Submitted by Dr T on May 22, 2013 – 10:58am
I am a 63 year old male. 5 feet 7 inches tall and weigh 170 pounds. I have sleep apnea, copd and went to see cardiologist due to irregular heart beat and what I thought was slow heart beat ave about 63-66 at rest. I have a finger pulse meter that I use. The initial visit the doctor found irregular heart beat and PACs with underlying sinus rythm. ordered holter monitor for 24 hours which noted supraventicular tachycardia with average heart rate of 68. wanted to use a beta blocker but I was concerned about heart rate. so a month later went back and did an echo whic showed left ventricle mildly increased and low left systolic function (ejection fraction 50-55%). Saw elecro cadriologist and said he did feel he would anything unless I started getting palpitation. I go back and see him in a couple days. I am now using supplemental oxygen when I walk and have noticed that heart rate will run 110-115 during walk but lately has dropped to 65-70 for a few minutes then return to 110-120. Do I need to ask the doctor anything since I feel more tired and drowsy and more episodes of light headiness but no really chest pains.
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 symptoms you describe unless you a have poor heart function (you don’t). An ejection fraction = 50-55% is essentially normal, and not a reason to be concerned about heart failure and its consequences. If not related to your heart, I’d request an evaluation of your carotid arteries and potential blockages there.
Definitely time to go back to your cardiologist!
Hope this helps,