Dr. Isaac Gana
Cardiology
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Patient's Query
Hello doctor,
I have been having episodes of tachycardia, with my pulse sometimes reaching 130 beats per minute. These are getting more frequent, and while my GP passed it off as anxiety. A few nights ago, I could feel vibrations just sitting and watching TV. I had brief chest pain, stomach pains, and a feeling of dizziness and nausea. I also felt hot and had some tingling in my fingers. My blood pressure reached 176/101 mm Hg. I called an ambulance, who said my ECG was normal; however, I was starting to feel better before they arrived. The paramedics stayed until my BP improved. I am unsure whether my symptoms are cardiac-related due to anxiety or even gastric reflux? I have hypertension, obstructive sleep apnea, and acid reflux. The doctor prescribed me the following Tablet Fluoxetine 40 mg, Tablet Propranolol 10 mg, Tablet Amlodipine 5 mg, Tablet Melatonin 2 mg at night and Tablet Lansoprazole 3 mg. Please advise. Thank you.
Hello,
Welcome to icliniq.com.
Did you get shortness of breath? Have you ever experienced something like this in the past? Was it associated with chest pain that radiates? Is there a family history of a heart attack? We must rule out the possibility of underlying heart disease. Do you have a history of tremors? Do you drink or smoke? Please answer the above so that I can guide you better. Thank you.
Patient's Query
Thank you doctor,
I had some shortness of breath, but the paramedics and I were unsure if it was related to anxiety. I had an episode of chest pain a few years ago, and tests (ECG and blood tests) showed no problem with the heart at that time. The chest pain was only for the recent episode, which did not radiate. The problem is that my pulse goes fast, and my BP reaches 176/101 mm Hg. This happens suddenly then goes back to normal after 30 minutes. My grandfather had a cardiac arrest following some years of angina at age 68. I have a slight tremor at times in my right hand. I only have coffee in the morning and 2 or 3 cups of tea during the day. I gave up smoking 17 years ago. Please help.
Hello,
Welcome back to icliniq.com.
Do you have results of any recent ECG (electrocardiogram)? Anxiety can present with shortness of breath with chest pain. But coronary artery disease is often undiagnosed in some patients and only detected when it is late, especially when you have a history of high blood pressure and a family history of a heart attack. I need to know your chest pain in detail. What is the nature of the pain? Is it stabbing or dull in the heart? Does it migrate to the back or arms, or jaw? When did you last check your cholesterol levels? Thank you.
Patient's Query
Thank you doctor,
Chest pain was stabbing but was only transient. The last time my Cholesterol was checked over a year ago, it was very slightly high. The paramedics said my ECG was nothing to worry about; however, my symptoms had improved. They also said there was a right bundle branch block. Please help.
Hi,
Welcome back to icliniq.com.
RBBB (Right bundle branch block) is a change we see in healthy patients also. It is only of concern if you have underlying heart conditions. What did you take for the high cholesterol? Are you still taking tablet Lansoprazole? Does hunger worsen the chest pain? Thank you.
Patient's Query
Thank you doctor,
I did not have any treatment for my high cholesterol apart from a healthy lifestyle (exercise and diet). I will get this tested again soon. Yes, I am still taking tablet Lansoprazole 30 mg, and I do not think my chest pain is worsened by hunger. I wonder if tablet Amlodipine 5 mg and my small doses of Propranolol are enough to keep my blood pressure stable? I will see a cardiologist face-to-face next week and will discuss the investigations you have mentioned with him.
Hello,
Welcome back to icliniq.com.
You should check your cholesterol because you might need medications to lower your cholesterol levels. How often do you check your blood pressure? What are the average readings you get? The dose of tablet Amlodipine and tablet Propranolol needs to maintained your blood pressure at a suitable value depends on the average readings you get now. I hope this helps. Thank you.
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Cardiology
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