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Suggest treatment for palpitations and abdominal pain

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Posted on Fri, 2 Dec 2016
Question: hi< I wonder if you can help me. I have been unwell for the last 8 days, my symptoms started last Thursday night, when my heart rate went suddenly up and wouldn't come back to normal for over an hour. On Friday morning I felt fine, had my breakfast as usual and left for work. On the way there started feeling very faint, had to be helped out of the train. After about an hour felt more or less ok, spent the rest of the day resting. On Saturday felt relatively ok, but on Sunday afternoon the same symptoms came back- fast heart rate and feeling faint and very weak- enough to go to A&E. They did EKG and measured my blood pressure, which by then was within normal. They discharged me with the diagnosis of a viral infection, told me to rest, and wait it out. Felt better on Monday, but on Tuesday the same symptoms occurred- went to A&E again, feeling extremely weak and shaking all over, but my temperature was only 37.2 centigrades. They did a blood test, EKG, urine test and chest x-ray, as I also have this pulling feeling going from my heart to the top left side of my chest( which, they said, is nothing to worry about). Again, I was told all was well and that it is some viral infection and should clear soon. They put me on a drip saying it should help and it did for a while. I felt very weak but had good appetite yesterday, so was happy thinking i'm getting over whatever this virus is. This morning woke up feeling fine, had a small breakfast, after half an hour felt like my stomach was sucked in and empty. At the same time my heart started pounding again, and the fast rate lasted for few hours( though not as fast as before, but still far too fast for me, especially as i was lying down all this time) .My stomach felt better when I ate a bit of an apple and bread. Now I'm resting again, but worry that my symptoms will come back again tomorrow. I still feel the pulling feeling at my heart, and this is what worries me- doctors at A&E said it's nothing.Please, advise.
doctor
Answered by Dr. Shuba Hariprasad (4 hours later)
Brief Answer:
Cardiac arrhythmia to be ruled out

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Based on your symptoms I would like to rule out cardiac arrhythmia (paroxysmal supra ventricular tachycardia, atrial fibrillation).

Would you clarify a few things for me please?
*what is your height and weight?
*how much caffeine do you have a day?
*do you have any other medical issues or take any medications?
*have you changed your diet in any way? Or take any supplements?
*did you have sweat during the episodes?
*any family history of heart disease?
*could you please attach any reports that you have so that I may be able to get a better idea?
*are your menstrual cycles normal?
*do you have children?
*any surgeries in the past?
*do you smoke or consume alcohol?

I recommend :
-a physician and cardiologist opinion.
-blood tests (complete blood count, Thyroid stimulating hormone, free t3 and free t4, cardiac enzymes, clotting parameters, kidney and liver function tests, electrolytes, blood glucose panel and lipid profile)
-an electrocardiogram and echocardiogram
-Holter monitoring to detect the heart rhythm disturbances while at home.
-ultrasound abdomen and pelvis
-limit caffeine to one small cup (100ml) a day.
-monitor the circumstances in which these symptoms appear. The food you ate, the physical activity, social/emotional events.
-avoid sudden movements, sudden turning and bending.
-avoid driving.

Based on these tests and clinical findings, a treatment plan will be made.
Heart rhythm disturbances can be intermittent and difficult to detect. I urge you to consider my suggestions in order to prevent complications.
Caught on time, treatment is based on the cause and will help minimize risk of complications.

Hope this helps. Please let me know if there is anything else I can help you with.

Wish you good health.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Shuba Hariprasad (8 hours later)
Thank you for advice, doctor Hariprasa. Here are the details you requested:
Im 162 cm tall, weigh around 50 kg, before I got sick I used to drink strong coffee twice a day- quite big portions. I dont have any medical issues as far as i know, but have occasionally faint, especially in the mornings, about an hour after breakfast. I only take Paracetamol once a month for menstrual pains, and usually only for 24 first hours. I have what I call ' a nervous stomach'- cant eat when im
stressed, and I'm generally an anxious person, so my diet is erratic from time to time. I avoid highly processed foods, though, sometimes indulge in the evenings.I don't take any supplements. During the episodes I was quite hot but not sweating- in fact, I have slways produced only a little bit of sweat, even in hot weather or when excercising. There is a history of heart disease in my family, but so far it was only my male relatives who had it. All the reports are still at the A&E department in Barnet Hospital.My menstrual cycles are normal.I dont have children.I have had a blood transfusion at the age of 3, following a toxic shock reaction to Penicillin. Prior to this illness I have been smoking some marihuana rolled with tobacco. I don't drink alcohol- very ocasionally, once in few years, when there is a wedding.
I will do all the tests that you recommend as soon as I'm able to stand on my feet and leave the house. I hope it won't be too late for that. Thank you.
doctor
Answered by Dr. Shuba Hariprasad (3 hours later)
Brief Answer:
Tobacco, caffeine and marijuana have been shown to increase heart rate

Detailed Answer:
Hello,
Thank you for the follow up and clarifications.

*have you lost consciousness during the fainting? Recovered quickly? Any loss of memory of eve to that happened around these episodes?

*what heart problems did member of your family have?

*how much coffee do you have now?

*how long have you been using marijuana & tobacco? Do you still use it?

Caffeine and tobacco are not good for the body, especially the cardiovascular system, both increase heart rate & increase its excitability

Marijuana has been linked with increased heart rate, however not enough studies are there to establish all the effects of marijuana on the heart.

Please do consider my recommendations. Practice meditation, yoga and deep breathing exercises to calm your mind & body.
Take a vitamin C supplement 500mg every day after breakfast or lunch (not dinner) .
If this irritates your stomach, stop.

Hope I've helped. I sincerely hope you feel better soon.
Please let me know if there is anything else I can help you with.

Wish you good health

Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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Suggest treatment for palpitations and abdominal pain

Brief Answer: Cardiac arrhythmia to be ruled out Detailed Answer: Hello, Thank you for your query. I'm Dr. Shuba Hariprasad and will be answering your query today. Based on your symptoms I would like to rule out cardiac arrhythmia (paroxysmal supra ventricular tachycardia, atrial fibrillation). Would you clarify a few things for me please? *what is your height and weight? *how much caffeine do you have a day? *do you have any other medical issues or take any medications? *have you changed your diet in any way? Or take any supplements? *did you have sweat during the episodes? *any family history of heart disease? *could you please attach any reports that you have so that I may be able to get a better idea? *are your menstrual cycles normal? *do you have children? *any surgeries in the past? *do you smoke or consume alcohol? I recommend : -a physician and cardiologist opinion. -blood tests (complete blood count, Thyroid stimulating hormone, free t3 and free t4, cardiac enzymes, clotting parameters, kidney and liver function tests, electrolytes, blood glucose panel and lipid profile) -an electrocardiogram and echocardiogram -Holter monitoring to detect the heart rhythm disturbances while at home. -ultrasound abdomen and pelvis -limit caffeine to one small cup (100ml) a day. -monitor the circumstances in which these symptoms appear. The food you ate, the physical activity, social/emotional events. -avoid sudden movements, sudden turning and bending. -avoid driving. Based on these tests and clinical findings, a treatment plan will be made. Heart rhythm disturbances can be intermittent and difficult to detect. I urge you to consider my suggestions in order to prevent complications. Caught on time, treatment is based on the cause and will help minimize risk of complications. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health. Regards, Dr. Shuba Hariprasad