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21 weeks pregnant. Feeling fatigued, pain in shoulder and breathing problem. Any complications?

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Practicing since : 1981
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I am 35 year old female - 21 weeks pregnant. I have been having problems with extreme palpitations (documented PVC's at about 7 a minute - some R on T). I get lightheaded, racing pulse (130 bpm) and I am very fatigued. I have right shoulder blade pain that has persisted for 4 days on and off. I am also getting intermittent pain in my right elbow and I have pressure on my cheekbones on both sides. I have had bloodwork done 3 times (normal) and 3 ecgs (normal). I also have a cough at night and some troubles breathing when I lay down. I have a resting heartrate of 100 since pregnant and it goes very high when I stand or walk up the stairs.
Posted Mon, 3 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 7 hours later
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
Your problem is serious enough to have a consultation between your obstetrician and cardiologist. There is only one option that is to give you full dose of drug to control arrhythmia but as all drugs have some pro arrhythmic (can induce arrhythmia on their own) and secondly the effect on your unborn child. It is beyond 8 weeks therefore, worry is not of interference with the development of child but if drug causes placental barrier it will produce some effect on fetal heart. In my opinion, a decision to administer drugs will depend upon type of arrhythmia and symptomatic status ..on that count you need a drug. Second will be your left ventricular function on echocardiography it is normal a simpler drug like B blocker can be used (provided you do not have basic bradycardia dependent rhythm). All other effective drugs like Amiadarone, Procainamide Verapamil and Diltiazem are classified as C by US FDA. Where human data is not available or not conclusive but have caused fetal toxicity in animal studies. Among these Verapamil has least toxic. The final call is to be taken by what your obstetrician decides in consultation with cardiologist. Good Luck. If you have a question please ask, I will be most happy to answer.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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