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Does airflow restriction cause tiredness and palpitations?

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Cardiologist
Practicing since : 1998
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Hi, I have been having palpitation symptoms for a while now. I have seen a cardiologist and an EP. They both said nothing is wrong with my heart, but in a sleep study, the EP said that I have airflow restriction. I do not have Sleep Apnea! He said that this is the cause of my daytime tiredness and palpitation symptoms. Is this accurate? Can a doctor comment on my issue. Thank you!
Posted Thu, 20 Feb 2014 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 33 minutes later
Brief Answer: please see details. Detailed Answer: Dear Sir 1. The work up of palpitation aims at identifying the rhythm you have at time of palpitation. Once the rhythm is identified, we look for a structural heart disease on cardiac ultrasound/ ECHO. Most of the time palpitation is caused by PREMATURE CONTRACTIONS. When these premature contractions are associated with a structurally normal heart, there is nothing to worry and we look for precipitating factors. We avoid precipitants like tea/ coffee/ anti-asthma drugs/ stress/ anxiety/ fever/ anemia/ thyroid diseases/ chest diseases etc. At times we use medicines to suppress them. 2. Airflow restriction, when severe enough to cause decrease oxygenation, may cause premature contractions. However, if there is no sleep apnea, it is not conducible to my mind that your day time tiredness is due to it. Second, how EP concluded that you have airway restriction by sleep apnea study. Airway restriction is diagnosed by pulmonary function tests. If you have undergone spirometry ? 3. Palpitation due to premature contraction can occur due to a variety of stimuli which may include a disturbed sleep or respiratory disorder. But work up will be as detailed in first para above. Hope this gives some insight into the issue. Feel free to discuss further , especially if you can upload your reports for discussion. Sincerely Sukhvinder
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Follow-up: Does airflow restriction cause tiredness and palpitations? 20 minutes later
Thank you! let me explain in further detail. I have been having this symptoms for a while, so I went to a cardiologist. I did all test including echo, stress, and the Holter moniter and blood test and everything came back normal but that my heart skipped beats once in a while but it is not concerning. He suggested I see and EP. The EP thought I had sleep apnea so I did a sleep Study. I have no sleep apnea. The EP said that I have bad sleep, minor airway restriction and noted snoring. Also,I do not get good RIM sleep. My symptoms are that in the morning I really do not notice any heart symptoms, but as the day does on. I feel it beating harder and harder. I feel exhausted around 3-5 pm everyday. I also feel I do not get good sleep. Thank You and please reply!
 
 
Answered by Dr. Sukhvinder Singh 44 minutes later
Brief Answer: please see details Detailed Answer: Dear Sir A bad sleep and airway restriction are two different things. A Bad sleep can make you feel bad in day, tired, listless, sleepy and may cause a number of psychological symptoms. however restrictive airway disease is entirely different. In a typical case it develops over years and causes dry cough and shortness of breath. It is very important to differentiate between two, as treatment is entirely different. A sleep specialist will look into issues of bad sleep. however a pulmonologist will treat restrictive lung disease. To rule out restrictive lung disease, you need to see a pulmonologist and a spirometry done. Snoring itself is not a diseases unless it is associated with evidence of sleep apnea. Since there is a minor airway restriction as per EP, see a sleep specialist first. You may only require a few tips about good sleep hygiene. All the best. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Does airflow restriction cause tiredness and palpitations? 11 hours later
Thank you ! That's why Iam seeking a second opinion. I am confused on which direction to take because the cardiologist said he couldn't find anything . Likewise , the EP is saying I have minimal airway restriction and wants me to see an Ent for a deviated septum! But I do not have sleep apnea. I just want to know if what the EP said is accurate for the cause of my heart symptons! Thanks!
 
 
Answered by Dr. Sukhvinder Singh 20 hours later
Brief Answer: please see details Detailed Answer: Dear Sir 1. I agree with your cardiologist. If holter and ECHO are normal, practically work -up for palpitations is over. 2. Although I do not agree that sleep study can diagnose airway restriction but still I can understand what he wants to say. 3. Yes, for deviated septum , ENT specialist should be consulted. He will also tell if it is really causing airway obstruction or not. I think a sleep specialist should also be consulted. If the problem of palpitations still persist after their treatment, the cardiologist can always use the drugs which can suppress palpitations. Sincerely Sukhvinder
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Follow-up: Does airflow restriction cause tiredness and palpitations? 3 hours later
Ok because EP told me to try breath right strips and see if that works. He said to see the Ent if that doesn't help. ALso he said that it can be fix and this is a minor issue! Do you agree?
 
 
Answered by Dr. Sukhvinder Singh 9 hours later
Brief Answer: see details Detailed Answer: Dear Sir "BREATH RIGHT" strips are mechanical nasal passage dilators which increases the area of nasal passages by lifting the nose. Hence help in decreasing airway obstruction at nasal level. Now again, these are two different etiologies of obstruction at nasal level. 1. Congestion (a phenomenon reversible by drugs/ steam/ strips) 2. Deviated septum (mechanical obstruction which mostly requires surgical correction). Hope the answer is clear to you now. For deviated septum you need to see ENT specialist but congestion can be tackled by other means. If the deviation is too minor and there is some congestion, BREATH RIGHT may help. The best judge is your ENT specialist. Sincerely Sukhvinder
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Follow-up: Does airflow restriction cause tiredness and palpitations? 20 hours later
Thank you! So overall, Do you agree that my condition can be fixed. I do have a lot of trust in my EP because he is one of the top Cardiologists in Florida. I am just kind of confuse on whether its a sleeping issue or a airway issue caused by a deviated septum? Thank you again doctor!
 
 
Answered by Dr. Sukhvinder Singh 14 hours later
Brief Answer: please see details Detailed Answer: Dear Sir 1. Both of these may coexist. Both have different treatment and evaluation. An ENT surgeon is best to guide you about deviated septum. A sleep specialist can guide best about sleep issues. Both of these are treatable conditions in most of patients. As I detailed earlier, it does not seem to be a cardiology issue. Sincerely Sukhvinder
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