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Low Iron and B-12 are confirmed / acquired / easily treatable. Administration of B-12 (preferably injection) and oral iron (may be with folic acid
) will be necessary and can cure it.
They are unlikely to account for the 'heartbeat'. If it 'only gets that way when I feel anxious' and at bed - it is most likely to be anxiety only.
A specific treatment for the beats may often not be necessary. Beta blockers like Metoprolol
– slow release and small dose – will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up
Anxiety / Alcohol / Tobacco / Caffeine (too much coffee, cola) are common causes. Medicines may be responsible – like phenlephrine used for ‘cold’ / salbutamol
used for asthma. Rarely, there are abnormal nerve paths (bypass tracts) in the heart.
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)
More Laboratory work-up like electrolytes (potassium in particular), thyroid (overactive) etc. may be needed.
The treating doctor may suggest them based on the situation.
Wishing speedy recovery