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February 28th, 2015
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I am a 63 year old male with HCM and AFIB. AFIB started in 2007 and currently on 25 mg of Atenolol in th am and twice a day 150 mg of Norpace. Only one event since October of 2011. I control my salt intake, drink no caffine and no alcohol. I recently had a ICD implated due to the results of a MRI of the heart. I have no lighheadiness, no fatigue, never passed out or other outward systems of HCM. My question relates to the below quote on Norpace: •talk to your doctor about the risks and benefits of taking disopyramide if you are 65 years of age or older. Older adults should not usually take disopyramide because it is not as safe or effective as other medications that can be used to treat the same condition. Since NORPACE is working I am hoping to continue to take it to eliminate AFIB events. Please explain the caution and how it might apply to me.
2012-07-28 Answered By : Dr. Miguel Valderrabano

Norpace has what is called "anticholinergic effects" which means that it antagonizes a part of the nervous system that controls body functions such as salivation, urination, bowel and function, eye function, and others. Side effects can occur as a result of this , and are more prominent in older individuals. These may include urinary retention, dry mouth, blurry vision and others.

I am a 68 yr old male who had a PVA back in 2003. It accomplished what it was suppose to do. However, I have experienced PVC's since and over the last year they have become more frequent )20 to 25 per minute) and have lasted for a month or so. Usually they come on in the evening after I have eaten...especially if I'm full. Not often but occasionally I feel light headed which makes me nervous to say the least. What are my options for handling this discomfort and Is there any relationship between AF and PVC's?
2012-07-28 Answered By : Dr. Miguel Valderrabano

There is no known connection between AF and PVCs. PVCs may be cured by an ablation procedure, technically different to the PVA. The are, as far as we know, unrelated problems.

I'm 63 and about 7 1/2 weeks post PVI ablation. At one week I had a 7 hour episode of AF after doing a workout on an Airdyne (erg machine). It resolved by itself and I was told not to do sprints but easy exercise for awhile. At three weeks post procedure I started walking 2 miles/day. By week 6 I got my 2 mile time under 30 minutes. On the weekend of the 7th week post procedure I started having missed beats, sometimes 3-4 out of 10 beats. This has been going on off and on for a couple of days. Is it normal to have minimum to no symptoms for several weeks after the procedure and then start having symptoms? Can I expect this to go away? Thanks for your help.
2012-07-28 Answered By : Dr. Miguel Valderrabano

We typically give ourselves a 3 month period after an ablation during which we don't consider episodes of AF as procedure failures. Irritation of the heart, some inflammation created by the procedure itself can cause some AF in the first weeks post procedure, and that may not necessarily means the procedure has failed. Many of these AF episodes do subside and cure is achieved. We like to wait 3 months before calling it a failure. Some drugs can help during this healing phase. If episodes continue after 3 months, then a repeat procedure may be considered.

I was wondering if you could answer my question. I am a 40 year old runner who had a cathetar ablation one year ago. I find that when i run or race like i use to in vigourous manner i prespire a great deal and often get nausea and head aches. could this be related to my sympathetic nervous system and the ablation? thanks
2012-09-28 Answered By : Dr. Dhanunjaya Lakkireddy, MD, FACC, FHRS.

As described in the question above, AF ablation can cause alterations in autonomic nervous system . Patient may develop symptoms like nausea after ablation which resolve over few weeks. One of presentations of atrial fibrillation is excessive sweating.In your case, excessive sweating may be due to runs of atrial fibrillation during exercise. We recommend you to follow up with cardiologist and consider transteplephonic monitoring during these episodes of excessive sweating to rule out AF recurrence. if you are in normal sinus rhythm on a monitor I don't have a clear answer toyour excessive perspiration.

I am 21 years old and overweight. I have been eating healthy food, fish, vegetables and that too leafy vegetable. For a couple of weeks ago I am having tensions due tom financial problems loss in the business, feeling a lot of anxiety and stress. Can a lot of anxiety and stress cause a heart attack in a person with a healthy heart? I have been to the cardiologist and a whole bunch of doctors to check if I have a heart problem.i have undergone with all the tests and all conclude that I have a healthy heart. Sometimes I feel a sense of my heart skipping a beat and off and on pain. . I have a heart obsession I'm always afraid of something happening with my heart. Why this heart skips beat occurs? Please suggest me?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. Anxiety and stress can cause heart disease. These conditions can cause problems with sleep, weight gain, high blood pressure, and also heart attack. Most of the time, anxiety and stress cause problems over time. Heart attacks often occur in those patients that also have other risk factors for disease such a high blood pressure, high cholesterol, diabetes, a family history of early heart disease, and a smoking history. If this regard at 21 you can take steps to minimize your risks be exercising at least 30 minutes a day, lowering your weight, and eating a well balanced diet. Lowering your weight will help reduce your risk of sleep apnea, high blood pressure, heart failure, and ultimately heart disease. Extra beats are usually from either premature atrial contractions (PAC)s or premature ventricular contractions (PVC)s. These are extra heart beats that can occur from either the top chambers of the heart (atrium) or the bottom chambers of the heart (ventricles). We all experience extra beats, but some people feel them more and in some people they can become very frequent. When your heart experiences an extra beat in which it is only partially filled up with blood it will delay the next beat so it can be more filled with blood. The heart does this so on average each beat has a similar amount of blood. The delayed beat that has extra time to fill up with blood often causes a heavy pounding sensation and in some people can cause other symptoms such as chest discomfort. Most of the time extra beats are an innocent occurrence and do not reflect an underlying heart condition. However, it is a good idea to see your doctor if they persist or become worse. After a careful history your doctor will likely use a monitor that lets you push a button when you experience the symptoms. This will let us understand what is causing you symptoms. It will also let us know how many extra beats you are experiencing and if they are coming from more than one spot in the heart. Depending on the monitor findings an ultrasound of the heart, called an echocardiogram, is often ordered to look at your heart function. Also, in some people these extra beats can occur consecutively and if this develops you may medication to slow down the heart or help it beat normal.

HI .i am 38 years old male.my neck got damaged met with an accident 20 years ago. I am having a lot more difficulty with it. Today I felt a disk slip inward towards the dorsal part of my throat. I am especially worried because I am facing trouble with breathing and have a really faint heartbeat of 60 beats per minute. I have an appointment day after tomorrow but what can I do between now and then?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. I suspect you already have the answer to your problem. There are nerves in the neck that when irritated or stimulated can cause the heart to slow. Usually these nerve bodies are located along the front of the next near the carotid arteries. These nerves should not have been irritated from a slipped disk. Nonetheless, if you are having trouble breathing then it is a very good idea to see your doctor urgently. Most of the time this is not from the slipped disk, but something in the airway itself or from the anterior/front of the neck.

Hi.my 17 year old sister was complaining of feeling unwell, headache and dizziness and light headed and way too hot. I have checked her temperature she has a slight fever. (99.8F) and she complained that her heart was beating weird.her heart rate was 94 bmp when she had been sitting on the sofa for three hours. I am going to take her to the hospital tomorrow.should I take her to the children's hospital ER? Or am I completely over reacting? And now it became nearly double 168 bmp. I am really worried about her and recently she was complaining that she can feel her heart beats in arms and back. Please help me?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. I suspect you probably already have the answer to your question. If your sister is sick with an infection the heart will usually respond in two ways to help the body fight the infection. First, the heart will be more quickly. This can result in a mild elevated heart rate and in people with a severe infection and very fast heart rate. Also, the heart will increase its contractility. What this means is the force the heart gives for each beat will be increased. This will make the heart beat your sister feels be more forceful and hard. Hopefully your doctors were able to find the cause of your sisters infection and she is feeling better. Since most of the time the heart is responding to the infection, the symptoms of a fast and hard heart beat will improve along with the infection and should not persist.

Hello.my boyfriend is 17years old he has a severe heart pain and he was born with a hole in his heart and he keeps getting severe heart pains. Usually when his heart hurts he turns bright red, and its becomes very difficult to take a breath. He blacks out a lot, and his heart goes really slow. He keeps going to the emergency room or doctors and they all keep telling we could not say anything and what is wrong him and he shouldn't have this kind of problems like at this age. He was saying that he feels like dying at that moment. I think he needs to consult a good heart specialist but he does not have much money or know of any heart specialist. it will be helpful if anyone can provide the information about this?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. I agree with you. Your boyfriend should see a heart specialist if he recurrently passes out and in particular if he has a hole in his heart. There are many different types of holes in the heart or structural problems of the heart. Some of these can be rather innocent and never cause problems. However, others can result in problems with the heart function, increase risk of infection of the heart, and also result in problems with the electrical parts of the heart. With such long term risks to the heart, people that have been born with a heart defect should be seen routinely be a heart specialist with specialized training in treating people with these type of problems that they are born with.

Hello .myself Akhila, 24 years old female. I don't drink coffee, rarely have tea and don't drink fizzy drinks. I know this is probably going to sound like nothing, but you know the feeling when your 'skips heart a beat'? For the last couple of weeks I've been getting that feeling in my chest at least once a day, like my heart is skipping a beat. There's no situation causing it and I don't feel nervous or anything. I am really worried about this. Do you think this could be something? Or just nothing? I don't exercise as much as I should but I'm still within my BMI healthy range. I don't eat excessive amounts of chocolate or sweet things either - I went on a diet recently and ever since my cravings for a lot of things have diminished! I've been sitting at the computer now for an hour an a half and I've had the feeling at least 5 or 6 times now just sitting before the system and also in my family my father is facing diabetic problem and also heart attack. Please help?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. From your history it sounds like you are experiencing either premature atrial contractions (PAC)s or premature ventricular contractions (PVC)s. These are extra heart beats that can occur from either the top chambers of the heart (atrium) or the bottom chambers of the heart (ventricles). We all experience extra beats, but some people feel them more and in some people they can become very frequent. In some people, these areas of extra beats are sensitive to caffeine and as such after caffeine consumption they occur more frequently. When your heart experiences an extra beat in which it is only partially filled up with blood it will delay the next beat so it can be more filled with blood. The heart does this so on average each beat has a similar amount of blood. The delayed beat that has extra time to fill up with blood often causes a heavy pounding sensation and in some people can cause other symptoms such as chest discomfort. Most of the time extra beats are an innocent occurrence. However, it is a good idea to see your doctor if they persist or become worse. After a careful history your doctor will likely use a monitor that lets you push a button when you experience the symptoms. This will let us understand what is causing you symptoms. It will also let us know how many extra beats you are experiencing and if they are coming from more than one spot in the heart. Depending on the monitor findings an ultrasound of the heart, called an echocardiogram, is often ordered to look at your heart function. Also, in some people these extra beats can occur consecutively and if this develops you may medication to slow down the heart or help it beat normal.

Hello .myself Akhila, 24 years old female. I don't drink coffee, rarely have tea and don't drink fizzy drinks. I know this is probably going to sound like nothing, but you know the feeling when your 'skips heart a beat'? For the last couple of weeks I've been getting that feeling in my chest at least once a day, like my heart is skipping a beat. There's no situation causing it and I don't feel nervous or anything. I am really worried about this. Do you think this could be something? Or just nothing? I don't exercise as much as I should but I'm still within my BMI healthy range. I don't eat excessive amounts of chocolate or sweet things either - I went on a diet recently and ever since my cravings for a lot of things have diminished! I've been sitting at the computer now for an hour an a half and I've had the feeling at least 5 or 6 times now just sitting before the system and also in my family my father is facing diabetic problem and also heart attack. Please help?
2012-05-28 Answered By : Dr. T. Jared Bunch

Thank you for your question. From your history it sounds like you are experiencing either premature atrial contractions (PAC)s or premature ventricular contractions (PVC)s. These are extra heart beats that can occur from either the top chambers of the heart (atrium) or the bottom chambers of the heart (ventricles). We all experience extra beats, but some people feel them more and in some people they can become very frequent. In some people, these areas of extra beats are sensitive to caffeine and as such after caffeine consumption they occur more frequently. When your heart experiences an extra beat in which it is only partially filled up with blood it will delay the next beat so it can be more filled with blood. The heart does this so on average each beat has a similar amount of blood. The delayed beat that has extra time to fill up with blood often causes a heavy pounding sensation and in some people can cause other symptoms such as chest discomfort. Most of the time extra beats are an innocent occurrence. However, it is a good idea to see your doctor if they persist or become worse. After a careful history your doctor will likely use a monitor that lets you push a button when you

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