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Irregular heart beats need to be documented by ElectroCardioGram (ECG / EKG).
Ectopic beats can be from ventricle (lower chamber - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC). APC are generaly harmless. Even VPCs are often harmless – ‘benign’. If they are frequent (More than 5 per hour, 2 or more coming in succession –they need investigations further.
THE FIRST STEP IS TO SEE A CARDIOLOGIST
Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) are common causes.
Medicines may be responsible – like phenlephrine, pseudoephedrine
used for ‘cold’ / salbutamol
, salmeterol used for asthma / Illicit ‘drugs’ like amphetamine
are notorious to cause abnormal beats
Rarely, there are abnormal nerve paths (pass tracts) in the heart.
Though they may be normal in many, it is advisable to investigate.
A thorough history and physical examination is the first step -
Routine 12-lead Electrocardiogram (ECG) is part of clinical examination.
If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management
is necessary to see the heart valves (Mitral Valve Prolapse
) / heart muscle (Cardiomyopathy
) and heart function (Ejection fraction
, wall motion abnormality) – Have you done it?
Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow) – OK in your case
Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) etc. The treating doctor will suggest based on the situation.
There are advanced techniques of investigations of increasing complexity more (some of them invasive), depending on need. The treating doctor may suggest them based on the situation.
These ectopic beats could be normal in some persons. The feeling depends on individual sensitivity. Some do not feel them at all / some may feel every beat.
A specific treatment for the beats may often not be necessary.
The first line medicine is generally beta blockers. Metoprolol – slow release and small dose – will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up
If they are not effective and if the problem is severe, several other classes of drugs are available – - acting by different mechanisms - the specialist will decide tailored to the individual / they may have lot of side effects and need frequent follow up.
Wishing speedy recovery