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Dr. Andrew Rynne
Dr. Andrew Rynne

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Suggest treatment for heart palpitations

Answered by
Dr. Neel Kudchadkar

General & Family Physician

Practicing since :2004

Answered : 531 Questions

Posted on Fri, 17 Apr 2015 in Hypertension and Heart Disease
Question: Hi, I had heart palpitations for several hours overnight, gradually subsiding. Now have occasional sense of tightness in chest. Background: have bradycardia w/1st degree AV block as of 2010. Last blood pressure check 103/71 (also 2010). 5 ft. 2 in., 125 lbs. Current: Ran earlier in evening w/minimal discomfort. Palpitations started about three hours later. Haven't slept much in last few days due to work. Thought that might be relevant. My main speculation, however, is that I'm vegan and had switched from supplementing with vitamin B-12 (1000mcg) daily to a B complex (w/ only 6mcg of B-12) about a week ago and I thought B-12 deficiency was a plausible cause (6mcg is 100% DV but perhaps poor bioavailability?). Spoke to a nurse who advised an ER visit but I would like to wait, especially if I can solve this just by reverting to the B-12 supplement, and see my PCP soon. Also thought anxiety/vagus nerve stimulation could be contributing as discomfort was worse when I was lying down. I don't want to incur the stress & expense of an ER visit for anxiety- and/or B-12-caused palpitations. Is it reasonable to wait until I can see my PCP since palpitations have receded and discomfort is now minor? Thanks so much.
Answered by Dr. Neel Kudchadkar 1 hour later
Brief Answer:
Watchful waiting is our best defense against unwarranted expenses.

Detailed Answer:
Dear XXXX,

I'm Dr. Neel Kudchadkar and I'll help you out with this dilemma.

I appreciate the fact that you happen to a well informed, educated, discerning consumer. The detailed and meticulous facts that you provided in the query were very helpful. I have given much thought to your case and this is arguably the best course of action.

We, both have to rather respect the opinions of a healthcare professional when it comes to a provisional diagnosis. Nurses in particular are pretty intuitively accurate when it comes to assessing patients in this regard. As regards advice to go to the ER, we must also keep in mind that human beings can be fallible to error.

These are some pertinent facts.
1. That you definitely had an attack of tachycardia that night.
2. That you were under stress.
3. That you are a health conscious vegan, and had decided to switch supplements.
4. I would say with confidence, that this is NOT a major cardiac incident.
5. My diagnosis is just that, stress induced tachycardia,

You can be assured, that you're OK. Just take it easy.
I know it's easier said than done;
Nevertheless you are free to visit an ER and while we could not say that it would be a waste of money, but one would have to face the stress and the baggage that goes with it.

I stand by my diagnosis.

Do take care,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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