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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Heart Pounding Even At Rest, Breathlessness, Dizziness. History Of Cysts In Heart, Anxiety. Cure?

Hi my heart has been pounding real hard for about the past two months mostly just out of no where I could be standing sitting and just doing nothing and it ll pound about five times and start slowing down and almost take the wind out of me and sometimes I feel as if I m going to pass out. I m 23 and also have a cyst on the lining of my heart and have some pretty bad anxiety . I don t have a physician but I m a single mom and am concerned about what this is. Help please!
Tue, 11 Dec 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).
THE FIRST STEP IS TO SEE A CARDIOLOGIST

Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) / Medicines like phenylephrine used for ‘cold’ are common causes. Occasionally, there are abnormal nerve paths (bypass tracts) in the heart.

It is advisable to have it investigated.
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 needed.

ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).

Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow).
     
Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation.

If there are no clues and if you are still bothered by it to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity (and invasive) – like Electro Physiological Studies (EPS).
A specific treatment is no always necessary. The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up
They are several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs...
There are other advanced treatment modalities - like RF ablation, which could be done during EPS.

You stand an excellent chance of returning to normalcy. You are tolerating the rate well - means that you may not have any basic disease of the valve, muscle and so on. Be in touch with your doctor - it is a question of time and you will be well. Medicine is well advanced nowadays – management is possible for almost all situations...

Take care
Wishing speedy recovery
God bless
Good luck
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Severe Heart Pounding Even At Rest, Breathlessness, Dizziness. History Of Cysts In Heart, Anxiety. Cure?

Hi friend, Welcome to Health Care Magic Irregular heart beats need to be DOCUMENTED by ElectroCardioGram (ECG / EKG). THE FIRST STEP IS TO SEE A CARDIOLOGIST Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) / Medicines like phenylephrine used for ‘cold’ are common causes. Occasionally, there are abnormal nerve paths (bypass tracts) in the heart. It is advisable to have it investigated. 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 needed. ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality). Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow). Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation. If there are no clues and if you are still bothered by it to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity (and invasive) – like Electro Physiological Studies (EPS). A specific treatment is no always necessary. The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up They are several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs... There are other advanced treatment modalities - like RF ablation, which could be done during EPS. You stand an excellent chance of returning to normalcy. You are tolerating the rate well - means that you may not have any basic disease of the valve, muscle and so on. Be in touch with your doctor - it is a question of time and you will be well. Medicine is well advanced nowadays – management is possible for almost all situations... Take care Wishing speedy recovery God bless Good luck