Dr. Sagar Ramesh Makode
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a home blood pressure machine as well as a home EKG machine. On Friday and Saturday morning, the BP machine detecting an unusual rhythm. Then the EKG machine said possible A-fib. All other readings the rest of the day (and I was scared, so checking hourly) were fine. I have attached some EKG readings for you to see if you can add any additional information. I am taking Allopurinol for gout, Amlodipine, Carvedilol, Losartan, Hydrochlorothiazide for blood pressure, and Rybelsus for diabetes (just diagnosed with a 7.2 A1c). My diabetes was found last month when I weighed 164, and I have lost weight, and I am now at 155. Kindly give your opinion.
Hello,
Welcome to icliniq.com.
I have gone through your reports (attachments removed to protect the patient's identity). There are few artifacts, and there is no atrial fibrillation. However, there is prolonged PR and intermittent missed beat, suggestive of second-degree AV block (Atrioventricular). This might be related to Carvedilol. So its dose should be reduced. Also, you should undergo a thyroid profile as well. So significant finding is missed beats, and the first step would be to reduce the Carvedilol dose. I hope this was helpful.
Patient's Query
Hi doctor,
Thank you. Is this considered an emergency situation, or would a visit to my cardiologist with the next two weeks be suitable? Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Yes, it is better to get the dose modified early as if it worsens can lead to syncope. So it is better to reduce the dose as soon as possible. You can also request GP (general practitioner) for a dose decrease if a cardiologist is not available. I hope this was helpful.
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Cardiology
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