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What Do Strong Irregular Hard Heart Beats Indicate?
Question: i have been suffering from strong irregular hard heart thuds. sometimes one thud sometimes a couple and sometimes all throughout the day sporadically for weeks on end and once i had an episode for 1o minutes. i have had an ekg 2 holters 2 echo stress tests. i find sometimes they arr worse with having eaten. im scared of them . could it be something worse? afib? pots?
Brief Answer:
please prvide more details.
Detailed Answer:
Dear Madam
1. I would request you to kindly upload all your ECGs , ECHO report and holter report.
2. Please also mention if you ever had syncope, presyncope, loss of consciousness, blackout or unexplained fall.
3. Please mention all prexisting illnesses.
Sincerely
Sukhvinder
please prvide more details.
Detailed Answer:
Dear Madam
1. I would request you to kindly upload all your ECGs , ECHO report and holter report.
2. Please also mention if you ever had syncope, presyncope, loss of consciousness, blackout or unexplained fall.
3. Please mention all prexisting illnesses.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Nagamani Ng
these were last yr the ones this yr was the same for the echo normal result and holter normal. ehich was done aboit a month ago the stress yest that is. im currently on thyroxine 125mg daily and have aneamia just recently diagnosed again had it on and off whole life. inherited thalassemia. no falls or sycope. both specialists have said im ok. but how can i be with these thumps irregular sudden beating.
Brief Answer:
relax and read details carefully. Ask if more queries are there.
Detailed Answer:
Dear Madam
1. The stress ECHO report says that your baseline LV and RV systolic function are normal and there is no evidence of inducible ischemia.
2. The holter report says that there were rare ventricular ectopics, sum runs of SVT and no significant pauses.
3. The irregular thuds are usually premature contractions. Mostly they are ventricular ectopics. However, it is difficult to guess the underlying rhythm disorder without an ECG. Holter is helpful only when you have symptoms on that particular day when holter was applied. Else, a long duration external loop recorder will be required.
4. Since you do not have a risk factor for AF and previous holter reports do not show any AF, it is less likely to be AF.
5. Premature ectopics are precipitated by coffee, tea, gastric distension, certain foods, anti-allergic and anti-asthma drugs, alcohol, smoking. All these should be avoided and if there is any particular precipitant, that must also be avoided.
6. If there is any loss of consciousness, blackout, unexplained fall or passing out episode, it must be discussed with your cardiologist on urgent basis.
7. Try to remain relaxed as anxiety increases all kind of ectopics.
Hope that provides some insight into the issue. Feel free to discuss further.
Sincerely
Sukhvinder
relax and read details carefully. Ask if more queries are there.
Detailed Answer:
Dear Madam
1. The stress ECHO report says that your baseline LV and RV systolic function are normal and there is no evidence of inducible ischemia.
2. The holter report says that there were rare ventricular ectopics, sum runs of SVT and no significant pauses.
3. The irregular thuds are usually premature contractions. Mostly they are ventricular ectopics. However, it is difficult to guess the underlying rhythm disorder without an ECG. Holter is helpful only when you have symptoms on that particular day when holter was applied. Else, a long duration external loop recorder will be required.
4. Since you do not have a risk factor for AF and previous holter reports do not show any AF, it is less likely to be AF.
5. Premature ectopics are precipitated by coffee, tea, gastric distension, certain foods, anti-allergic and anti-asthma drugs, alcohol, smoking. All these should be avoided and if there is any particular precipitant, that must also be avoided.
6. If there is any loss of consciousness, blackout, unexplained fall or passing out episode, it must be discussed with your cardiologist on urgent basis.
7. Try to remain relaxed as anxiety increases all kind of ectopics.
Hope that provides some insight into the issue. Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Remy Koshy
i download an app photo afib and when i feel.not right it always says im in afib. should i not rely on an app? also should i not worry as my echo is clear or can you have a serious electrical heart problem with a clear echo also? just afraod as i hate the strong thud. could it be from aneamia or thyroid related as my thyroid was killed by the radio iodine i never felt heart thuds and have neen on thyroxine for 5 yrs now and only rhe last 2 i have felt like this. also i get bad acid in my stomach and they happen more when i eat even when i havent eaten that much. i just want to know if i have done all testing. also i was wondering if i could have POTS.
Brief Answer:
apps are not reliable for primry diagnosis,
Detailed Answer:
Dear Madam
1. Any device can get confused between AF and multifocal multiple ectopics or any other rhythm disorder that produces irregular rhythm. Hence it can not be used to ascertain a diagnosis. Their primary utility lies in ascertaining load of AF in those who are already known to have paroxysmal AF.
2. The likelihood of AF in given scenario with no risk factors, multiple ectopics and recent normal stress ECHO is low but it can not be ruled out 100%.
3. Hyperthyroidism, that is excess of thyroid hormone can cause various tachyarrhythmias. Excessive replacement by thyroxine can result in ectopics. This can be detected by measuring level of thyroid hormones in blood.
4. Anemia and bad acid in stomach can precipitate ectopics.
5. Ectopics can have variety of reasons and we may not be able to find a reason.
There is not fixed set or table of reasons. Testing can only tell about structural heat disease and may rule out serious rhythm disorders at time of testing.
6. For diagnosis of POTS we require head up tilt table test. However, clinically in POTS, the palpitation and tachycardia (increase in heart rate) occurs after standing and it is excessive. Thuds or ectopics is not a usual feature of POTS.
Hope that helps. Feel free to discuss further.
Sincerely
Sukhvinder
apps are not reliable for primry diagnosis,
Detailed Answer:
Dear Madam
1. Any device can get confused between AF and multifocal multiple ectopics or any other rhythm disorder that produces irregular rhythm. Hence it can not be used to ascertain a diagnosis. Their primary utility lies in ascertaining load of AF in those who are already known to have paroxysmal AF.
2. The likelihood of AF in given scenario with no risk factors, multiple ectopics and recent normal stress ECHO is low but it can not be ruled out 100%.
3. Hyperthyroidism, that is excess of thyroid hormone can cause various tachyarrhythmias. Excessive replacement by thyroxine can result in ectopics. This can be detected by measuring level of thyroid hormones in blood.
4. Anemia and bad acid in stomach can precipitate ectopics.
5. Ectopics can have variety of reasons and we may not be able to find a reason.
There is not fixed set or table of reasons. Testing can only tell about structural heat disease and may rule out serious rhythm disorders at time of testing.
6. For diagnosis of POTS we require head up tilt table test. However, clinically in POTS, the palpitation and tachycardia (increase in heart rate) occurs after standing and it is excessive. Thuds or ectopics is not a usual feature of POTS.
Hope that helps. Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Yogesh D
how do i clear myself of it being something dangerous? can it weaken my heart ir development of something worse can or should i excersise will that help?
Brief Answer:
please see details.
Detailed Answer:
Dear Madam
To know if it is dangerous or not, we need to know the "rad flag signs" and the exact rhythm disorder of heart. There are no "red flag signs" as I asked you and you denied in previous discussion. To ascertain exact rhythm of heart at time of those "thuds" we must get an ECG at that time or if they occur daily, then we may get a HOLTER done. If the occur once in a week, we may get an external loop recorder implanted.
Theoretically if there are excessive ectopics, say many thousands in a day, there may be chance of weakening of heart but the risk is very low.
Exercise help suppress a variety of ectopics and you may do exercise as your stress test is normal.
Hope this helps.
Feel free to discuss further.
Happy New Year
Sincerely
Sukhvinder
please see details.
Detailed Answer:
Dear Madam
To know if it is dangerous or not, we need to know the "rad flag signs" and the exact rhythm disorder of heart. There are no "red flag signs" as I asked you and you denied in previous discussion. To ascertain exact rhythm of heart at time of those "thuds" we must get an ECG at that time or if they occur daily, then we may get a HOLTER done. If the occur once in a week, we may get an external loop recorder implanted.
Theoretically if there are excessive ectopics, say many thousands in a day, there may be chance of weakening of heart but the risk is very low.
Exercise help suppress a variety of ectopics and you may do exercise as your stress test is normal.
Hope this helps.
Feel free to discuss further.
Happy New Year
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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