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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Irregular Heart Beat, Fatigue And Chest Pain?

Hi, I am a 33/F. with weight about 126 pounds and height about 5feet 2 inches. I recently developed this irregular heart beat which has gotten worse lately. I am always very tired and fatigued and always want to sleep, however I cannot fall asleep immediately. I noticed the tiredness a year ago and did blood sugar and thyroid tests which came back normal. But i didnt take any medications. I am usually a very anxious person and get startled easily. This past two months I noticed new symptoms. My heart suddenly beats so slowly and strongly and I counted most of the time. It ranges from 45-50bpm. I felt unusal congestion around my chest and tired all of a sudden and kind of short of breath. But after 5-10mins the symptoms dissaperared and I felt like nothing happened and heart rate became 80-90bpm. I kept a chart and it became frequent recently. I feel like my heart would suddenly stop beating. It has made me unable to go out alone and work. My heart beats so strongly that I can feel my body moving along with the beat. I can feel my pulse everywhere and most specific in my left ear, which is driving me crazy. Its a loud thumping sound. I also developed this tingly feeling in the middle of my left chest and instantly started coughing. I have no fever as I measured but I am constantly cold and gets chills. I sometimes gets chest pain but havent lost consciousness or anything. I am really worried about these symptoms. please suggest. Thank you.
Tue, 18 Dec 2018
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General Surgeon 's  Response
Hi,

Your symptoms seem to be related to a cardiac arrhythmia. Diltiazem is a calcium channel blocker which helps not only reduce your heart rate but also prevent cardiac arrhythmia. Anyway, if you are feeling shortness of breath or lightheadedness, I would recommend going to the ER for a careful physical exam and a resting ECG to determine the type of cardiac arrhythmia.

Other tests are also necessary to investigate for the possible underlying causes:
- a cardiac ultrasound to examine your heart function and structure
- a chest X-ray study and pulmonary function tests to exclude a lung disorder
- complete blood count for anemia
- thyroid hormone levels for thyroid dysfunction
- blood electrolytes for possible electrolyte imbalance.

An ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends during a prolonged time and identify the type of cardiac arrhythmia, especially if a simple resting ECG is not able to register them (when these episodes occur frequently during the day).

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ivan R. Rommstein,
General Surgeon
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What Causes Irregular Heart Beat, Fatigue And Chest Pain?

Hi, Your symptoms seem to be related to a cardiac arrhythmia. Diltiazem is a calcium channel blocker which helps not only reduce your heart rate but also prevent cardiac arrhythmia. Anyway, if you are feeling shortness of breath or lightheadedness, I would recommend going to the ER for a careful physical exam and a resting ECG to determine the type of cardiac arrhythmia. Other tests are also necessary to investigate for the possible underlying causes: - a cardiac ultrasound to examine your heart function and structure - a chest X-ray study and pulmonary function tests to exclude a lung disorder - complete blood count for anemia - thyroid hormone levels for thyroid dysfunction - blood electrolytes for possible electrolyte imbalance. An ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends during a prolonged time and identify the type of cardiac arrhythmia, especially if a simple resting ECG is not able to register them (when these episodes occur frequently during the day). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon