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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Erratic Heart Rhythm, Drop In Pressure, Chest Rattling, Pain Around Sternum, Difficulty In Sleeping On Front And Sides, No Digestive Problems. Prescribed Reflux Tablets. Suggestion?

Hello I am a 47 year old male. A couple of weeks ago after teaching a dance class (I am dancer/ teacher) I came home with an erratic heart rhythm and drops in pressure and was consigned to bed. Since then I have had an ecg , blood test and 24 heart monitor but they have all come back normal. Sometimes the pulse is normal and at others throughout the day it can become markedly erratic, chest rattling and localized pressure/ pain around the sternum which subsides with relaxation. When I am dancing or active all seems normal. I am also now having problems sleeping on my front and sides because of the pressure and change in pulse rate. I feel I may have pericarditis but my doctor, today seemed to have ruled this out and prescribed reflux tablets though I have no digestive problems that I am aware of. And advice would be helpful, many thanks,
posted on Mon, 26 Mar 2012
Twitter Thu, 22 Aug 2013 Answered on
Twitter Thu, 22 Aug 2013 Last reviewed on
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Cardiologist,  's  Response
Dear patient,

Thanks for your concerns. By your clinical description, one could suspect indeed an arrhythmia causing such symptoms; something that many physicians do not understand is that if the symptoms are sporadic, a Holter monitor is only a 24 hour window of opportunity to catch an arrhythmia; if we dont it does not mean it doesn't exist. A more prolonged method of monitoring such as an event monitor, can be indicated, which can be worn for 3-4 weeks and increase the chances of detection. If nothing is seen after such period of monitoring, particularly if you document symptoms and the EKG/ST segment analysis is normal, then other causes, such as anxiety, panic disorders, GI causes, etc could be pursued.


Truly yours,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
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Erratic Heart Rhythm, Drop In Pressure, Chest Rattling, Pain Around Sternum, Difficulty In Sleeping On Front And Sides, No Digestive Problems. Prescribed Reflux Tablets. Suggestion?

Dear patient, Thanks for your concerns. By your clinical description, one could suspect indeed an arrhythmia causing such symptoms; something that many physicians do not understand is that if the symptoms are sporadic, a Holter monitor is only a 24 hour window of opportunity to catch an arrhythmia; if we dont it does not mean it doesn t exist. A more prolonged method of monitoring such as an event monitor, can be indicated, which can be worn for 3-4 weeks and increase the chances of detection. If nothing is seen after such period of monitoring, particularly if you document symptoms and the EKG/ST segment analysis is normal, then other causes, such as anxiety, panic disorders, GI causes, etc could be pursued. Truly yours, Dr Brenes-Salazar MD Cardiology Mayo Clinic MN