Brief Answer: Reevaluation by your carddiologist needed. Detailed Answer: Hi and thanks for the query, Body and environmental temperatures for sure have an effect of the rate at which one's heart beats. Having a history of heart disease compels a specific regime. With a history of heart disease, change of drug regimen should be done with the knowledge of your doctor, except in cases of an acute adverse reaction. It is important to know if your heart rate is back to normal or not. It is recommended that your heart rate should be above 60 beats per minute. A heart rate of 40 is extremely low. It might of great interest to exclude other serious condition that could explain low heart beats as such like heart blocks. It is possible the improper manipulation of Metoprolol, considering your past history and recent environmental changes could partially explain these. An electrocardiography and a cardiac ultrasound remain imperative to appreciate cardiac function. While waiting to pick up an urgent appointment with your cardiologist, I would strongly you stick to your doctor's prescription, or contact him in case of any serious adverse or weird feeling. Thanks and kind regards as I wish you the best of health. But do feel free asking any further follow up questions in case of need. I would be glad making any humble contributions. Dr Bain

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Brief Answer: Blood pressure levels are reassuring. Detailed Answer: Hi and thanks for the query, Your blood pressure readings are quite OK. I do think if the pre operative work up concerning your clotting profile and general health status, you can go ahead with the surgery. Your blood pressure parameters are quite reassuring. Thanks and kind regards. Dr Bain.

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