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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Am I In Need Of A Pacemaker At This Time?

Dear Doctor, I am 40yrs old. Last 07/08/2014, I am attacked in heart by stress. Local doctor`s comments are have palpitation, HbA1c-5%, TC-130mg/dl, HDL-40mg/dl, LDL-67mg/dl, TG-113gm/dl, ECHO Results are EF-67%, LV-Normal in dimension with Inferior wall hypokinesia, Mildly impaired LV Diastoolic function, ASD/VSD/PDA flow absent. CAG Results are 50% mid RCA block, 20-30% LAD block and small caliber 100% at distal part. Now I am suffering from cardiac abnormalities like- palpitation, sometimes BP is 80/50 and sometimes BP is 160/110. No chest pain, Modarate Physical movement induced palpitation high. Diabetes Melitus is my previous experience. My local doctor prescribed 1)metoprolol 12.5mg bd, 2) nitroglicerine 6.25mg bd, 3)trimetazidime 35mg bd. 4)aspirin150+clopidogrel150mg od, 5)clonazepam 1mg od and 6)Rabeprazole 20mg bd, 7)nitroglicerine spray sos. Here my questions are 1. Is my local doctor`s treatment appropriate? 2. Is pacemaker require? If not in both questions, plz give me suggestion/ medication.
Wed, 8 Oct 2014
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Psychiatrist 's  Response
Hi welcome to HCM.
Palpitations are extremely common in patients with coronary heart disease.Your coronary angiogram revealed significant blockades in the main coronary vessels.You are currently on the right treatment aspects for your diabetes,hypertension and low cardiac reserve.I advise you to have a 24 hr holter EKG monitoring which can accurately quantify the ventricular arrhythmias.Electrophysiological study guided Cardiac pacemaker can be safely implanted in case of persistent low heart rates.Consult your cardiologist for further queries.
Thank you.
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Am I In Need Of A Pacemaker At This Time?

Hi welcome to HCM. Palpitations are extremely common in patients with coronary heart disease.Your coronary angiogram revealed significant blockades in the main coronary vessels.You are currently on the right treatment aspects for your diabetes,hypertension and low cardiac reserve.I advise you to have a 24 hr holter EKG monitoring which can accurately quantify the ventricular arrhythmias.Electrophysiological study guided Cardiac pacemaker can be safely implanted in case of persistent low heart rates.Consult your cardiologist for further queries. Thank you.