Hello,
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I understand you are a little worried about your heart and have been on the Holter monitor for a while. I appreciate that you have uploaded the reports in full for my consideration (attachment removed to protect patient identity). From the fact that you are not on any regular medications, I can say you are healthy. Your heart is working well as shown from your cardiac output numbers on echocardiography. Your Holter monitor findings seem to be pretty good. There is not any major abnormality seen in your heart's electrical activity at large. Your heart is working pretty much normal, and there is mostly normal synchronization in the heart's electrical and mechanical activities. Yes, at times, there is supraventricular tachycardia (SVT). That is due to a change in the heart's electrical rhythm due to an ectopic origin of the electrical activity that interferes with the normal heart rhythm. It gives a feeling like the heart is jumping in your chest or as if it has paused. It is a natural course of the disease process to feel like you are about to pass out. I suggest you try doing the following. Cut down on caffeine and alcohol intake. If you smoke, you need to quit that. In case you are a passive smoker, you need to avoid that as well. Cut down on spices. Take a bland diet and include plenty of fluids. Avoid heavy meals. Rather, go for light but frequent meals. Avoid eating red meat. It would be good to include a lot of fresh fruits, vegetables, and fish in your diet. Continue your exercises, especially cardio. But, keep an eye on how much exercise your heart can withstand. Set yourself safe limits. If you feel your heart pounding, dizziness, jumping heart, shortness of breath, pain in the stomach, shoulder, jaw or hands, then stop working out and call your emergency physician right away. Coughing can provide some relief in this situation. I do not think you require any further investigations on your heart's blood supply. But, you should keep a check on it in the future, in which case your cardiologist will recommend angiography and thallium scan to see if there is any blockage in the blood supply to the heart muscles. If there is any blockage, it leads to a lower number on echocardiography. That means, the heart is unable to pump normally and with force enough to fulfill the need of the body under specific situations like climbing stairs, doing physical activity, etc. Watch your blood pressure, blood sugar, and cholesterol levels. These are the factors that are directly related to the output. If not taken care of, they may affect the normal functioning of the heart. Your BMI (body mass index) is in the normal range, and I assume you have an active lifestyle. So, there are no major risk factors for you right now regarding physical activity levels and others at large. I do not have data on your fasting blood sugar levels, blood pressures, and cholesterol levels, meaning, I am unable to comment on these risk factors. Hope this helps.