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Hi Doctor. My Name Is Yasmin. I Had Already Few
Question: Hi doctor. My name is Yasmin.
i had already few consultation with dr? ilir Sharka here. i do not know how to continue with the same doctor so i add again my information:
Hi, I am 64 year old woman. I measure 1.50cm And my weight is 54 kg
I am not drinker nor smoker.
I eat healthy.
My blood pressure has been always good and a bit on low side.
I do not exercise except going most of days for a walk.
Medications and conditions:
I have been diagnosed with an over active thyroid 6 years ego. This has been so far well under controlled (for the past 6 years) by taking:
-Carbimazole 5mg, once a day in mornings
I also have high cholesterol which is controlled by taking:
-Crestor 10mg, once a day in mornings.
I also take
-aspirin 100mg once a day
-magnesium supplement
I have also mild gastritis and on occasions I have stomach upset I take
- somac 40mg one at night
My Other conditions is having AF
For the past 20 years I had at times feeling of flutter, palpitation, uncomfortable flip-flopping in my chest and feeling of Lightheadedness. But never showed anything when I went to doctors and the ECG was always showing normal heart beat. 7 years ego on a trip to emergency room, they detected that I was having irregular heartbeat.
And after being followed by cardiologist and she put Medtronic on me (I had it for 3 years) I was told that I have occasional AF plus occasional atrial ectopics and atrial bigeminy.. I have not been explain quite how often I use to get these. But they seemed unfrequent, months nothing and suddenly few episodes one after other. The atrial bigeminy, were happening more often. So the cardiologist put me on Metoprolol to control the symptoms. She performed couple of echocardiogram and stress test the result was normal. And the cardiologist at time considered me to me on low risk.
At the moment I do not have the Medtronic any more. But I do get the symptoms, so I%E2%80%99m aware of getting them occasionally.
Instead I have been given flecainide 50mg and metoprolol tablet to take only when I get these and does not resolve fast.
My cardiologist also discussed that if the episodes happened more frequently then I could take flecainide 50mg and metoprolol everyday.
Some additional information: I had a blood test 4 months ego all was good, including my thyroid and cholesterol.
And I had echocardiogram and stress test 9 months ego all was normal!
Also I am not on Metoprolol on regular base anymore, as my heart beat at times fell low and also I have low blood pressure so cardiologist decided to stop metoprolol.
last month or so, since i was getting some symptoms i went to see a cardiologist and had holter monitor for a week. The result showed that I had couple short and one long period (an hour) of AF and few ectopics. In case if AF my heart beats where between 120 highest to lowest 50s.. Because of pandemic the cardiologist asked me to have a phone consultation with him.
-He suggested that I should take flecainide 50mg twice a day with quarter Metoprolol twice a day.
When I asked if that was better than to take these medication just when I was experiencing the symptoms?
- he said yes I could do that too. As these are not correcting anything but rather are for symptoms. I asked if I need to take any blood thinners to reduce risk of stroke?
- he said yes I could and he suggested apixaban 5mg twice a day.
After this phone consultation I am still confused.
Now My questions:
1- Are flecainide and Metoprolol just to reduce the symptoms (as he suggested) or they can correct the heart beat and reduce risk?
2- From what he suggested the holder monitor showed, would you recommend me to take flecainide and Metoprolol regularly?
Or is better to have them as pill in pocket?
3- Is these any maximum or minimum amount of episodes to justify the medications?
4- Should I take the blood thinner?
5- in case I need to take all of these medications, should I first start with blood thinner? For how long before I take the others?
thank for your time
i had already few consultation with dr? ilir Sharka here. i do not know how to continue with the same doctor so i add again my information:
Hi, I am 64 year old woman. I measure 1.50cm And my weight is 54 kg
I am not drinker nor smoker.
I eat healthy.
My blood pressure has been always good and a bit on low side.
I do not exercise except going most of days for a walk.
Medications and conditions:
I have been diagnosed with an over active thyroid 6 years ego. This has been so far well under controlled (for the past 6 years) by taking:
-Carbimazole 5mg, once a day in mornings
I also have high cholesterol which is controlled by taking:
-Crestor 10mg, once a day in mornings.
I also take
-aspirin 100mg once a day
-magnesium supplement
I have also mild gastritis and on occasions I have stomach upset I take
- somac 40mg one at night
My Other conditions is having AF
For the past 20 years I had at times feeling of flutter, palpitation, uncomfortable flip-flopping in my chest and feeling of Lightheadedness. But never showed anything when I went to doctors and the ECG was always showing normal heart beat. 7 years ego on a trip to emergency room, they detected that I was having irregular heartbeat.
And after being followed by cardiologist and she put Medtronic on me (I had it for 3 years) I was told that I have occasional AF plus occasional atrial ectopics and atrial bigeminy.. I have not been explain quite how often I use to get these. But they seemed unfrequent, months nothing and suddenly few episodes one after other. The atrial bigeminy, were happening more often. So the cardiologist put me on Metoprolol to control the symptoms. She performed couple of echocardiogram and stress test the result was normal. And the cardiologist at time considered me to me on low risk.
At the moment I do not have the Medtronic any more. But I do get the symptoms, so I%E2%80%99m aware of getting them occasionally.
Instead I have been given flecainide 50mg and metoprolol tablet to take only when I get these and does not resolve fast.
My cardiologist also discussed that if the episodes happened more frequently then I could take flecainide 50mg and metoprolol everyday.
Some additional information: I had a blood test 4 months ego all was good, including my thyroid and cholesterol.
And I had echocardiogram and stress test 9 months ego all was normal!
Also I am not on Metoprolol on regular base anymore, as my heart beat at times fell low and also I have low blood pressure so cardiologist decided to stop metoprolol.
last month or so, since i was getting some symptoms i went to see a cardiologist and had holter monitor for a week. The result showed that I had couple short and one long period (an hour) of AF and few ectopics. In case if AF my heart beats where between 120 highest to lowest 50s.. Because of pandemic the cardiologist asked me to have a phone consultation with him.
-He suggested that I should take flecainide 50mg twice a day with quarter Metoprolol twice a day.
When I asked if that was better than to take these medication just when I was experiencing the symptoms?
- he said yes I could do that too. As these are not correcting anything but rather are for symptoms. I asked if I need to take any blood thinners to reduce risk of stroke?
- he said yes I could and he suggested apixaban 5mg twice a day.
After this phone consultation I am still confused.
Now My questions:
1- Are flecainide and Metoprolol just to reduce the symptoms (as he suggested) or they can correct the heart beat and reduce risk?
2- From what he suggested the holder monitor showed, would you recommend me to take flecainide and Metoprolol regularly?
Or is better to have them as pill in pocket?
3- Is these any maximum or minimum amount of episodes to justify the medications?
4- Should I take the blood thinner?
5- in case I need to take all of these medications, should I first start with blood thinner? For how long before I take the others?
thank for your time
Brief Answer:
Please refer to the detailed answer below
Detailed Answer:
Hello XXXXXXX
After going through the medical query raised by you I can very well understand your concern for your health and first of all I would like to appreciate the details of your medical history which you have mentioned as that gives us a clear idea of your past history and help us guide you in future.
Now I would like to answer your queries in the following manner
1. If during the asymptomatic times your heart rate stays below hundred beats per minute then there is no need to take these medications regularly. Fecainide is basically a preventive medicine to avoid the occurrence of irregular heartbeats but if these episodes are happening in frequently like once in couple of months then you should take both of these medication at the time of symptoms.
2. Better to use them as pill in the pocket.
3. After two episode at two different intervals justify the introduction of these.
4. As AF is an important risk factor for CVA so it’s advisable that you should follow your doctor’s advice of starting blood thinners.
5. You can take them together as there is no know interaction between these medications. But the time of apixaban should be fixed.
Kind Regards
Please refer to the detailed answer below
Detailed Answer:
Hello XXXXXXX
After going through the medical query raised by you I can very well understand your concern for your health and first of all I would like to appreciate the details of your medical history which you have mentioned as that gives us a clear idea of your past history and help us guide you in future.
Now I would like to answer your queries in the following manner
1. If during the asymptomatic times your heart rate stays below hundred beats per minute then there is no need to take these medications regularly. Fecainide is basically a preventive medicine to avoid the occurrence of irregular heartbeats but if these episodes are happening in frequently like once in couple of months then you should take both of these medication at the time of symptoms.
2. Better to use them as pill in the pocket.
3. After two episode at two different intervals justify the introduction of these.
4. As AF is an important risk factor for CVA so it’s advisable that you should follow your doctor’s advice of starting blood thinners.
5. You can take them together as there is no know interaction between these medications. But the time of apixaban should be fixed.
Kind Regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you so much doctor for your prompt respond. It was very helpful. I have a phone consultation with my GP in couple weeks. If she could give me any additional information, I would forward them to you. As it is I find your advice most helpful. Thank you again.
Warm regards,
Yasmin
Warm regards,
Yasmin
Brief Answer:
Hello again
Detailed Answer:
It’s a pleasure helping you out. In future if you need any assistance just address your question in my name and I’ll answer that.
Kindly close the discussion and rate the answer. And in case you have any other doubt kindly feel free to ask.
Kind Regards
Hello again
Detailed Answer:
It’s a pleasure helping you out. In future if you need any assistance just address your question in my name and I’ll answer that.
Kindly close the discussion and rate the answer. And in case you have any other doubt kindly feel free to ask.
Kind Regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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