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
Hi doctor,
I am a 55-year-old woman without any known medical conditions. Recently, I started experiencing cardiac episodes with faster heartbeats. I consulted a cardiologist and did some blood tests. I have attached it for your thorough analysis and review. After doing a 12 channel ECG and echocardiogram, my doctor determined that I have a left bundle branch block. Initially, I started to have mild dizziness with shortness of breath. I did some home tests and it showed a heart rate of 190 beats per minute for about 10 to 15 minutes and it got decreased gradually to a normal heart rate again within a course of half an hour. I bought a heart monitor as advised by my doctor and recorded the event every day. I am seeking a second opinion. I am attaching my previous and current reports. Kindly advise.
Hi,
Welcome to icliniq.com.
I have gone through your reports (attachment removed to protect patient identity). You are having supraventricular tachycardia and atrial fibrillation. As your heart rate remains high, it is difficult to differentiate between these two. Their management remains the same. Atrial fibrillation is a benign condition and there is an increased risk of having a stroke due to it because of clot formation in the heart and dislodgement. You can start taking beta-blockers like tablet Metoprolol ER 25 mg once a day. It prevents your heart rate from increasing and you can also take blood thinners like Aspirin or Dabigatran depending upon whether you have coronary artery disease or not. It prevents blood clot formation. Regarding LBBB (left bundle branch block), it is an age-related change or it can occur along with coronary artery disease. In this condition, it is necessary to rule out whether you have coronary artery disease due to LBBB. So you need to do stress thallium or CT coronary angiography. You can repeat echocardiogram also. If it shows decreased function again, then you can do coronary angiography directly. Your lipid profile is deranged and you need lifestyle changes by regular exercising and taking tablet Rosuvastatin 10 mg at bedtime.
Patient's Query
Thank you doctor,
I have attached a 12 lead ECG report. Does ablation is required for me? Is it possible for me to get a prescription?
Hi,
Welcome back to icliniq.com.
Yes, your ECG shows an LBBB pattern. You can take Metoprolol and it is a common medicine. You can get a prescription by consulting a local practitioner.
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Cardiology
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