Brief Answer:
waiting for details

Detailed Answer:
Dear Sir
I answered the question about a week back. The answer is written below.
1. These symptoms talk of poor exercise capacity of individual. There are many causes for low exercise capacity. These include low pumping capacity of heart, low relaxability of heart, anginal heart disease, anemia, lung diseases or any debilitating generalized disorder can give rise to similar symptoms. If you can detail me other symptoms of her, I will be able to further pinpoint the disease process and possible course. I would request you to upload her ECHO and other recent blood reports too.
If you can provide me with these results at earliest, we can discuss the issue further.
Sincerely
Sukhvinder

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Brief Answer:
please provide your documents

Detailed Answer:
Dear Sir
Dear Sir
1. I am so sorry to say that none of your documents has been uploaded on this webpage. Please upload your documents on right top corner of this page or send them by mail to YYYY@YYYY and put ATTN DR SUKHVINDER XXXXXXX in subject line.
2. Medicine is practiced by taking appropriate steps one by one. Whenever we are told about certain complaints we think of all possible causes for them. We ask more question pertaining to a particular possiblity if symptoms suggests so. The complaints of sweating and palpitation can be indeed a result of all the possibilities mentioned above.
Waiting for your documents.
Sincerely
Sukhvinder

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Brief Answer:
Possibly AF, need complete ECG, few more tests

Detailed Answer:
Dear Sir
I have gone through her reports.
1. Her ECG is partly available. Not all the leads are seen in it. I would request you to upload picture of complete ECG as it shows some rhythm disturbance possibly atrial fibrillation (AF) which I can confirm after seen the full ECG only. This is important as it could very well explain her symptoms.
2. Her sugar, electrolytes, serum creatinine, thyroid function test and ECHO are within normal limits.
3. AF or atrial fibrillation will cause palpitation. In fact it is the main symptom of AF.
4. Certain issues when associated with AF increases the symptoms of patient. These include high blood pressure, low hemoglobin, lung disorders. I would do a clinical examination in any such patient of mine and will possibly also get hemoglobin, X-ray chest and Pulmonary function tests done.
5. Since she was diagnosed with AF in the past, What medications she is on for same?
6. The medications mentioned by you on this webpage are not from standard formulary and I could not find the basic allopathisc medicines in them. If they are indeed allopathic drugs please write down name of the basic salts they contain.
7. I would discuss more on AF, once you upload the complete ECG and it is sure that she has AF.
Sincerely
Sukhvinder

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Brief Answer:
please see below.

Detailed Answer:
Dear Sir
1.The ECG indeed shows Atrial fibrillation. This along with the mild LV systolic dysfunction mentioned in her fresh ECHO report explains her symptoms. The low cardiac pumping (LV systolic dysfunction) manifests itself in the form of increased heart rate as patient walks/exerts.
2. Your cardiologist has started her on PRADAXA and CARDARONE. As I explained to you in one of the earlier answers, pradaxa is a blood thinner to prevent clot formation in heart. Cardarone aims at reverting her abnormal rhythm (AF) to normal.
As per the plan written on the card he wants to try electrical cardioversion. It means he will try to revert the abnormal rhythm to normal by giving electrical shock.
3. In view of evolving LV dysfunction, the strategy seems reasonable.
Sincerely
Sukhvinder

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Brief Answer:
all modalities have some side effects.

Detailed Answer:
Dear Sir
1. There is no medicine in English system of medicine which do not have side effects, however in clinical trials these side effects are found to occur in acceptable proportion of patients. Only then the drug is approved for clinical use. Your cardiologist must have considered everything before writing the prescription.
Whenever you feel anything unusual while using a drug, you must report to your physician.
2. If these drugs fail to convert her rhythm to normal, electrical cardioversion is the other option. This may also be used as first option in view of LV dysfunction and marked symptoms.
3. Yes, Electrical cardioversion may have its side effects. These may be related to effect of cardioversion like clot formation in heart or may be unrelated like worsening of heart rhythm, although that is a rare phenomenon. Local skin burn may also occur. As I told you with every standard recommended treatment there are some side effects, tangible, real but mostly acceptable.

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Brief Answer:
details discussed below.

Detailed Answer:
Dear Sir
1. Concor is meant to control the heart rate (the ventricular rate in patients with AF). This will help in reducing palpitation as well as easy fatiguability associated with exertion. But this will not change AF to normal rhythm.
2. Propafenone is like CARDARONE (amiodarone) which was prescribed by your previous cardiologist. Propafenone has the ability to restore normal rhythm. It can cxonvert AF to sinus (normal) rhythm. Hence it will hit at the basic cause. It is another drug for pharamacological cardioversion just like Amiodarone.
3. Pradaxa is a blood thinner about which we have already discussed.
4. My opinion on this issue is as follows:- Since your mother is in AF since august 2013 (as per the records of questions available on this website) the attempts to convert AF to normal rhythm may not be that successful. In my practice and as per literature converting an AF which is more than an year old to Normal rhythm is not a very successful strategy. However People do try it. As I discussed in one of my previous answers, if attempts to convert to normal rhythm or maintain normal rhythm fail, rate control strategy is used. In the rate control strategy, AF persists but drugs are given to control overall heart rate (ventricular rate) and to avoid clot formation. It is nearly equally good. Every cardiologist has his preference for one of these strategies.
Hope that helps.
Feel free to ask if there is any more query.
Sincerely
Sukhvinder

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