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Is Reduced And Faint Heart Rate A Sign Of A Weakened Heart?
Question: Hello dear Dr Iliri,
I am embarrassed by my last question as I meant to ask a urologist but I'm glad you answered as no urologist could have answered as thoroughly as you did. Thank you so very much.
Are you quite sure I wouldn't be helped by going to get an echo and tests at the hospital? It's been 6 weeks since my last set of tests and two months since my last echo and I get increasingly anxious as time goes by. Are you sure nothing could have changed so quickly?
One change is that I am doing daily cardio, up to 10 miles on bike or running. As a result, my resting heart rate seems to have gone down, sometimes in the 40s. I worry when it feels slow and also feels faint in my wrist. Is this not possible indication of weakened heart? My exercise endurance is good. My cardio has lowered my Coreg from 6.25 bid to 3.125. I am worried it will lower my EF.
When will this anxiety ease off? I really want to believe I'm cured but I'm so scared because I didn't feel very sick when I was sick.
Thank you so much, as always.
XXXX
I am embarrassed by my last question as I meant to ask a urologist but I'm glad you answered as no urologist could have answered as thoroughly as you did. Thank you so very much.
Are you quite sure I wouldn't be helped by going to get an echo and tests at the hospital? It's been 6 weeks since my last set of tests and two months since my last echo and I get increasingly anxious as time goes by. Are you sure nothing could have changed so quickly?
One change is that I am doing daily cardio, up to 10 miles on bike or running. As a result, my resting heart rate seems to have gone down, sometimes in the 40s. I worry when it feels slow and also feels faint in my wrist. Is this not possible indication of weakened heart? My exercise endurance is good. My cardio has lowered my Coreg from 6.25 bid to 3.125. I am worried it will lower my EF.
When will this anxiety ease off? I really want to believe I'm cured but I'm so scared because I didn't feel very sick when I was sick.
Thank you so much, as always.
XXXX
Brief Answer:
You are on the right way!
Detailed Answer:
Hi dear XXXX!
You don't have to be embarrassed when discussing with me, as I thing this is the right way to resolve your concerns and relieve your anxiety bouts.
I am glad to know that my opinions about urological issues have been helpful, and I hope you are following my last underlying advices.
Regarding your cardiac issues, I would explain again that I am pretty sure too frequent medical tests are useless.
On your clinical conditions, a yearly cardiac follow up is quite enough (a careful physical exam, a resting ECG, cardiac ultrasound, and some blood tests, like complete blood count, renal function tests, blood electrolytes, etc).
As your attending doctor is down-titrating your Carvedilol (Coreg) dose, you need to be periodically in close contact with him until the medication will be completely withdrawn.
You seem to be on the right way. There are several components that suggest me this conclusion (Carvedilol down-titration, your quite perfect exercise endurance, the fact that our discussions have modified your daily life-style profile).
I would like to congratulate for your perseverance and willingness on properly addressing your psychological issues. The fact that you are quite independent from ER doctor reassurance for several weeks confirms that you can properly deal with every health issues and manage very well.
Regarding your slower heart rate, I would explain that it isn't absolutely a sign of any cardiac disorder. In contrary, it is an expression that frequent physical fitness has yielded its results (a good myocardial and skeletal muscles conditioning).
At the end, I would say that you don't need to believe you are cured. You are in fact quite normal. You are expressing a physical and mental strength much larger than your male counterpart.
Wish you a pleasant weekend!
Don't be embarrassed discussing with me!
If you need my opinion, just ask me directly, as it will avoid unnecessary delay.
Kind regards,
Dr. Iliri
You are on the right way!
Detailed Answer:
Hi dear XXXX!
You don't have to be embarrassed when discussing with me, as I thing this is the right way to resolve your concerns and relieve your anxiety bouts.
I am glad to know that my opinions about urological issues have been helpful, and I hope you are following my last underlying advices.
Regarding your cardiac issues, I would explain again that I am pretty sure too frequent medical tests are useless.
On your clinical conditions, a yearly cardiac follow up is quite enough (a careful physical exam, a resting ECG, cardiac ultrasound, and some blood tests, like complete blood count, renal function tests, blood electrolytes, etc).
As your attending doctor is down-titrating your Carvedilol (Coreg) dose, you need to be periodically in close contact with him until the medication will be completely withdrawn.
You seem to be on the right way. There are several components that suggest me this conclusion (Carvedilol down-titration, your quite perfect exercise endurance, the fact that our discussions have modified your daily life-style profile).
I would like to congratulate for your perseverance and willingness on properly addressing your psychological issues. The fact that you are quite independent from ER doctor reassurance for several weeks confirms that you can properly deal with every health issues and manage very well.
Regarding your slower heart rate, I would explain that it isn't absolutely a sign of any cardiac disorder. In contrary, it is an expression that frequent physical fitness has yielded its results (a good myocardial and skeletal muscles conditioning).
At the end, I would say that you don't need to believe you are cured. You are in fact quite normal. You are expressing a physical and mental strength much larger than your male counterpart.
Wish you a pleasant weekend!
Don't be embarrassed discussing with me!
If you need my opinion, just ask me directly, as it will avoid unnecessary delay.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you dr iliri- how do I ask you directly? Did I not do that?
Wishing you a wonderful weekend,
XXXX
Wishing you a wonderful weekend,
XXXX
Brief Answer:
The above link is used for direct asking.
Detailed Answer:
Thank you XXXX!
You have almost always asked me directly, except the last one.
I will be at your disposal if you need medical support.
Regards,
Dr.Iliri
The above link is used for direct asking.
Detailed Answer:
Thank you XXXX!
You have almost always asked me directly, except the last one.
I will be at your disposal if you need medical support.
Regards,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you so much, as always. You are so knowledgeable and reassuring.
Do you say I will need close follow up getting off of carvedilol because of possible rebound pvcs and tachycardia? I am scheduled to see my cardio every three months and my EP quarterly as well. Do you think the cardiomyopathy could recur on lowered dosage of carvedilol or when it is completely withdrawn? I have heard so many scary stories of people who have stopped medications and gotten sick again.
I know I must seem so naive and crazy. I actually am a woman of science and technology, and teach computer science at a top university. It is not like me to be so anxious and illogical but nothing has ever scared me like being told I would leave my child motherless.
Thank you so much for all your help. I am trying very hard to regain my senses and understand that I'm ok now.
Hope you are having a good weekend. You are an amazing doctor.
Thank you so much,
XXXX
Thank you so much, as always. You are so knowledgeable and reassuring.
Do you say I will need close follow up getting off of carvedilol because of possible rebound pvcs and tachycardia? I am scheduled to see my cardio every three months and my EP quarterly as well. Do you think the cardiomyopathy could recur on lowered dosage of carvedilol or when it is completely withdrawn? I have heard so many scary stories of people who have stopped medications and gotten sick again.
I know I must seem so naive and crazy. I actually am a woman of science and technology, and teach computer science at a top university. It is not like me to be so anxious and illogical but nothing has ever scared me like being told I would leave my child motherless.
Thank you so much for all your help. I am trying very hard to regain my senses and understand that I'm ok now.
Hope you are having a good weekend. You are an amazing doctor.
Thank you so much,
XXXX
Brief Answer:
My opinion as follows:
Detailed Answer:
Hi dear XXXX!
I would explain that keeping in periodic contacts with your prescribing physician meanwhile on Coreg down-titration, means that you always should follow only your doctor advice on how to lower the drug doses up to the final withdrawal.
We have so far discussed and clarified that your PVCs and tachycardia have been treated by the successful cardiac ablation; so when it comes the time to withdraw Coreg, nothing bad is going to happen.
Coming to this point, you should be happy, as all the previous cardiac history would seem a remote memory.
I don't think at all you are naive or crazy, instead you have demonstrated during our comprehensive discussions to be a highly sensitive and intelligent person, who loves her son, and cares for her health.
I think that you have passed through a difficult situation, but now seems that the sky is turning clear blue again and the bad time is left behind.
So, just smile for a while and think that your doctor has assured you are completely cured and healthy!
It is normal to be a bit anxious. We all experience that way time after time. But it doesn't change the truth. Our health is a bigger matter, and anxiety could not harm so easily.
My advice and wish is you have a relaxing weekend and be happy!
If any bad thoughts is disturbing you, just let me know and discuss if it is a real issue to consider.
Kind regards,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hi dear XXXX!
I would explain that keeping in periodic contacts with your prescribing physician meanwhile on Coreg down-titration, means that you always should follow only your doctor advice on how to lower the drug doses up to the final withdrawal.
We have so far discussed and clarified that your PVCs and tachycardia have been treated by the successful cardiac ablation; so when it comes the time to withdraw Coreg, nothing bad is going to happen.
Coming to this point, you should be happy, as all the previous cardiac history would seem a remote memory.
I don't think at all you are naive or crazy, instead you have demonstrated during our comprehensive discussions to be a highly sensitive and intelligent person, who loves her son, and cares for her health.
I think that you have passed through a difficult situation, but now seems that the sky is turning clear blue again and the bad time is left behind.
So, just smile for a while and think that your doctor has assured you are completely cured and healthy!
It is normal to be a bit anxious. We all experience that way time after time. But it doesn't change the truth. Our health is a bigger matter, and anxiety could not harm so easily.
My advice and wish is you have a relaxing weekend and be happy!
If any bad thoughts is disturbing you, just let me know and discuss if it is a real issue to consider.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
You are so calming and wonderful. I wish I was local to you but then your problem would be that I would make too many appointments and ask for constant tests.
Of course I will follow my doctor's orders on stopping carvedilol. Are you quite sure it is safe for me to be lowering and stopping? I am so afraid of a recurrence. The same doctor who told me I would die from fluid explicitly told me I would need to be on medication for life and even if I got better would always be on meds or would immediately relapse. I wish I could forget I had ever seen him. I only took lisinopril for 2 months and highest dose of carvedilol- 9.375- was only for 3 months. Would it seem to you that ablation and not medication cured me?
And my obligatory fluid question. I have never been on diuretics but hospital gave me rx. My cardio has always said I didnt need it. Would it be absolutely crazy for me to take it because of my anxiety issues? I know the answer, of course, but wish there was a solution to my fluid obsession. I don't want to cause problems.
Thank you Dr Iliri. I hope you are having a wonderful, relaxing weekend.
Take care and thank you so much,
XXXX
You are so calming and wonderful. I wish I was local to you but then your problem would be that I would make too many appointments and ask for constant tests.
Of course I will follow my doctor's orders on stopping carvedilol. Are you quite sure it is safe for me to be lowering and stopping? I am so afraid of a recurrence. The same doctor who told me I would die from fluid explicitly told me I would need to be on medication for life and even if I got better would always be on meds or would immediately relapse. I wish I could forget I had ever seen him. I only took lisinopril for 2 months and highest dose of carvedilol- 9.375- was only for 3 months. Would it seem to you that ablation and not medication cured me?
And my obligatory fluid question. I have never been on diuretics but hospital gave me rx. My cardio has always said I didnt need it. Would it be absolutely crazy for me to take it because of my anxiety issues? I know the answer, of course, but wish there was a solution to my fluid obsession. I don't want to cause problems.
Thank you Dr Iliri. I hope you are having a wonderful, relaxing weekend.
Take care and thank you so much,
XXXX
Brief Answer:
My thoughts as follows:
Detailed Answer:
Dear XXXX!
I am glad you feel better after our discussion.
Regarding Carvedilol down-titration, I would explain that it is an indicator of an ongoing improvement, and not a harbinger of an imminent risk of recurrence.
So, relax!
As a general rule, every medically-guided therapy modulation is considered safe.
With your actual cardiac tests conclusions, it would be a ridiculous and completely nonsense to think about a recurrence.
After the successful cardiac ablation you are considered totally cured and additional medications are a good supportive therapy as guided by your doctor.
The same holds true for your fluids uncertainties. Your heart is strong enough to properly distribute the body fluids without any needs for diuretic therapy.
You are young and fortunately with a perfectly normal cardiovascular status.
There is no need to think about a supportive therapy. Your heart is able to succeed in every daily extreme activity.
Regarding your obsession, I think the situation is getting better.
I can feel that from our discussions. It is my impression that you are achieving a great success over anxiety and after several weeks you will be able to manage better your fears. Meditation and regular physical fitness will be of great help.
Wish you a pleasant evening!
Regards,
Dr. Iliri
My thoughts as follows:
Detailed Answer:
Dear XXXX!
I am glad you feel better after our discussion.
Regarding Carvedilol down-titration, I would explain that it is an indicator of an ongoing improvement, and not a harbinger of an imminent risk of recurrence.
So, relax!
As a general rule, every medically-guided therapy modulation is considered safe.
With your actual cardiac tests conclusions, it would be a ridiculous and completely nonsense to think about a recurrence.
After the successful cardiac ablation you are considered totally cured and additional medications are a good supportive therapy as guided by your doctor.
The same holds true for your fluids uncertainties. Your heart is strong enough to properly distribute the body fluids without any needs for diuretic therapy.
You are young and fortunately with a perfectly normal cardiovascular status.
There is no need to think about a supportive therapy. Your heart is able to succeed in every daily extreme activity.
Regarding your obsession, I think the situation is getting better.
I can feel that from our discussions. It is my impression that you are achieving a great success over anxiety and after several weeks you will be able to manage better your fears. Meditation and regular physical fitness will be of great help.
Wish you a pleasant evening!
Regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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