held mine. There was no need for him to say anything. I felt his energy extend into me and the panic slipped away.

                   As the panic receded formed thoughts started to enter my mind. The fist was what my mother must be going through in the outer room. My father had died at the age of thirty seven under the exact same circumstances and I knew she would be having a hard time dealing with this. So even though it was clear that the doctor did not want visitors I asked if I could see her. I had a compelling need to tell her that I was going to be fine. To make her understand that I wasn’t going anywhere and she should let everyone know that. It could have been that obstinate character flaw of denial that is still evident in me today. She was emotionally unable to come to my side and later I felt quite saddened by it.

                   They had been administering morphine, that lovely I don’t feel anything drug that in all likelihood was the reason I felt as well as I did. The last thing I remember is the doctor telling the nurse to inject another dosage of so many whatever’s. Her voice was quiet as she explained to the doctor the amount that had already been injected. He acknowledged her input but obviously felt the urgency of the situation outweighed the possible problems that might occur and she did as she was instructed. By this time I personally had complete faith; after all he was the doctor and if he felt this was the right thing to do then so be it. It was then I left consciousness behind and began my own silent struggle to survive.

                   Later I was told that the next forty eight hours were touch and go. They discussed sending me by air ambulance to London for possible surgery or transplant. Thankfully it ended up not being necessary. I had sustained three heart attacks and even with that knowledge I was not aware of the very long road that lay ahead of me.

                   The Grim Reaper went home alone that night.

Continued……….

Quotation

When you live in the moment and live free, you’re living in Soul. So let go of each moment as it passes. Forgive any judgments. Detach yourself from this earth, from memories of the past, from expectations of the future. Do those things that awaken you to your Soul, and let the rest go.

                                      (Author: John-Rodger)

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Tags: atrial ventricular, ejection fraction, Heart Disease, Heart Failure, icd, left coronary artery, tachycardia, wide complex

Posted By Debbie on July 8, 2009

Continued……….I managed supper and staying awake until the girls went to sleep and then I succumbed to the bone weariness that I felt.

                   Around the same time as the previous night I was awakened with this meddlesome attack of heartburn. Again it was persistent, so I rolled out of bed to walk it off, get a drink of water and wait for it to subside as it had the previous evening. After getting my drink I got as far as the entry to the living room before it hit me. The pain felt like a spike had been driven into my heart and it incapacitated me. This was not normal and finally my brain clicked (danger Will Robinson danger) and I knew something was terribly wrong. Duh!! I literally fell to my knees trying to call out to my husband but I couldn’t breathe enough air in to push a sound out. The pressure I felt on my chest was choking me and the most intense pain filled my entire upper body. For the life of me all I could do was stay conscious.

                   I knew I had to move and the thought of my family finding me in the morning was what propelled me forward. I crawled down the hall to our bedroom and woke my husband by grabbing his arm in a death grip. Digging my always too long nails into it for all I was worth. This seemed to be substantial according to the markings left on his arm. To say the least he was a little put out and because I couldn’t talk there was a bit of confusion as to why I had chosen this particular avenue to wake him up. I was just trying to breathe. And then I felt the need to empty the contents of my stomach so I instinctively crawled into the bathroom to visit John, wouldn’t want to leave a mess now would I.  When I got there my bowels were also trying to get my attention. It quickly turned into an urgent need to assess just what was going to happen first. It turned out it didn’t matter because by that time I was not in control of the outcome. As unpleasant as the whole procedure was it turned out to be a good thing. I could finally breathe again and the pain receded enough that I could tell my husband that I needed to go to the hospital. I know your thinking “why didn’t you call an ambulance” and it is a perfectly logical question. However, we lived in a small village forty five minutes out of the city with the nearest corner store four miles away and our expectation was that he would get there faster than they could get to me.  Yes, it seems idiotic now, I could have used a hit of oxygen,  but we did what came naturally to us. This was to take care of things ourselves. Yes, I agree, that is a sad state of affairs. Unbelievably, it still hadn’t occurred to me that my heart was the problem. Or it had and I was denying it for all I was worth.

                   When my husband finally realized that the situation was dire he propelled himself into action. This was difficult for him because the word “hurry” was not in his copy of the dictionary. And he was not doing well keeping himself calm and in control of the situation. So I diverted my thoughts into giving him direction in what should be done next. He managed to get the kids up and dressed. Carrie had to go to school in “dad clothes” that day poor child. I don’t remember getting myself dressed or how I got to the car but once I was there my memory picks up again. We dropped the kids off at his mothers around the corner (yes, his whole fam-damily lived within two miles of us) and were on our way to the city. Things were heating up and he was driving like a mad man. It didn’t seem like the right time to criticize him for it so I put the zipper on my mouth. Not that I felt like talking anyway. I had others things to deal with. I remember thinking that if the police tried to pull us over there was no way my husband was going to stop for them. As always my imagination took over. They would have to follow us. This would call for the sirens and flashing light. A police escort did not seem like a bad thing at this point.  Surely because of the circumstances they would see fit to overlook it just this one time. Or they would run us off the road and that would be the end of that.

                   Once we reached the city limits yellow lights meant go faster, as my four year old Grand Daughter expressed the last time I had them in the car. After all it was four o’clock in the morning (I had already been dealing with the issue for two hours) and the streets were pretty much deserted. Not to mention that my husband’s foot was stuck to the gas pedal. Our luck lasted and the police did not appear. I peeked over and my husband was looking quite ashen and I could feel the fear starting to envelope him. He looked at me like he was looking at a ghost because, unknown to me I was so pale at that time I looked like one.

                   I did my best trying to appear better than I felt and probably failed miserably. If a person can will something to happen then I did that night. The one single thought that if I could just make it to the hospital everything would be fine kept me from passing out and focused enough that my husband was not left alone in this journey.  And I did make it, fool that I am I even walked into the emergency room. But when I stepped up to the little emergency window and saw all those cute nurses in their white uniforms I gave way to my body.  I have no recollection of how I got undressed and in a hospital bed.

Continued…….

                                      Quotation:

“Courage is not the absence of fear but the mastery of it.”

                                   (Author: Mark Twain)

 

   

 

Category: My Heart Story | No Comments »
Tags: atrial ventricular, ejection fraction, Heart Disease, Heart Failure, icd, left coronary artery, tachycardia, wide complex

Posted By Debbie on June 29, 2009

 

Continued……….It was the night of Wednesday, April 8, 1987.

                   It was a night no different from any other. My eleven o’clock bedtime came and as always I struggled to keep the never ending thoughts out of my head until an exhausted sleep could take me comfortably into slumber. It was about two in the morning when a grinding pain in my chest dragged me out of a dead sleep. I had suffered dearly from heartburn during my pregnancies and this felt very much like those attacks. After getting up and getting a drink it eased and allowed me to fall back into sleep. There was no more thought put into it than that. However it was unusually difficult to get myself out of bed the next morning. I seemed to be in a deep funk, not one of those self-induced ones that occasionally happened after a day out on the skidoo trails. I could not shake this weariness that wanted to overtake me.  This was going to be a long, long day.

                   It was one of my few mornings of arriving late, an occurrence I prided myself for not repeating on a regular basis. It was payday so the early birds had to wait an unacceptable ten minutes to get their cheque. When it comes to money people have a very low tolerance for tardiness and patience is not a virtue on those days. The penetrating “where the hell were you” stares didn’t faze me. It was not a good morning to push my buttons. Funny the things you remember. But these thoughts are engrained in my mind, like a well used trail in the woods that never really disappears.

                   The tired feeling I was having seemed to be worsening and by two in the afternoon I could no longer deny that things were just not quite right. In all my wisdom (or the kick in the butt I gave myself) I decided to call the doctor and try to get in to see him. That, as so often happens with the medical profession, wasn’t possible. We all know this is an even more prevalent problem in current day society. So being a good little girl I made an appointment for the next week but I clearly remember jokingly saying to the receptionist, “That’s if I’m still alive”. That should have meant something to me but I wasn’t listening to my body. Denial has always been a tool I was adept at using.

                      In retrospect the doctor’s assistant realized that my previous pattern of having to be half dead before I actually went in to see him didn’t come to the forefront of her mind and she felt partially responsible for the outcome of that mistake. My doctor also felt some responsibility lay with him. However, I felt the responsibility wasn’t all theirs, I should have insisted or just gone in to emergency knowing the family history that I had but I didn’t. I was young and like all people my age the thought that my heart was giving out just didn’t occur to me. Also, I have always had a sense of order from the universe. It is my belief that all things happen for a reason. Allowing anything to weigh you down for an unnecessary amount of time is unhealthy for anyone. And I sincerely doubt that there was anything that would have changed the event or the outcome.    

                   My compromise was that I decided to leave early and retire before eleven and get some much needed rest. It was very surreal, this perplexing state that had enveloped me. Everything appeared to me like I was watching a movie in slow motion. My senses were intensified. I felt the cool breeze caress my face and the warmth of the sun penetrating my skin. My hearing increased and all of the sounds around me which had previously been muddled together became individual. The feeling of separation from my body was soothing to my mind. It was a place I wouldn’t have minded visiting for a little longer.

                   After picking up my four year old daughter, Kelly, from my in town babysitter I headed home and was feeling a little better after the forty five minute drive. It had become my downtime before all those ghastly chores, and I came to rely on it. Pulling into the drive way gave me even more comfort than usual. My twelve year old daughter, Carrie, was at my brother-in-laws. Not being able to reach anyone on the phone (you know those country people can not get enough of that farm fresh air) I decided to let dad start supper and bike over to bring her home.

                   On my way over I felt like the wicked witch in The Wizard of Oz. Bent over and furiously pumping the pedals seeming to not get anywhere. My first thought was that the bike needed fixing. Ten speeds (the fad of the decade) were not meant for country riding and we often had problems with it. I could not catch my breath and the ride left me gulping for air.  My sister-in-law was laughing at me and saying that she would not recommend any long bike trips until I was in better shape. She is a lovely woman but for some reason the comment annoyed me. I just was not in the mood for light banter. But on that day I could not help but agree with her, which was also frustrating.

                   The ride home was no less daunting and I was glad to see my driveway stretch before me. I managed supper and staying awake until the girls went to sleep and then I succumbed to the bone weariness that I felt.

 

Continued……….

 

                                       Quotation:

We are all born into this world with this intuitive guidance system. And if we had all been raised in a more enlightened way, we would have learned to follow this inner guidance throughout our lives. Instead, most of us did not receive much support or encouragement in trusting our own deepest feelings. In fact, many of us were actively taught not to trust ourselves but instead to follow an external authority. Or we were encouraged to be rational — to the exclusion of our intuitive faculties. As adults we can take responsibility for rediscovering and reconnecting with our natural intuitive sense. As we learn to listen to and follow our intuition, we develop an increasingly trusting and powerful relationship with our own inner guidance.

                                                (Author: Shakti Gawain)

Category: My Heart Story | No Comments »
Tags: atrial ventricular, ejection fraction, Heart Disease, Heart Failure, icd, left coronary artery, Myocardial Infarct, tachycardia, wide complex