Ask Dr T

Ask Doctor T. Blog

Posted by Dr T on May 23, 2013 - 9:58am

Time to see your doctor! At your age (46 years) these symptoms could have many causes and be related to these palpitations, or an underlying heart problem (or nothing serious). Without a consultation and testing there is no way to diagnose whether you have a problem that requires treatment, or whether these are related to early menopause. You should check your cardiac risks and calculate whether you are at risk...

Posted by Dr T on May 22, 2013 - 10:58am

Hi Fred,

Has coronary artery disease (CAD) been ruled out? It seems you have a number a cardiac risk factors for CAD, assuming your COPD/sleep apnea as related to heavy smoking in your past. These variations in your heart rate - if related to these new symptoms of fatigue and lightheadedness - are definitely something that needs further investigation and probably treatment. The slow heart rates you describe are usually not a cause the...

Posted by Dr T on May 16, 2013 - 8:23am

Hi P,

I agree you with that the Mitral Valve Prolapse (MVP) is probably not a serious condition in your case. Antibiotic prophylaxis is used to prevent an infection inside the heart (called Infective endocarditis) of susceptible patients. As an example, even a minor infection, such as a tooth abscess can cause severe bacterial endocarditis. However, recent recommendations for prophylactic antibiotic therapy before a procedure  in patients with...
Posted by Dr T on May 15, 2013 - 4:52pm

Hi Louisa,

I doubt the procedure/anesthesia have anything to do with these new symptoms. Since these skipped beats are new, and - depending on your age and cardiac risks, you should be checked for underlying heart disease. If you are concerned about your heart, you can try this questionnaire for the Prediction of Coronary Artery Disease (CAD).
 
Hope this helps,
Dr T
 
...
Posted by Dr T on May 14, 2013 - 5:19pm

An 80% obstruction of the ramus branch of the circumflex coronary artery means you have coronary artery disease, but not  necessarily that your chest pain is angina, caused by this blockage. For that, other tests such as a stress test are necessary. Considering this lesion was discovered in 2011 and the ramus is as small as described by you, the volume of blood that flows through is also very small and therefore unlikely to cause much trouble even now, and an even less likely reason for angina since 1996. Meanwhile, you should review ...

Posted by Dr T on May 14, 2013 - 11:22am
Hi Amrita,
There are a lot of considerations about the treatment of aortic valve disease, and especially aortic insufficiency:
  1. An aortic valve repair should be considered first. If possible, this is the best solution, but it requires an experienced surgeon.
  2. For aortic valve replacement the choice between tissue vs. a metal valve depends first of all...
Posted by Dr T on May 14, 2013 - 10:16am

 

As a physician you should already know the answer: You don't have anything to worry about. The great majority of PACs are completely benign and require little if any treatment at all.  In rare cases, PACs may be a sign of underlying heart disease.

PVCs...

Posted by Dr T on May 13, 2013 - 3:04pm

 

Hi Chris,
The combination of heart block and bradycardia indicates you may need a pacemaker implant in the nearby future. To see whether your heart rhythm affects your health (as I suspect), ask for a stress test. This will also check whether you have coronary asrtery disease.
This will demonstrate how your heart response to exercise.
Hope this helps,
Dr T
Posted by Dr T on May 12, 2013 - 6:55pm

 

Hi Cliff,
No patient should take pain medications such as tramadol other than for a short period after recovery from heart surgery. Your symptoms (irregular heart beat, light headedness) however indicate that not all is well. They may be caused by an arrhythmia such as atrial fibrillation, anemia or other causes. You may need some blood tests, a chest X ray and a cardiac echo to make sure your heart is working the way it should.

Hope this helps,

Dr T

Posted by Dr T on May 10, 2013 - 8:08am

 

Yes! You need to be checked out and have an EKG & blood work, including cardiac echo and perhaps another EP study and ablation. Your new fast arrhythmia and symptoms are suggestive of another ...