Dr. Muhammad Zohaib Siddiq
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.
Answered by
Medically reviewed by
Patient's Query
Hi doctor,
I have been having palpations for many years. This includes the fast, pounding heart, PVCs, PACs, bigeminy, and other weird heart movements daily. Additionally, I have body and chest tension every day, which gives me some shortness of breath, but I do not have that when I exercise. Attached is a seven day ECG I did last year. I did a stress ECG two years ago, and that was all good. I echoed two years ago, and I have a mild mitral valve prolapse with mild regurgitation. I was told nothing to worry about this. I do not know where this shortness of breath comes from, including the daily palpations. Can it be from the heart murmur? I thought my adrenals are acting up, but that test was normal, the same with the thyroid. Do you have any suggestions? I am currently taking, Propanolol 10 mg one to two a day.
Hi,
Welcome to icliniq.com.
Thanks for the query. Your five days of Holter monitoring is normal. Your symptoms do not correlate with ectopic beats. I think there is an element of anxiety. Moreover, those with mitral valve prolapse have such weird type of symptoms. MVP (mitral valve prolapse) is usually not harmful, yet routine echocardiography should be done every two to three years to see mitral regurgitation progression. Please have echocardiography done. Take tablet Nebivolol 2.5 mg per day instead of Propranolol as Nebivolol has fewer side effects. All your previous tests are normal, so no need to worry about your heart.
Investigations to be done
Treatment plan
Preventive measures
Regarding follow up
Patient's Query
Hi doctor,
Thank you for your answer. I have been thinking about putting down Propranolol, but I read you should not just put it down. How should I do it? Can I take this down to one per day for a week and then leave it? Secondly, if MVP's mild regurgitation is harmless and not a problem, why could that create all these shortness of breath feeling and palpations? Note that this shortness of breath is not like I cannot get air or have heavy air hunger, but it feels constant chest tension. Can I ask for an ECHO from my doctor?
Hello,
Welcome back to icliniq.com.
Yes, these medicines called beta-blockers should not be abruptly stopped but can gradually be tapered down. 10 mg is not a high dose. You may take it once for a week and then stop, as you said already. Propranolol, Nebivolol, and other beta-blockers are used to lower the heart rate. If your heart rate continually remains above 100 even at rest and no other cause is found such as anemia, hyperthyroidism, etc., then heart rate is controlled with these medicines. If your heart rate is normal, you do not need Nebivolol or any other such rate lowering medicine. Yes, mild MR (mitral regurgitation) is harmless. As you said, you feel shortness of breath; this occurs in severe MR, which is why I advised echocardiography. Also, have a new ECG done if not done in the last few months. Do you have asthma? Asthma also causes chest tightness. Do you have a cough?
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
Cardiology
Related Questions
Is shortness of breath related to thyroid issues?
Severe heart palpitations in a 20-year-old man. What can be done?
Is mitral valve prolapse a reversible condition?
Is shortness of breath and chest pain associated with anxiety?
Reports show AML prolapse. Is there a way to avoid mitral regurgitation developing?
Why are palpitations occurring even after pacemaker implantation?
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
