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On and off chest pains. Test normal. Heart beating fast, pulse high. Medical care required?

Im 31. Ive had chest pains on & off for a couple of years. Finally had test done in 2012. Nothing showed up. Everything GOOD! Doc. Gave me like indigestion/ heartburn meds. That didnt help and gave me heart burn for real! Well today I hopped over a desk at work by sliding my but on and swinging my legs over. Right away it felt like it made my heart have the wrong rythem. Then my heart started beating really fast & hard...for 4 hours! Heart rate was 140bpm. Laid down I laid down for a min. My face got super hot I recked my pulse it was down to 109. Do I need to go to ER?
Asked On : Fri, 11 Jan 2013
Answers:  1 Views:  37
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

Fast heart beats need to be DOCUMENTED by ElectroCardioGram (EKG).

Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much coffee, cola) / Medicines / abnormal nerve paths (bypass tracts) in the heart may be responsible.
It is advisable to have it investigated.
A thorough history and physical examination is the first step -

     Routine 12-lead Electrocardiogram (ECG) is part of clinical examination. If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
     Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow).
     Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation.
     If there are no clues and if you are still bothered by it to the extent of interfering with life style, there are more tests, like Electro Physiological Studies

     The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. Several other classes of drugs are available – acting by different mechanisms - There are other advanced treatment modalities - like RF ablation, which could be done during EPS.

Relax. You are young; you sound intelligent – you stand an excellent chance of returning to normalcy.
Be positive – why fear the heart beats faster? The problem iis only if it could not beat! You are tolerating the rate well - means that you may not have any basic disease of the valve, muscle and so on. Be in touch with your doctor - it is a question of time and you will be well. Medicine is well advanced nowadays – management is possible for almost all situations...

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Sat, 12 Jan 2013
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