
Have Had A Aortic Heart Valve Replacement. Why Am I Experiencing Extra Heartbeat?

I generally have a regular heartbeat. Lately, I experience an extra heartbeat, especially in the evening. I had a aortic heart valve replacement over a year ago. This recent extra heartbeat has been going on for several hours this evening. I'm having no pain or other symptoms. I don't notice the symptoms during the day, if they happen then. I notice my heartbeat in my ears at night when I lying down.
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You need further assessment and assistance.
You should see your cardiologist, as soon as possible.
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Irregular heart beats need to be documented by ElectroCardioGram (EKG).
Ectopic beats can be from ventricle (lower chamber - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC). If they are frequent (More than 5 per hour, 2 or more coming in succession –they need investigations further.
In your context – valve replacement and bypass - heart is the prime suspect.
[Anxiety / Alcohol / Tobacco / Caffeine (too much coffee, cola) are common causes. Medicines may be responsible – like phenlephrine, pseudoephedrine used for ‘cold’ / salbutamol, salmeterol used for asthma]
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it is advisable to investigate, as soon as possible.
A thorough history and physical examination is the first step -
Routine 12-lead Electrocardiogram (ECG) is part of clinical examination.
If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management
ECHOcardiogram is necessary to see the valves / muscle / and function (Ejection fraction, wall motion abnormality).
Treadmill exercise ECG (TMT) may be in need to exclude recurrent ischemia.
Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. The treating doctor will suggest based on the situation.
If there are no clues and they are troublesome, there are more tests - like Electro Physiological Studies (EPS) – the test is invasive, has a risk (though small) and is not generally done unless there are compelling indications. The treating doctor may suggest them based on the situation.
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The first line medicine is generally beta blockers – probably you are already receiving. The dose may need to be upped.
If they are not effective and if the problem is severe, several other classes of drugs are available – - acting by different mechanisms - the specialist will decide tailored to the individual / they may have side effects and need frequent follow up.
There are other advanced treatment modalities - like RF ablation.
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You need further assessment and assistance.
You should see your cardiologist, as soon as possible.
Take care
Wishing speedy recovery
God bless
Good luck

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