Dr. Sagar Ramesh Makode
Cardiology
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Patient's Query
Hi doctor,
I am a 41 year old, and since the past five years, I have had some heart issues. I was hospitalized for SVT, five years back. The medications had it under control for a while, but I got older, a little bit heavier, and had some life changes, so things changed. It was also recommended that I have an echocardiogram, stress test, and Holter monitor. But, I put it off and did it a few months back only. My EF came back 50 to 55 %, my aortic valve was leaky, and I have a murmur. Based on those results, my doctor increased Metoprolol to 100 mg, twice a day. It was going fine for a while, but gradually it crept back up. Last night, I had chest pain and pain in my jaw, so I went to the ER. My troponin level was 2.4. The doctor never called my cardiologist, and he did not increase my medication, and I was going from NRS to SVT to SVPB, with my heart rate going all over the place. I have all my results, so I can show them to my cardiologist tomorrow, while I go to work. Should I be concerned? Was something missed? I was taken aback because I was not given any medication to stop the pain and heart rate, and I am still on the same medication dosage. The same medicine was in my system while all that was happening, and it did not resolve anything.
Hello,
Welcome to icliniq.com.
Firstly, I think you should upload your reports like the echocardiogram to know the severity of aortic regurgitation, and electrocardiography to know what kind of SVT (supraventricular tachycardia) it was. It will give a better idea if it is PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation. It appears from your description that you had a repeat episode yesterday, so certainly you should have been added with some more medicine like tablet Diltiazem, to control your heart rate further. Regarding troponin, you did not mention the unit, was it within normal range or out of range. If it is within range, then no need to worry and your chest pain is probably due to high heart rate. Also, ECG would have shown some changes if it is due to heart attack. So you, please upload the ECG. I advise you undergo electrophysiological studies, which will diagnose the exact type of arrhythmia and treat it permanently in most cases. So, at this moment if you still have it and heart rate is still up, then certainly more drug needs to be added. Also, your leaky valve does not seem to be severe as your diastolic BP (blood pressure) is not low. Hope this helps you. Get back with reports for better opinion and if you have any doubts.
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Cardiology
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