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Detailed Answer:
Respected Ma'm
1. Palpitation or perception of heat beat results either from a disturbance in normal rhythm of heart of changes in volume which it handles. If the palpitation is associated with blackout/ loss of consciousness/ vertigo or chest pain , do see your doctor on priority. Otherwise, best way to work them up is to see the type of rhythm disorder on ECG. If ECG could not pick them up, we advice 24 hours holter monitoring, provided you get at least one episode during that period. Following determining the type of rhythm disorder, next step is ECHO. ECHO tells if there is a structural heart disease or not.
2. Most of the palpitations are premature contractions. They are precipitated by tea/ coffee/ smoking/ anxiety/ anti-asthma medication/ stress/ anti-cold medication/ thyroid disorders/ anemia etc. Premature contractions with a normal ECHO are benign entities and do not require much treatment. They can be controlled with one drug only (Beta-blockers).
3. If you are taking petril-beta every other day, The causes of palpitation can be this drug if the there is a temporal (time based)association. When the effect of petril-beta goes , ~after 8-10 hours, you may feel more palpitations because of cessation of beta-blockage effect.
4. A pricking sensation which lasts for a second, especially in a young female, do not suggest anginal pain or heart attack.
In nutshell you can consult your physician / cardiologist and can get a holter and ECHO done, to resolve the issue. Physician will also look for other common causes of palpitation like anemia and hyperthyroidism.
Hope this helps.
Feel free to discuss further.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Respected ma'm
1. To detect the reason for palpitation you have to get either an ECG at time of palpitation or you have to get a holter.
2. When were you not able to walk for a minute? if that was in April or recent event? If it is a recent phenomenon, you must see your doctor on priority to get evaluated. If your ECHO is old and breathlessness is recent, a repeat ECHO may be required after clinical examination. Clinical examination will rule out an obvious cause for breathlessness. There are many causes of breathlessness beside heart disease like anemia, obesity, lung diseases, kidney diseases etc. Right now I do not see a role for TMT.
3. Petril beta on alternate days is not a standard prescription. You are not being covered by effect of propronolol (one of the drugs in this combination) for full 24 hours. Hence the prescription should be reviewed by your treating doctor. Since I can not decide about the need for the other drug (i.e. clonazepam) in this combination.
Hope this provides more clarity.
Feel free to discuss further.
Sincerely
Sukhvinder

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Brief Answer:
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Detailed Answer:
Respected Ma'm
1. Petril beta was most probably given for your anxiety and hyperventilation. You should discuss it's withdrawal with your cardiologist now.
2. Since your ECHO was normal when you had shortness of breath , so need to repeat it right now.
3. You need an assessment by a cardiologist for evaluation of palpitation only and proceed accordingly.
Hope this helps.
Sincerely

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Brief Answer:
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Detailed Answer:
Respected ma'm
1. Most important step in management of acute heart attack is to identify it correctly. Most commonly the pain of heart attack occurs behind the breast bone with radiation to arms, jaw or upper abdomen. It is more like heaviness or pressure. It may be associated with sweating, breathlessness, vomiting, uneasiness etc.
A pain which is pricking in nature, lasts for less than a minute, can be elicited by touch or pressure and can be localized, it is unlikely to be of heart attack.
2. The first thing we give to heart attack patient is to let them chew a tablet of disprin/ aspirin. This is followed by nitroglycerin tablet or spray under the tongue. Patient should not use stairs/ move much or exert at all in such circumstances. A medical help should be sought at the earliest.
Sincerely
Sukhvinder Singh

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