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Reoccuring A-FIB treating with DILTIAZEM. Why heart rate is low?

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I have had three episodes of a-fib in the last week. I have had 6 in the last 6 months. The two earlier this week I was brought back to a normal rhythm using electrical cardioversion. Last night I had another episode and at the ER we decided not to shock me again and just slow my heart rate and then start me on Diltiazem. They also used dosages of diltiazem to slow my heart at the ER. My rhythm did convert back to normal in the ER using these dosages. They have now started me on a dose of diltiazem 4 times a day of 60mg. I took it this morning and just checked my heart rate and blood pressure. They are 135/79 and heart rate is 59. My next dose I am supposed to take in about an hour. Is my heart rate to low to be on this much of a dose? I am a 42yr old male with no other medical issues other than this recent a-fib issue. When is my heart rate to low? I was also started on warfarin at the same time.

Category: OBGYN

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Category: Infertility Specialist
 23 Doctors Online

Hello
Thanks for posting your query at DoctorSpring.com

Can you please upload the ultrasound scan report that has revealed the baby weight ?
I would like to go through the report and various parameters mentioned in it before guiding you further.
Looking forward to hearing from you.
Feel free to discuss further,
Regards.


Patient replied :

hi Mam, LMP is 14/5/14, doctor says baby is under wieght & adviced those two prescription mentioned above , pls can u check is that prescription are correct & can u advise what should be diet ,Exercise for proper growth
pls can u advise is it safe to have sex during third trisemseter


Hello,
At 27 weeks, the baby weight should be around 800 - 900 gms, so the baby weight is absolutely fine.
The baby is not underweight.
Alivher and Argipreg both increase the blood flow to the baby and increase baby weight and growth, in your case, there is absolutely no need to take these drugs.
Please present your doctor with these facts and ask her / him why this prescription has been given.
I can advice about diet - please let me know if your wife is vegetarian or non vegetarian.
She should be taking iron, calcium, vitamin D and protein powder supplements.
Daily walk for 30 minutes is sufficient exercise.
SHe should enrol in antenatal classes for proper pelvic floor exercises.
If there are no complications detected in the pregnancy so far, then you can continue having sexual intercourse.
All the best
Please feel free to discuss further.
Regards.


Patient replied :

Hi, Mam
we visited doctor ,doctor says according to calculation of LMP 14/05/14 her week on 15 dec is 30W , but scaning report shows 27W on 15 Dec. So baby growth is lagging by 3W, doctor says that lagging of growth is because of tere is not sufficient flow of blood for placenta to the baby
Pls can u advise medication ,diet or anything more for above issue
My wife is Vegetrian & Non Vegetrain
Thanku


As per 30 weeks, the growth is slightly less, but ultrasound scans in 3rd trimester are not reliable for dating.
However, she can improve her diet.
It is alright to take Alivher and Argipreg if she is 31 weeks now.
Also, she should be taking 2 eggs per day, chicken, poultry, fish, beans, dal, chana, paneer, protein powder ( protinex 2 tablespoons per day in a glass of milk ).
Drink lots of water ( atleast 5 litres per day ).
Take lots of green leafy vegetables and fresh fruits.
Get her BP checked, blood sugars checked, hemoglobin levels also.
She should be taking 3 major meals ( breakfast, lunch and dinner ) and 3 snacks in between.
Lots of milk, curd, buttermilk, paneer, dairy products are recommended.
Repeat scan can be done after a week.
Take care.
Regards.


Patient replied :

Thanku very much for valuable advise, now she is following the diet & exercise .
should we go for any other details scan or could it be fine with the ultrasound scan,when u recomend to do the scan, our doctor has advise to do the scan after 4 weeks from 15 DEC
Thanking you


Hello,
Yes it is fine to repeat the scan after 4 weeks.
Alongwith that a Colour Doppler also should be done.
She should have weekly visits with her doctor to ensure that everything is going well.
Take care.
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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