Hello.
Thank you for your query at DoctorSpring.com.
I understand your concern.
Do you exercise regularly?
Lack of exercise may lead to increase in heart rate on low intensity exercise.
Those who are trained to exercise regularly do not have any major increase in heart rate on low intensity exercise. So if you are not trained to exercise regularly, then you may have this problem of increase in heart rate on minimal exertion.
Did you have your hemoglobin checked? Low haemoglobin may lead to increased heart rate on minimal exertion.
How did you come to know that you have Atrial Premature Complexes or PACs? Did you have a Holter examination done?
I would suggest you to undergo a treadmill test to look for the type of increase of heart rate. If it is the normal sinus rhythm, then Propanol or any other Beta Blocker like Metoprolol or Carvedilol are good for you and you may take them for long term benefit and symptom relief.
Alternatively, drugs like Ivabradine may be helpful for inappropriate increase of heart rate on minimal exercise.
Your blood pressure is well controlled.
Kidney stones wouldn't cause these symptoms.
Regards,
Dr. Vivek Mahajan,
DM Cardiology.
Patient replied :
Hi thank you for your reply and your recommendations.
Yes I have had a 24 hour holter monitor which picked up ectopic beats.
I can tell when I am having a PAC because I can feel the sensation in my throat and I have the urge to cough immediately after.
I have also had a 12 lead ecg which happened to pick up an Incomplete Right Bundle Branch Block. Do you think this has any significance to my symptoms?
Also could there be any reason for the vibration/tremor sensation I feel from my heart when I fall asleep?. It feels like a motor running sensation.
Thanks Again
Hello.
An incomplete rbbb doesn't have much of a clinical significance if present right from birth. In view of normal 2d echo findings it doesn't carry much of a significance.
The vibration like sensation in heart is unlikely to be pathologically significant in view of normal 2d echo.
I would still recommend a stress test in view of the increased heart rate in exercise. If it doesn't reflect any grave arrhythmia you can be relaxed and just continue propranolol or metoprolol.
Regards
Dr Vivek Mahajan
Patient replied :
Hi, thank you for your reply. I have one last question
i am wondering, for a condition such as Mitral Valve Prolapse, would it always be visible during an Echocardiogram?. Can the abnormality in the valve be proximal or can there be moments in the day where the valve functions well and then later starts to function abnormally again?
I am just wondering if it is worth me doing a repeat Echo, as alot of my symptoms seem to be similar of that of MVPS
thanks
I will leave a good rating after your reply
Hello,
Thanks for the follow-up.
MVP is usually not intermittent. Mitral regurgitation associated with MVP maybe intermittent. Subtle MVP maybe missed by the observer occasionally. If your previous echo in the recent times has been normal then there appears no need to do it again.
Regards
Dr Vivek Mahajan