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Dr. Andrew Rynne

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I am writing to you because I am having some

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6217 Questions

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Posted on Sun, 20 Jan 2019 in General Health
Question: I am writing to you because I am having some difficulty getting answers from my current cardiologist regarding my overall heart health. I have used you for a few of my questions and feel comfortable reaching out to you again.
I am 47 years old (female) and have been battling with High Blood Pressure most of my life. Just in the last year it seems it is somewhat under control. I am a little overweight (although I have lost 15lbs since August) and am trying to exercise and eat better. My most recent bloodwork came back normal, with the exception that my blood glucose was borderline (pre diabetes) and my ALT was 55 (liver). I had a liver ultrasound and the results state, “Suggest hepatic steatosis” – fatty liver.
I was on Hydrochloraidizide for a while and it was wiping out my electrolytes (potassium, chloride sodium, etc.), so my electrolytes were off for about a year and half—causing palpitations, etc. I was recently taken off the medicine, thanks for a doctor at the local hospital and all my electrolytes went back to normal. The problem is now I have developed PVCs.
I was first diagnosed with them in the hospital and then via a 24 Holter monitor. I was told they were not life threatening, benign in nature and not to worry. I had a stress test (regular) and an echocardiogram. I was noted as having a “leaky value—mitral?”—but the doctor did not seem too alarmed and again was assured on a number of occasions that I would be just fine. I went to see an Electrophysiologist and they too looked at the EKG readings and said they were benign in nature.
Since that time, I continued to have PVCS and other flutters, etc. so I begged my cardiologist to give me a two-week monitor. The two week results (attached) are not showing PVC couplets/triplets and Ventricular Tachycardia. I don’t know how bad this condition is? It appeared one time during the 12 days/18 hours. My doctor did seem real concerned about that result. I don’t know how this all happened. I have been relatively healthy. I am very depressed and worried that my situation is no longer non-life threatening/benign and is moving into a direction that could cause sudden cardiac arrest/death.
I was hoping perhaps you could offer me some guidance/information. Is this heart thing related to the fat in the liver? Is it real serious? I have been restricted from exercise until I complete a Nuclear Stress Test. I point blank asked my doctor (so I could understand the severity) on a scale of 1-10 ten being the best, where did my heart health fall—he said “seven.” So concerned. Any information you are willing to provide would be greatly appreciated. Thank you. **I am looking for a way to upload my monitor report***
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Follow up: Dr. Ilir Sharka 0 minute later
I am writing to you because I am having some difficulty getting answers from my current cardiologist regarding my overall heart health. I have used you for a few of my questions and feel comfortable reaching out to you again.
I am 47 years old (female) and have been battling with High Blood Pressure most of my life. Just in the last year it seems it is somewhat under control. I am a little overweight (although I have lost 15lbs since August) and am trying to exercise and eat better. My most recent bloodwork came back normal, with the exception that my blood glucose was borderline (pre diabetes) and my ALT was 55 (liver). I had a liver ultrasound and the results state, “Suggest hepatic steatosis” – fatty liver.
I was on Hydrochloraidizide for a while and it was wiping out my electrolytes (potassium, chloride sodium, etc.), so my electrolytes were off for about a year and half—causing palpitations, etc. I was recently taken off the medicine, thanks for a doctor at the local hospital and all my electrolytes went back to normal. The problem is now I have developed PVCs.
I was first diagnosed with them in the hospital and then via a 24 Holter monitor. I was told they were not life threatening, benign in nature and not to worry. I had a stress test (regular) and an echocardiogram. I was noted as having a “leaky value—mitral?”—but the doctor did not seem too alarmed and again was assured on a number of occasions that I would be just fine. I went to see an Electrophysiologist and they too looked at the EKG readings and said they were benign in nature.
Since that time, I continued to have PVCS and other flutters, etc. so I begged my cardiologist to give me a two-week monitor. The two week results (attached) are not showing PVC couplets/triplets and Ventricular Tachycardia. I don’t know how bad this condition is? It appeared one time during the 12 days/18 hours. My doctor did seem real concerned about that result. I don’t know how this all happened. I have been relatively healthy. I am very depressed and worried that my situation is no longer non-life threatening/benign and is moving into a direction that could cause sudden cardiac arrest/death.
I was hoping perhaps you could offer me some guidance/information. Is this heart thing related to the fat in the liver? Is it real serious? I have been restricted from exercise until I complete a Nuclear Stress Test. I point blank asked my doctor (so I could understand the severity) on a scale of 1-10 ten being the best, where did my heart health fall—he said “seven.” So concerned. Any information you are willing to provide would be greatly appreciated. Thank you. **I am looking for a way to upload my monitor report***
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome back on Ask a Doctor service!

I reviewed carefully your Holter results and would explain that I am not really sure that this is ventricular arrhythmia. In my opinion this is a more benign type of supraventricular arrhythmia.

Anyway, you should know that the significance of a cardiac arrhythmia depends also on the heart condition and other comorbidities.

We can not know if this cardiac arrhythmia is related to the heart, without a careful examination of the myocardial tissue.

For this reason, I would recommend performing a cardiac MRI with contrast enhancement, which is the best tool to examine better the myocardial tissue and exclude any possible cardiac causes underlying arrhythmia.

I don't think that these findings are related to the fatty liver, but I would recommend checking also your thyroid hormone levels and blood electrolytes for possible imbalance.

I would also recommend avoiding straining physical activity, caffeine and energy drinks intake.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka,

Cardiologist


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome back on Ask a Doctor service!

I reviewed carefully your Holter results and would explain that I am not really sure that this is ventricular arrhythmia. In my opinion this is a more benign type of supraventricular arrhythmia.

Anyway, you should know that the significance of a cardiac arrhythmia depends also on the heart condition and other comorbidities.

We can not know if this cardiac arrhythmia is related to the heart, without a careful examination of the myocardial tissue.

For this reason, I would recommend performing a cardiac MRI with contrast enhancement, which is the best tool to examine better the myocardial tissue and exclude any possible cardiac causes underlying arrhythmia.

I don't think that these findings are related to the fatty liver, but I would recommend checking also your thyroid hormone levels and blood electrolytes for possible imbalance.

I would also recommend avoiding straining physical activity, caffeine and energy drinks intake.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka,

Cardiologist


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 hours later
I am scheduled for a nuclear stress test on Monday and the doctor said he would have more information after those results. I will certainly request a cardiac MRI w/contrast as you recommend. I did have a CT scan of the lungs, etc. a month ago. Not sure if that would show anything?

The doctor did ask me to refrain from strenuous exercise until we can finish some tests. So you think, based on what you saw, that I am not in a life threatening situation? Would it be ok from time to time to have some wine/beer--I have cut out caffeine, sugar, etc.?

My thyroid and electrolyte levels all came back fine. I have no idea what is causing this agitation in my heart, but it has been going on since July. I have small kids and am afraid that that these incidents will lead to more serious events. In your experience is that likely? Sorry to inundate you with all these questions.
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Follow up: Dr. Ilir Sharka 0 minute later
I am scheduled for a nuclear stress test on Monday and the doctor said he would have more information after those results. I will certainly request a cardiac MRI w/contrast as you recommend. I did have a CT scan of the lungs, etc. a month ago. Not sure if that would show anything?

The doctor did ask me to refrain from strenuous exercise until we can finish some tests. So you think, based on what you saw, that I am not in a life threatening situation? Would it be ok from time to time to have some wine/beer--I have cut out caffeine, sugar, etc.?

My thyroid and electrolyte levels all came back fine. I have no idea what is causing this agitation in my heart, but it has been going on since July. I have small kids and am afraid that that these incidents will lead to more serious events. In your experience is that likely? Sorry to inundate you with all these questions.
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Dear Kelly!

Let me explain that both nuclear stress test and lung CT scan may help in clarifying better your medical conditions. Their drawback is the fact they pose the patient to some doses of radiation.

From the other side, cardiac MRI offers a much higher image resolution, sensibility and accuracy regarding possible structural heart disorders. But, it will depend also by the local expertise.

Furthermore, it has a safe profile as its operation is not based on ionizing radiations.

Meanwhile I recommend you to don't worry too much yours is not a very complex arrhythmia and at the same time is quite manageable.

You are not actually at any dangerous or life-threatening condition, and besides from avoiding strenuous physical activity and those stimulating drinks you are allowed to do everything.

Sure you may drink wine (of course no excessive amounts).

Let me know in case of any further questions!

Regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
My opinion as follows:

Detailed Answer:
Dear Kelly!

Let me explain that both nuclear stress test and lung CT scan may help in clarifying better your medical conditions. Their drawback is the fact they pose the patient to some doses of radiation.

From the other side, cardiac MRI offers a much higher image resolution, sensibility and accuracy regarding possible structural heart disorders. But, it will depend also by the local expertise.

Furthermore, it has a safe profile as its operation is not based on ionizing radiations.

Meanwhile I recommend you to don't worry too much yours is not a very complex arrhythmia and at the same time is quite manageable.

You are not actually at any dangerous or life-threatening condition, and besides from avoiding strenuous physical activity and those stimulating drinks you are allowed to do everything.

Sure you may drink wine (of course no excessive amounts).

Let me know in case of any further questions!

Regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 14 hours later
Thank you very much for taking the time to provide the information. I hope overtime that this arrhythmia corrects itself. I will never understand where it came from/what brought it on. I keep thinking that perimenopause is playing a factor, but you are the doctor--I, of course, am not:) Thanks again. Happy New Year!
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Follow up: Dr. Ilir Sharka 0 minute later
Thank you very much for taking the time to provide the information. I hope overtime that this arrhythmia corrects itself. I will never understand where it came from/what brought it on. I keep thinking that perimenopause is playing a factor, but you are the doctor--I, of course, am not:) Thanks again. Happy New Year!
doctor
Answered by Dr. Ilir Sharka 44 minutes later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

The hormonal changes during this period have also a great influence on the heart rhythm. But this is a normal physiological reaction in every woman at your age.

Anyway, let me know about everything!

I would like to directly review your future cardiac tests for a second opinion, whenever you will upload them.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

The hormonal changes during this period have also a great influence on the heart rhythm. But this is a normal physiological reaction in every woman at your age.

Anyway, let me know about everything!

I would like to directly review your future cardiac tests for a second opinion, whenever you will upload them.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 4 hours later
You have been wonderful and I want to keep using you for a second opinion--thank you!!!! I will send you the results of my Nuclear Stress test as soon as I have them. Sincerely, me
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Follow up: Dr. Ilir Sharka 0 minute later
You have been wonderful and I want to keep using you for a second opinion--thank you!!!! I will send you the results of my Nuclear Stress test as soon as I have them. Sincerely, me
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

I would be glad to review all your tests as soon as you will be able to upload them!

Please, feel free to ask me directly at any time!

Wishing all the best,

Dr.Iliri


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

I would be glad to review all your tests as soon as you will be able to upload them!

Please, feel free to ask me directly at any time!

Wishing all the best,

Dr.Iliri


Above answer was peer-reviewed by : Dr. Raju A.T
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