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Have had two cardiac stents, have type 2 diabetes. Why do I have skipped heart beats? Why do I have ear infection?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
58 year old male. I have had two cardiac stents. On e 6 years ago and one four years ago. I recently was diagnose with type 2 Diabetes. Myt sugar is usualy 150 -200 in AM and 90 before evening meals.
recently about one week , I experince skipped heartbeats from AM to mid afternoon. Approximately 3-6 per minute and increasing. Sometimes associted with indegestion. Everything was fairly normal in my last blood tests 10 months ago. My recent tests just indicate Now my A1C is 7.2 triglyserides 723. sugar 208. Started taking metformin this week. I am 6'2 tall in ht, weigh 270 pounds. I have experinenced seizure disorders 30 years ago been treating with Dilantin. Ihave hpertension but very controlled with current meds.

I have had a past history of PTSD from viet Nam, which was treated well but had years in the past where I had panic attacks. Have not had a panic attack in ten years. I work and am a professional.
Aspirin 80mg
Maxide 37.5
Lopressor 50 bid
Crestor 20 bid
Louvasa 2g bid
Dilantin 400mg
Vit D3 2000
vt b complex

I just passed one omth ago a cardiac stress test.
Carried a monitor and decent echo.

My ENT ordered a TSA test for hoarseness.
I was in the hospital in Dec for 5 days bt my ENT for a sever ear infection and fluid in my mastoidis or some such thing.
My sugar spiked when I has the infection but they tested me in the hospital 5 times a day for a wekk and my sugar was fairly normal.

I dont understand the sugar problem nor the skipped heartbeats, but its al driving me crazy and my doc is out of town till may.

Can you help
Posted Tue, 22 May 2012 in General Health
Answered by Dr. Raja Sekhar Varma 1 hour later
Thank you for the query.

As I understand, you have type 2 diabetes, hypertension, dyslipidemia, CAD, S/p PCI with 2 stents, recent ear infection.

1. The skipped beats are usually due to premature complexes or ectopics. These could be atrial, ventricular or junctional. This is basically a type of arrhythmia of the heart. The diagnosis is achieved by recording the missed beats on an ECG taken during the time when the symptom is actually happening. Since this is difficult at times, it is also possible to do a 24 hour continuous ECG recording known as Holter monitor. Analysis of this should tell us what type of ectopic beats are happening, what is the frequency of the problem, whether it needs any specific treatment at all and if so, what drugs are likely to work.

2. Sugar levels do rise whenever there is an infection. It is likely that the ear infection has triggered a loss of control of the sugar values. Also, mastoiditis is known to take some time before healing, and prolonged antibiotics may be required. You may need to increase/adjust the dosage of the anti-diabetic medicines during this period. Insulin might be needed sometimes.

3. The triglyceride levels are very high and you may need a special drug called fenofibrate to control this. Such high levels of triglycerides could result in pancreatitis. Thus, you need to consult your physician and get the triglyceride levels attended to. You should also reduce milk and milk products in your diet, as also cream, pastries, excess oil, fried food, red meat, etc. Walking for half an hour per day is also very useful.

Many factors, including high sugars, electrolyte disturbances, infection, stress, anxiety, sleeplessness, excess tea/coffee/stimulant drinks, alcohol, ischemia, etc are known to trigger ectopic beats. Many are benign and do not need active treatment except to remove the triggers and correct the underlying cause. However, there are some types of arrhythmias which could be XXXXXXX and therefore, it is essential to rule out these types by an exact diagnosis.

I hope this helps to answer your query. Feel free to ask me for any specific clarifications.
With regards,
Dr Raja Sekhar Varma,
Consultant Interventional Cardiologist
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