How to manage cardiac arrhythmia?

Question

Hi doctor,

I am 33 years old. Sometimes, out of nowhere, I start feeling dizzy, with pressure in my chest, heavy breathing, and weakness in my legs and hands. Occasionally, I also have headaches. I do not experience any arm or chest pain. Initially, this would happen when I was lying down, but now it occurs when I am standing as well. I took medication for acid reflux for two weeks, but I do not have heartburn and still have these symptoms.

My blood pressure is normal, and my heart rate fluctuates between 59 and 78 beats per minute. I do not have stress or anxiety; these symptoms appear when I am very relaxed, mostly at night but recently during the day as well. I had an ECG, and they said my heart was fine, though I wonder if there might be something it did not detect. Two weeks ago, my blood pressure was 152/99 mmHg, but after changing my diet, it dropped to 120/81 mmHg.

Please suggest.

Answer 1

Hi,

Welcome to icliniq.com.

This could be a cardiac arrhythmia, such as PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation, where the heart rate suddenly increases and then quickly decreases. Blood pressure can drop during these episodes, leading to dizziness, fainting, chest discomfort, blackouts, and sometimes syncope. Typically, an ECG appears normal when done between episodes; however, an ECG performed during an episode would likely show abnormalities.

You may need 24-hour Holter monitoring, so please visit a cardiologist for further investigation. Is there any stress or anxiety associated with these episodes? Until your evaluation is complete, you might ask your local doctor about taking Propranolol 20 mg once daily. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent. Additionally, a thyroid test is recommended. To help stop these episodes, try coughing hard when they occur.

Hope this helps, and feel free to reach out with any questions.

Thank you.