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Had a racing heart and slowed down through breathing. Should I be concerned?

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Practicing since : 1998
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My fiance,53, told me yesterday she had a racing heart beat that wanted to jump out of her chest... took 45 minutes to slow down through breathing and being calm... she was blow drying her hair! She is not on meds or caffeine. She has never had this before. She is 115 lbs 5'0 height, sedentary life. When she came to AZ and hiked some hills with me, hills that I breeze up in 15 minutes (Im 43, 165 lbs 5'7, mostly sedentary), she had to stop a lot and wait for her heart rate to slow down.. It took us 45 min to an hour to do what I can do in 15 minutes. Her bloodwork checks out fine she says from her physicals she has done, but I doubt they do stress tests or anything more advanced. What concerns should we have?
Posted Sat, 31 Aug 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 29 minutes later
Respected Sir,
1. An unprovoked racing of heart indicates heart rhythm disorder. If it is associated with loss of consciousness/ chest pain/ blackout, then it is an emergency and should be looked into at priority. Otherwise, the most appropriate way to look at a heart rhythm disorder is to identify that what kind of rhythm is it. This can be best done by an electrocardiogram (ECG) taken at time of racing of heart. At times when it is not feasible, we can apply a 24 hour ECG monitor (Holter monitor) provided that likelihood of occurrence of event in 24 hours is high. If that is also not feasible, we do a generalized small work-up which includes a thorough clinical examination, resting ECG, an echocardiogram (ECHO or ultrasound of heart), blood profile mainly including thyroid hormone levels & hemoglobin. If all come out to be normal, we wait for the next event and tend to record ECG at that time.
2. The reasons for apparent undue shortness of breath may be cardiac and non-cardiac. Cardiac disorders mainly include disorders of heart pumping, disorders of relaxation of heart, valvular abnormalities, anginal heart disease, high blood pressure and its effects on heart etc. Non-cardiac issues include sedentary life style, obesity, low hemoglobin (anemia), renal failure, lung diseases, any severe systemic illness. Sedentary life style is a very important factor in a number of patients. Normally such patients require a thorough cardiac and systemic examination by your doctor followed by a few tests including ECG, X-ray chest, blood profile, pulmonary function test (guided by examination).If it all comes to normal or inconclusive, an Echocardiaogram should be done. I hope this much of work-up will give enough clues that in which direction should we proceed.
Hope this gives some insight into the issues.
Feel free to discuss further.
Sukhvinder XXXXXXX
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