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Suggest Treatment For Palpitations And Tachycardia
I am a 23 year old female, studying medicine. For past 8 months, i have been having some episodes of heart 'dysfunctions' that now have turned constant. I need help in knowing what is the condition.
It started last may when one day i started feeling so weak that i just could not get up and was having a splitting headache, when i measured my BP was 90/55mmHg ( before it was always 120/80mmHg). I was having palpitations, bradycardia at times, tachycardia at times, extreme weakness, sweating ( especially on scalp) after sleeping after headache. I was also having light sleep.
Slowly, these episodes became constant. Now I am feeling weak all times, light headed if sitting or standing for long, headache (thumping with constant heaviness), inability to sleep, tightness in chest, chest pain sometimes, tachycardia at any normal activity (walking, doing some tidy up), BP is still low. I also get dry cough on breathing sometimes.
So i got a holter done for 24 hours, got following:
- sinus tachycardia( 110- 120) almost all day with some normal rate in between, my heart rate dropped to 50 in middle of night ( reason causing me to wake up from sleep and not to sleep again) and it remained like that for 3 hours
- average pulse -81
- my heart rate jumped to 179 per min when i climbed stairs ( 9 floors, easily climbed by others), breathing became laboured, headache with blacking out sensations ( i did not faint though)
- I have some abnormalities in lead I, II and III ( looks like left axis deviation as lead I is showing highest peaks and is moving away from III ) even the avL and avF looks weird, QTc>450ms is 47%, no ST deviation, no T wave abnormalities
I also have tachypnea (26-28 per min) and accentuation of Pulmonary part of second heart sound. I also have slight edema on my feet ( bluish tinge)
I also did a blood work up, I do not have thyroid problems or anemia
I need some advice on what i might be having, so as to proceed further on treatment.
It started last may when one day i started feeling so weak that i just could not get up and was having a splitting headache, when i measured my BP was 90/55mmHg ( before it was always 120/80mmHg). I was having palpitations, bradycardia at times, tachycardia at times, extreme weakness, sweating ( especially on scalp) after sleeping after headache. I was also having light sleep.
Slowly, these episodes became constant. Now I am feeling weak all times, light headed if sitting or standing for long, headache (thumping with constant heaviness), inability to sleep, tightness in chest, chest pain sometimes, tachycardia at any normal activity (walking, doing some tidy up), BP is still low. I also get dry cough on breathing sometimes.
So i got a holter done for 24 hours, got following:
- sinus tachycardia( 110- 120) almost all day with some normal rate in between, my heart rate dropped to 50 in middle of night ( reason causing me to wake up from sleep and not to sleep again) and it remained like that for 3 hours
- average pulse -81
- my heart rate jumped to 179 per min when i climbed stairs ( 9 floors, easily climbed by others), breathing became laboured, headache with blacking out sensations ( i did not faint though)
- I have some abnormalities in lead I, II and III ( looks like left axis deviation as lead I is showing highest peaks and is moving away from III ) even the avL and avF looks weird, QTc>450ms is 47%, no ST deviation, no T wave abnormalities
I also have tachypnea (26-28 per min) and accentuation of Pulmonary part of second heart sound. I also have slight edema on my feet ( bluish tinge)
I also did a blood work up, I do not have thyroid problems or anemia
I need some advice on what i might be having, so as to proceed further on treatment.
Mon, 10 Sep 2018
Hi,
It seems that you have done a good workup but I suggest you get an echocardiogram done as well for evaluating valvular heart diseases.
Your Holter does not seem to have any important problem. You should also try to reduce your anxiety and have regular exercise to increase your functional capacity.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Mohammad Mostafa Ansari Ramandi,
Cardiologist
It seems that you have done a good workup but I suggest you get an echocardiogram done as well for evaluating valvular heart diseases.
Your Holter does not seem to have any important problem. You should also try to reduce your anxiety and have regular exercise to increase your functional capacity.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Mohammad Mostafa Ansari Ramandi,
Cardiologist
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