Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

I understand your concern and would like to explain that to properly review your arrhythmic events it is necessary to consider qualitative (types of arrhythmia: supraventricular or ventricular, only isolated ectopic beats or more complex episodes [runs of arrhythmia], etc) and quantitative (amount of arrhythmic events during a certain period of time) data.

All the above mentioned necessary informations comes quite convenient from the loop recorder monitoring.

Could you please provide me with more specific information as to what extent and what kind of arrhythmia has been revealed by the overall test?

I would like to assure you that nothing dangerous or life-threatening could derive from those ectopic beats lasting for a few minutes or from sinus tachycardia.

The fact that your doctor has recommended you a loop recorder concludes that your arrhythmic events are quite scarce (as they could not be detected by a routine Holter tests).

This is another evidence that you are not suffering from any frequent and important arrhythmia.

As you are having a structurally normal heart (I suppose your cardiac ultrasound has resulted normal as you are directed to MRI test [as I read on your previous medical history]), is another strong evidence that your scarce ectopic beats are not an expression of any serious cardiomyopathy.

So, I would like to assure you that nothing dangerous is going to happen.

Just relax and don't worry too much about!

Please, could you provide me with your last cardiac ultrasound report (could you upload it here?)?

At the end, I would explain that those non-important arrhythmic events you are experiencing seem to have some triggering factors that could be efficiently controlled.

Peri-menopausal hormonal imbalances are a known factor that could be controlled by properly supervising of your gynecologists. Remember that this delicate period is transitional and this adverse factor on your heart will disappear soon.

My advice relies on possibly increasing Propranolol daily dose, as 10 mg is quite insufficient. The usual initial dose would be 10 - 30 mg every 6-8 hours, then increasing according to clinical response. You need to discuss with your prescribing doctor about this important issue.

Propranolol crosses hemato-encephalic barrier and if taken at least 40 mg/day may have beneficial effects on anxiety disorder as well.

You need to discuss with your psychiatrist for finding the most suitable management strategy of anxiety disorder. Remember that even Aropax (Paroxetine) may have important influence on triggering sinus tachycardia.

If you could provide me with the above information, I could give a more concrete professional opinion.

Hope to have been helpful to you!

In case of further uncertainties, do not hesitate to contact me!

Kind regards,

Dr. Iliri

Dr. Iliri

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Brief Answer:
My opinion:

Detailed Answer:


Hi again,

As your cardiac ultrasound and stress tests have resulted normal, then nothing to worry about.

I insist on my advices about Propranolol daily dose increase and seriously addressing your anxiety issues.

I also recommend you checking your thyroid function tests (thyroid hormones), as non-rarely may show responsible for anxiety bouts and also cardiac arrhythmic events.

When a full conclusion of rhythm recordings evidence on loop recorder will be available, please do not hesitate to upload it here for a second opinion.

You can reach me directly on the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Regards,

Dr. Iliri

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