What may be the cause for my father's chest pain and blurred vision?

Hi,

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I have noted all your details. The Holter reports (attachment removed to protect patient identity) of your father reveal his baseline rhythm to be atrial fibrillation. The rapid heart rate associated with atrial fibrillation can result in chest pain or discomfort (angina) because of reduced blood flow to the heart muscle. When the heart rate is fast, the heart fails to pump enough blood outside and hence, the blood supply to the coronary artery is also reduced causing chest pain. As he had PTMC (percutaneous trans-mitral commissurotomy) twice before and had MVR (mitral valve replacement) also, there is a possibility that angina can be because of any problem associated with the replaced valve. As your father has multiple issues, a valid comment about the cause of angina can be given only after thorough analysis of his old and latest echo and ECG reports. Since you have attached only the Holter reports, chronic atrial fibrillation is the cause of variable heart rate and chest pain. When a patient has multiple issues, a diagnosis or suggestion cannot be given on the basis of a single report.