Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Should Be Attentive Of To Make An ER Visit While Having Bigeminal PVCs And Type 2 Diabetes?
Question: I'm a 69 yo white male with Type II Diabetes and heart challenges. BP 155/64, pulse rate 34 with Bigeminal PVC's. Checking and recording BP and Pulse several times each day. Went to the ER last Saturday and saw my Cardiologist last Monday. Had EKG and blood work. Wore Holtor Monitor for 48 hours on Tuesday / Wednesday.
Haven't heard from Cardiologist since Monday. Next appt. scheduled for the 18th. What symptom/sign milestone should I be looking for that tells me when to return to the ER before the 18th appt.?
Taking 1. Losartan / Hctz tabs 50/12.5 (2 tabs daily); 2. Amlodipine Bestlate tabs, 5mg before Monday appt. Increased Amlodipine to 10 mg daily.
Haven't heard from Cardiologist since Monday. Next appt. scheduled for the 18th. What symptom/sign milestone should I be looking for that tells me when to return to the ER before the 18th appt.?
Taking 1. Losartan / Hctz tabs 50/12.5 (2 tabs daily); 2. Amlodipine Bestlate tabs, 5mg before Monday appt. Increased Amlodipine to 10 mg daily.
Brief Answer:
Chest pain, dizziness, syncope
Detailed Answer:
Hello,
Firstly, can you upload ECG as I want to confirm the heart rate. You mentioned pulse rate of 34, I guess it must be more (count including vpcs). One would be very symptomatic at this rate and have dizziness, syncope etc. So just confirm your pulse rate twice.
Warning signs and symptoms include sudden rise of heart rate(palpitations) to nearly 150 and associated with dizziness, syncope, chest pain, severe shortness of breath. Inappropriate increase in heart rate associated with other symptoms suggests the possibility of ventricular tachycardia, while just dizziness, syncope suggests the possibility of excessive bradycardia.
Also, other symptoms include chest pain or heaviness or even epigastric pain associated with sweating, uneasiness, low bp points towards acute coronary syndrome.
In the management part, you should undergo echo, and of normal then stress test like stress thallium or TMT to look for blockages. You should be started empirically on Aspirin and statin till evaluation is completed. Also, beta blockers to suppress vpcs if heart rate permits.
Regards
Chest pain, dizziness, syncope
Detailed Answer:
Hello,
Firstly, can you upload ECG as I want to confirm the heart rate. You mentioned pulse rate of 34, I guess it must be more (count including vpcs). One would be very symptomatic at this rate and have dizziness, syncope etc. So just confirm your pulse rate twice.
Warning signs and symptoms include sudden rise of heart rate(palpitations) to nearly 150 and associated with dizziness, syncope, chest pain, severe shortness of breath. Inappropriate increase in heart rate associated with other symptoms suggests the possibility of ventricular tachycardia, while just dizziness, syncope suggests the possibility of excessive bradycardia.
Also, other symptoms include chest pain or heaviness or even epigastric pain associated with sweating, uneasiness, low bp points towards acute coronary syndrome.
In the management part, you should undergo echo, and of normal then stress test like stress thallium or TMT to look for blockages. You should be started empirically on Aspirin and statin till evaluation is completed. Also, beta blockers to suppress vpcs if heart rate permits.
Regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
