Did my keto diet just send me to the ER??

In 2008 I had my first experience with SVT. Surpaventricular tachycardia is basically when your heart beats abnormally fast from improper conduction coming from somewhere above the ventricles. It’s name is fairly self explanatory if you know even a little about the heart. Anyway, this isn’t a cardiac lesson as I am not in a position to give one. I mean I am a paramedic so I can make some moves to stabilize SVT in a patient but let’s go back to me as the patient instead.

The 2008 episode cleared itself up with valsalva maneuvers (look them up if you need too) and I never thought about it again until 2010. In 2010 I was on a 48 hour shift at the firehouse and it hit me again sometime in the late afternoon one day 1. It passed after a few minutes and I went back about my business as there were really no other symptoms. The incident was reported because I was at work and just want to make it known that something happened. Of course this time we tried to catch it on a heart monitor but it was gone before we could hook it up. The next day, I was completely exhausted for some reason. Having a mild “cardiac situation” that is not exactly uncommon, I was advised to got tho the ER. I hated the idea but like we tell patients everyday, “You only got one heart so you might as well get it checked out”. Labs, an EKG, and a 24hr halter monitor revealed  nothing out of the norm. The blame was placed on energy drinks of all things. I really did love Rockstar at the time and 2 a day was commonplace. Anyway, I cut back a little and all was well again.

This brings us to last night. Thanks to my new Apple Watch, I was able to catch this beauty in real time as it happened. Unprovoked SVT but this time there were symptoms to go along with it. I got pale, I started to sweat, and I needed to lean up against something while I was going through it. This time it happened within 15 of an EKG monitor and two other paramedics. As soon as it hit, all I could say was “Holy shit. I’m in SVT”. Within 4 minutes I was in the ambulance trying to get the 12 lead to capture it. Unfortunately, within about 3 and a half minutes I got myself out of it. My BP was like 140/100 right after which is crazy high for me as well. This time, they convinced me to go to the hospital right away and I complied.

Chest X-ray was normal. EKG was normal. Something was a little out of whack though.

Glucose 89 (nice)

Electrolytes seem to be an issue for some on keto diets

Sodium 138 (nice considering I salt everything I can salt and still eat)

Magnesium 2.3 (good)

Potassium 3.3 Hmm. (LOW: ref range 3.5-5.1)

I’m not a doctor and mine didn’t seem to concerned but it has always been in the reference range. Low potassium can lead to heart arrhythmia like SVT. In 2010, I don’t think this was an issue because I was never told anything about it, but it is down to 3.3 from 3.9 in August. I’m not sure what the daily variation of potassium level are but I can’t help but think that my diet, which I bet has been low in potassium may have had something to do with last night. The ER doctor didn’t mention my level nor did I mention being on a keto diet for the past few weeks. I’m not smart enough to say that this is the cause, but it definitely got me thinking about paying more attention to this stuff.

I’m following up with my Dr next week and I’ll let her know my dietary activity but I think I need to up my potassium regardless. I’ll probably do more blood work in about 6 weeks unless she wants some sooner.

Lesson of the story. If you’re doing keto, pay attention to your micronutrients as well as your macros. I’m not blaming the diet, but I am blaming my lack of attention to detail and my planning. I know I’m gonna get back to daily logging of food for a while.

 

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