My heart skips beats at times, and I feel a pinch in my heart. What could be the cause?

Hello,

Welcome to icliniq.com.

I understand your concern.

Heavy drinking in the long term will be detrimental to the liver and the heart. Moreover, it can certainly reduce your life expectancy, so gradually try to reduce alcohol consumption. It can cause atrial fibrillation in the early stages, which you got earlier. You might call it intermittently now with heavy drinking, which might be asymptomatic. ECG (electrocardiogram) or Holter monitoring can diagnose or rule it out reliably. But, this can also worsen with time and may cause a stroke. Besides, your lipid profile is deranged (attachments removed to protect the patient's identity), especially LDL (low-density lipoprotein) cholesterol. It is a risk factor for CAD (coronary artery disease). So, this highlights the importance of modifications in lifestyle like reducing alcohol intake, oily and fatty meals, light dinners, etc. So you should repeat your lipid profile after six weeks of a healthy lifestyle, and if there is a response, you may continue with the same, or else you will need medicine like Statins. If not recently, I suggest you undergo an ECG, echo, and Holter monitoring. TMT (treadmill test) is also recommended after 40 years of age every five years.

Regarding your current symptoms, the pinching pain is probably non-cardiac, and it is likely related to acid reflux or may be related to ectopias. Cardiac pain classically occurs in exertion, is relieved with rest, and persists for a few minutes. Antacids, changing dietary patterns, avoiding heavy meals, regular walking after each meal, and having a light dinner may be helpful. Besides, I suggest you take vitamin D, B12, and folic acid levels, which can be deficient in alcoholic patients. So, in a nutshell, your current symptoms may not be related to the heart. However, there is a high risk of developing heart disease with the contemporary lifestyle. Therefore, it is also essential to rule out the possibility of asymptomatic atrial fibrillation.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

Alright, so that is good. However, a normal ECG does not rule out the possibility of intermittent ectopics. The likely cause for such a pinch sensation can be ectopics or acid reflux. Anginal pain has different characteristics. It occurs on exertion, persisting for a few minutes, and relieves with rest. Your pinch might be related to ectopics or acid reflux.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern. It will help if you continue to take Cymbalta regularly, as advised by a treating doctor. Sudden stoppage may lead to withdrawal symptoms, and blood pressure rise may be related. Occasional readings above the 140/90 mmHg threshold are not problematic and may be watched. Now, you should continue to monitor blood pressure regularly a week and preferably three times a day, taking two to three readings at a time after a rest of five minutes with your arm relaxed on the table. If blood pressure is consistently above the threshold of 140/90 mmHg, you must be on regular blood pressure medications. Some follow the point of 130/85 mmHg as well. However, 140/90 mmHg is acceptable. Since drinking is undoubtedly affecting your heart, it is crucial that you gradually stop it altogether. Or else you may develop cardiomyopathy or permanent atrial fibrillation, for which you may need to start another regular medicine. A healthy lifestyle, including regular exercises at least brisk walking, will be helpful in the long term and may defer additional medication. It will also keep blood pressure under control. Stress will be there throughout life; you should learn to manage it without medicines. Try yoga and meditation or other ways.

I hope this information will help you.

Thanks.