I get pounding and burning sensation in my mid-chest area. Kindly suggest treatment.

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Teczine is an antiallergic, and Novoret is a supplement. These are unlikely to affect the current symptoms directly. Telmisartan is for blood pressure, and Aztor (Atorvastatin) 20 is for cholesterol, so those are unlikely to help your palpitations. Regarding possibilities, firstly, considering your age, it is wise to undergo some cardiac tests and rule out the possibility of primary cardiac cause, as cardiac diseases are quite common in this age group. Intermittent chest burning with palpitations just before sleep is likely due to gastric reflux or anxiety (especially thinking about stressful events or having insomnia).

• You should avoid oily, spicy, and heavy meals, especially at dinner.
• So dinner should be light and have some time before the expected sleep time.
• You should have a walk for 15 to 20 minutes after dinner.
• You may try having antacids prokinetic combination like Pantoprazole or Rabeprazole and Domperidone before breakfast or other antacids. Do you get any breathlessness, chest pain, chest discomfort, heaviness on exertion, or do these palpitations occur on exertion? Patients with cardiac diseases usually have symptoms on exertion, which relieves them with rest. So, you should modify your lifestyle and get some tests done, like ECG (electrocardiography), echocardiography, etc. Get your blood pressure and pulse, checked by a local doctor. It is better to undergo a serum fasting lipid profile, random blood sugar test as well. So, in the absence of exertional symptoms and not having symptoms throughout the day, these may not be cardiac, but possibility of cardiac should be ruled out with further investigations and examination. I hope this helps.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

These are not enough, and further tests would be advised after seeing these preliminary tests' results. You will probably need Holter monitoring and stress tests, but initially, let us see the above tests report. You should also visit the nearby doctor and request medications like Aspirin until you undergo tests.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

It shows ventricular ectopic (also called extra beat). Now it is a probable reason for your symptoms (attachments removed for patient identity protection). Now these extra beats can sometimes be seen as normal. However, they may indicate heart disease as well. So you will need further tests, which include an echocardiogram (echo) first, and if the echo is normal, then you will need a stress test like a treadmill test or computed tomography coronary angiography. And if the echo is abnormal, then we will probably need an angiography. Also, you will need to undergo a thyroid test (thyroid profile) because abnormalities can also cause these. Other factors which may worsen these are too much coffee, stress, sleep, and disturbances.

In treatment, you will need blood thinner like Aspirin and beta-blockers like Metoprolol to suppress these. So there are some abnormalities on the electrocardiogram for which you will need further tests to rule out the possibility of structural heart disease.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

(attachments removed for patient identity protection).

Your echo and thyroid profile is fine. But in the lipid profile, low-density lipoprotein (LDL) is slightly elevated (less than 100 is best). This does not need any treatment at present, and lifestyle modification like a healthy diet (avoiding fatty, oily food, light dinner) and regular walking for at least 30 min a day should bring it down.

However, as a part of the evaluation of extra beat, the next step would be to undergo a stress test like a treadmill test or CT coronary angiography to rule out the possibility of blockages.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.