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What Causes Tremors In Left Arm And Extreme Fatigue?
Question: My dad is 72 and physically active and (up to now) healthy. He has a previous history of heart attack at age 46 which he recovered with no relapses and stage 1 lung cancer which was removed with lobectomy. He currently has a tremor in his left arm which they think is a hereditary essential tremor. Anyway, he is being treated for extreme fatigue. His cardiologists disagree with one thinking he needs a pacemaker and one thinking a narrowing that he has had for years and has been tested on is instead a blockage. He had a treadmill test today and they were not happy that his heart rate did not get over 70. Is 70 low, especially since he is on Tenorman which I know slows heart rate? If so, does it indicate a blockage or the need for a pacemaker?
Brief Answer:
Please do upload all relevant reports, medication n we will workout d best
Detailed Answer:
Hello , I am Dr Mody and i will be addressing your concern to the best of my knowledge .
Fatigue in your father may be due to many reasons .
I would be brief and too the point so as to avoid confusion .
I would be pleased if you can upload the ecg , last 2D echo and blood investigation and medication he is on , so i can objectify my recommendation .
1) pacemaker has some recommendations in a subgroup of patient who has low EF , some specific ECG abnormality and patients clinical profile . it does'nt benefit all patients
2) you are right that tenormin was the reason why the heart rate didnt go up and as a protocol we stop it for atleast 24 to 48 hours before stress test if patient clinical condition permits . Also what stage he achieved during treadmill test would determine whether 70 is adequate or not and what was his baseline pulse rate .
3) also the fatigue may be due to either blockages or low heart pumping or both together . It will be difficult to interpret based on the short history , post review of investigation i would help you with further course of action .
Be reassured , mostly by titrating the medication we would be able to help your father symptoms .
Regards . Dr. Priyank Mody
Please do upload all relevant reports, medication n we will workout d best
Detailed Answer:
Hello , I am Dr Mody and i will be addressing your concern to the best of my knowledge .
Fatigue in your father may be due to many reasons .
I would be brief and too the point so as to avoid confusion .
I would be pleased if you can upload the ecg , last 2D echo and blood investigation and medication he is on , so i can objectify my recommendation .
1) pacemaker has some recommendations in a subgroup of patient who has low EF , some specific ECG abnormality and patients clinical profile . it does'nt benefit all patients
2) you are right that tenormin was the reason why the heart rate didnt go up and as a protocol we stop it for atleast 24 to 48 hours before stress test if patient clinical condition permits . Also what stage he achieved during treadmill test would determine whether 70 is adequate or not and what was his baseline pulse rate .
3) also the fatigue may be due to either blockages or low heart pumping or both together . It will be difficult to interpret based on the short history , post review of investigation i would help you with further course of action .
Be reassured , mostly by titrating the medication we would be able to help your father symptoms .
Regards . Dr. Priyank Mody
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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