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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Experiencing Pulse Abnormalities, Irregular Heart Beat, Strong Pulse In Throat. Reason?

I am 33 and have been experiencing some pulse abnormailities over the past few weeks. It happens mostly when I lay on my left side. My heart will have a little bit of an irregular pulse (like for 3-5 seconds) and I can feel a strong pulse in my throat . I also feel s strong pulse in my throat when I lean over sometimes. Thank you.
Wed, 14 Nov 2012
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

Irregular heart beats need to be documented by ElectroCardioGram (ECG / EKG).
Ectopic beats can be from ventricle (lower chamber - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC). APC are generaly harmless. Even VPCs are often harmless – ‘benign’. If they are frequent (More than 5 per hour, 2 or more coming in succession –they need investigations further.
_______________________________________________________________________
THE FIRST STEP IS TO SEE A CARDIOLOGIST
_________________________________________________________________
Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) are common causes.
Medicines may be responsible – like phenlephrine, pseudoephedrine used for ‘cold’ / salbutamol, salmeterol used for asthma / Illicit ‘drugs’ like amphetamine are notorious to cause abnormal beats
Rarely, there are abnormal nerve paths (pass tracts) in the heart.
________________________________________________________________
Though they may be normal in many, it is advisable to investigate.
A thorough history and physical examination is the first step -
     Routine 12-lead Electrocardiogram (ECG) is part of clinical examination.
     If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) – Have you done it?
     Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow) – OK in your case
     Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) etc. The treating doctor will suggest based on the situation.
     There are advanced techniques of investigations of increasing complexity more (some of them invasive), depending on need. The treating doctor may suggest them based on the situation.
___________________________________________________________________
     These ectopic beats could be normal in some persons. The feeling depends on individual sensitivity. Some do not feel them at all / some may feel every beat.
     A specific treatment for the beats may often not be necessary.
     The first line medicine is generally beta blockers. Metoprolol – slow release and small dose – will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up
     If they are not effective and if the problem is severe, several other classes of drugs are available – - acting by different mechanisms - the specialist will decide tailored to the individual / they may have lot of side effects and need frequent follow up.


Take care
Wishing speedy recovery
God bless
Good luck
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General & Family Physician Dr. Pradipta Ghosh's  Response
hi.good morning.i have gone through your problem.you are suffering from irregular pulse.sometimes it is normal,but sometimes it is pathological.
your problem may be from smoking,alcohol,caffeine.it may be from some drugs.
but mostly it occurs from anxiety.

so,inform me about your addiction history,drug history.

your problem may also be from heart disease,as ventricular ectopic or atrial ectopic may occur.so you must consult a cardiologist.

you perform some tests.ecg,echocardiography,trade mill tests are necessary.24 hours holter monitoring may be needed to monitor the pattern of irregularity.

do some routine blood tests like hemoglobin,urea,creatinine,blood sugar,electrolyte.check your thyroid hormone level.

but you should avoid anxiety.avoid smoking,alcohol.
do yoga,meditation.

among drugs,slow release low dose beta blocker may help to get rid of this problem.but you first consult a cardiologist and do above mentioned tests.

bye.take care.
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Experiencing Pulse Abnormalities, Irregular Heart Beat, Strong Pulse In Throat. Reason?

Hi friend, Welcome to Health Care Magic Irregular heart beats need to be documented by ElectroCardioGram (ECG / EKG). Ectopic beats can be from ventricle (lower chamber - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC). APC are generaly harmless. Even VPCs are often harmless – ‘benign’. If they are frequent (More than 5 per hour, 2 or more coming in succession –they need investigations further. _______________________________________________________________________ THE FIRST STEP IS TO SEE A CARDIOLOGIST _________________________________________________________________ Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) are common causes. Medicines may be responsible – like phenlephrine, pseudoephedrine used for ‘cold’ / salbutamol, salmeterol used for asthma / Illicit ‘drugs’ like amphetamine are notorious to cause abnormal beats Rarely, there are abnormal nerve paths (pass tracts) in the heart. ________________________________________________________________ Though they may be normal in many, it is advisable to investigate. A thorough history and physical examination is the first step - Routine 12-lead Electrocardiogram (ECG) is part of clinical examination. If a routine ECG does not show, 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) – Have you done it? Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow) – OK in your case Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) etc. The treating doctor will suggest based on the situation. There are advanced techniques of investigations of increasing complexity more (some of them invasive), depending on need. The treating doctor may suggest them based on the situation. ___________________________________________________________________ These ectopic beats could be normal in some persons. The feeling depends on individual sensitivity. Some do not feel them at all / some may feel every beat. A specific treatment for the beats may often not be necessary. The first line medicine is generally beta blockers. Metoprolol – slow release and small dose – will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up If they are not effective and if the problem is severe, several other classes of drugs are available – - acting by different mechanisms - the specialist will decide tailored to the individual / they may have lot of side effects and need frequent follow up. Take care Wishing speedy recovery God bless Good luck