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Weird heart rhythms even with normal MRI with ANGIOGRAPHY.

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Hello!

So, my name is René Odenthal (28), I'm from Leverkusen / Germany and I'm experiencing weird heart rhythms from time to time. Yet we've done already (2 years old patientago) a heart MRI with Angiography which didn't show any results. Everything seems to be alright. Yesterday I had a 24 hour holter monitoring my heart beats - and it came out, I had 12 missing QRS complexes and one pause of 1.8 seconds while sleeping. Should I be concerned about this? The medic for inner medicine said there's nothing to worry about.

Maybe good to add and know:

- I'm hypertensive.
- I take 47.5mg Metoprolol, 5mg Ramipril and 50ug L-Thyroxine
- My hearts septum is 22.5mm

Other than that, I'm fine - but this scares me a bit.

Category: Cardiologist

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Category: Internal Medicine Specialist
 22 Doctors Online

Dear Doctor,
Thank you for your query at DoctorSpring.com

I have gone through all the reports you have sent. I would like to see the EKG report . You have mentioned you had weird rhythms in your EKG , if you have that report, I would like to see that report. I would like see the detailed echocardiogram report.
Is any family history of Hypertropic cardiomyopathy.
As per your holter report , you don't have any significant problem. Pauses of 1.8 sec is insignificant and may be due to usage of beta blockers and also due hypothyroidism for which you are taking medications.
I would like review with reports.

Regards
Dr Satish


Patient replied :

My family physician has the report - I'll ask him if he can print it out. The only thing I know is that there were 12 missing QRS complexes and yeah, that 1.8 sec long pause. I'll send them to you asap.


In addition to the EKG report i would like to see the detailed echo cardiogram report.
Have you recently checked your Free T3 , Free T4 ,TSH ?
As the long the person does not have any giddiness or syncope ,there is nothing to be apprehensive about.
Regards
Dr Satish


Patient replied :

Hello Dr. Kumar,
I want to thank you a lot for your clarification. My Echo was okay, the thickness of my septum seems to be reversible, as it went back from 22.5mm to 17mm, which I, personally, consider to be positive - same as my cardiologist.
As for the ECG reports: This seems to take a longer while to request them from the hospital, since they seem to not have enough personal actually to bear with the entire burocratic problems they're facing at the moment.
Nonetheless, of all ECGs done in the past - also does done with Holter monitor - only 2 have shown pauses. One, with a pause of 2.5 sec and one with 1.8 sec. During both 24 hours there were in the first one only 3 VES, 20 SVES - and in the second basically the same. So, I personally consider this to be "normal" and not as something which has to be treated. Oh, and there was a small 7 sec atrial fibrillation, which is totally okay, since everyone seems to have it from time to time.
I've to add, that I'm currently losing weight as part of my diet, in order to reduce my overall RR - which seems to work quite good.
Actually, I think I've a small cardiologic neurosis / cardiophoby somehow, possibly because my wife is pregnant and I'm just having a bit of panic about the future.
My Cardio MRI with angiography was excellent. No seizures, no scars, nothing. Everything perfect. My vessels are clear and clean, blood flows perfectly. My valves are perfect too.
The only thing I'm currently concerned about is, that at night, my RR drops down to 90 / 60 and my HR is at 55. Is this something I've to be concerned about overall?


There is nothing to worry about as long you have no symptoms. In patients who have good exercise tolerance especially in athletes their heart rate is usually on the lower side .In case you have giddiness you will require 24 hr ambulatory blood pressure measurement.
Ecg could help to see whether you have any heart block which may be insignificant now , but periodically it may reviewed to see whether there is any progression.
Regards
Dr Satish


Dr. E. Satish Kumar
Category: Internal Medicine Specialist
Experience: 
Fellowship, Cardiology - Tamil Nadu Doctor M.G.R. Medical University - DNB, Cardiology, 2002 – 2005Training in Germany in Complicated AngioplastiesMedical School - Maharaja Krushna Chandra Gajapati Medical college, MBBBS MD, Int Medicine, 1989 – 1999.
Trained in Rota Abalation for treating Calcific coronary artery disease in Japan
Dr. E. Satish Kumar and 4 other Medical Specialists are ready to help you

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