
What Causes Persistent Heart Palpitations?

Do you take supplements while in gym , Investigate and treat as discussed
Detailed Answer:
Mostly PvC'S in absence of structural heart disease may be completely benign , it's just due to some misfiring from your heart .
Now at your age some reasons may be as you mentioned excess stimulants like caffeine, nicotine if you smoke , alcohol , aerated drinks ,and if you do any drugs, steroid supplements or other protein if you are into gym as you said .
Thyroid disorders, ongoing infection , any mental or physical stress may push extra adrenaline into the circulation which may cause the pvc.
Mostly they would be asymptomatic but may cause palpitation, uneasiness, giddiness in some patients.
So at your age I would suggest you to get
Some investigation done
1) 2 D Echo cardiography for heart structure
2) 24 hour holter to know exactly the morphology and frequency of PvC'S
3) blood test like thyroid profile , baseline cbc, s. Electrolytes for finding any reversible cause .
If they are bothersome , beta blocker would be the safest drug to control them after a thorough evaluation of the cause .
Let me know if any clarification needed and I would be happy to help .
. Also you may upload the ER ecg and investigation for a review.
Regards Dr Priyank Mody


The blood work is normal , ecg shows extra beats of different morphology
Detailed Answer:
Hello , I went through the reports attached ,
All the blood work up is normal including your kidney profile and electrolytes , so not to worry in that context.
Trop is maybe awaited and that will give us an idea if there is any injury to heart muscle , at your age any myocarditis .
Now your ecg shows polymorphic extra beats , to help you understand extra beats arising from different areas of your heart , so rather than ischaemia which may have resulted from any blockage in artery ,This pattern is more common of any systemic stimulant ( a detailed history about all medicines , supplements you use , any recent infection should be ruled out ,
As I said echocardiography, some blood tests like Cardiac injury profile which would contain troponin and C Reactive protein ( marker for inflammation) along with thyroid profile should be done to find the cause .
The best treatment would be avoidance of factors causing the extra beats .
Till than tab metoprolol according to your blood pressure and pulse should be the way forward .
Let me know if anything needed and I would be happy to help.
Do rate for others reference.
Regards Dr Priyank Mody


trop 0 is normal and rules out any damage to the heart muscle
Detailed Answer:
Hello,
Troponin as 0.0 means no injury had occurred to the heart muscle starting from as early as 3 hours to last 1 week from the time test was done .
So we can rule out ischaemia (most common blockage of artery for you) as the cause of all the extra beats .
As I said I think there is some systemic stimulant causing electrical activation of the circuit of your heart .
Try avoiding all the things I have mentioned. Consider a holter monitoring and if persistent extra beats consider taking metoprolol 25 mg to start with and increase the dose till 100 mg according to the blood pressure and pulse under supervision.
let me know how have you been in a weeks time and also if any further investigation you carry (ones mentioned in my previous replies).
Hoping I could help.
Do rate for others reference
Regards Dr Priyank Mody

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