Brief Answer:
I would suggest you some key points to follow.

Detailed Answer:

Hello! Thank you for asking on HCM!

I understand you concern, and would like to explain that, regarding your heart palpitations, there are a variety of triggering factors to consider.

Beginning with your recent medication, Movicol, in general it is a well tolerated drug in respect to cardio-vascular physiology. Nevertheless, as it includes also some electrolytes inside its composition, it may be speculated that it may interfere seriously with serum electrolyte balance. This may be a possible reason for your palpitations. I recommend you to check first your blood electrolyte levels.

Another reason, may be the primary disorder that leads to constipation, etc, that may be a irritable bowel syndrome. Anxiety and raised stress may be the reasons behind all this clinical scenario.

Regarding your cardiac ultrasound finding, that is mitral valve prolapse, as it is an innocuous entity (unless it is not associated with important mitral valve regurgitation), it is frequently associated with palpitation feelings and other unpleasant subjective complains. So, this may be another reason for your palpitation.

Regarding your performed ECGs, I could give an expert opinion, if you could load them on HCM as a follow-up query, so would be possible for me to have a look on them.

So, at the end, to cut it clear and short for you, I would recommend you to perform the following steps regarding palpitations:

(1) If palpitations persist, you should perform an ambulatory 24 to 48 hours ECG monitoring.

(2) Change Movicol, for a safer alternative, such as a stool softener (psyllium, etc)

(3) Perform some blood tests (complete blood count, thyroid hormone levels, etc), as a possible anemia, thyroid imbalance, etc. would influence palpitations.

(4) Continue to fight your anxiety and stress; yoga and cardio stress are excellent regarding this issue.

Hope to have been helpful to you.

Feel free to ask me whenever you need. Dr. Iliri

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Brief Answer:
No medical evidence for any relevant cardiac abnormalities.

Detailed Answer:

Hello again XXXX!

The way you refer your palpitations complain, seems that it may be connected to Movicol intake.

Nevertheless, I would recommend you to follow my above mentioned advices, if complains keep persisting.

Regarding your heart rhythm, I would like to explain that sinus rhythm is exclusively considered normal. Otherwise (different heart rhythm patterns are not normal). This issue is identified by ECG.

Facing your mild mitral valve prolapse, I would like to assure you that it doesn't impose any risks for your cardiac function and your general health. As long as mitral valve prolapse is not associated with important mitral regurgitation, there is absolutely nothing to worry about.

The only advice is a periodic follow up by cardiac ultrasound to reconfirm and compare the previous echo data.

So, to conclude, I want to confirm you that you look perfectly in a good health, without any relevant suspicions for any serious heart issues.

Please, send me a view of your ECGs for an objective confirmation (if ECG is available).

My best wishes! Dr. Iliri

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Brief Answer:
You can safely stop Nebivolol.

Detailed Answer:

Hi XXXX!

You are right about Nebivolol.

Its use may be associated with increased tiredness. in physically active young people, it may lower overall physical performance.

You could stop it without any significant side effects (as 1.25 mg per day is a minimal dose, and the risk of rebound is quite non existent).

Yoga would be a very nice alternative to face your actual complains.

Greetings! Dr. Iliri

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