Patient's Query
Hi doctor,
I had a glandular fever a few weeks ago, and since then, my heart has been beating really strong. I have a heart rate of 56 bpm at the moment and still have swollen lymph nodes. It has never been that slow before. Can you please help me?
Hi,
Welcome to icliniq.com.
Regarding heart rate, please reply to the following questions. What is your age? Did you have any cardiac issues? What medicines are you taking for glandular fever? Do you have any thyroid or liver issues? Do you exercise regularly? How long are you feeling strong beats? 56 bpm is not a bad rate. Please have an ECG (electrocardiograph) done and send me along with the above-asked details. Regards.
Patient's Query
Hi doctor,
Thank you for the reply. I am 20 years old. I do not have any cardiac issues. Currently, I am not taking any medicines for glandular fever, as I was ill a few weeks ago. I do not have any thyroid or liver issues. I exercise few times a week but not of high intensity, and my resting heart rate is normally around 70 bpm. For a few weeks now, I am feeling strong beats, and I can see the pulse in my neck. Can you please help me?
Hi,
Welcome back to icliniq.com.
Glandular fever (infectious mononucleosis) can uncommonly cause myocarditis, atrial fibrillation, and even heart block. If your heart rate continuously remains low and does not increase much on exertion, please have an ECG done to see whether there is any heart block or sinus bradycardia. Feeling of pulsations in the neck usually occur in the block. Therefore I am asking for an ECG. Do you have symptoms of bradycardia (decreased heart rate) such as dizziness, generalized weakness, etc.? Any history of syncope (sudden loss of consciousness), blackout? Get back with the answers and ECG report for further treatment and management.
Patient's Query
Thank you doctor,
I feel tired a lot but have not fainted. I recorded the heartbeat using my phone. Does it sound fine?
Hello,
Welcome back to icliniq.com.
There seems to be some error in the attachment. Is your heart rate normal now? The normal resting heart rate is 60 to 100 per minute. Does your heart rate increase with exercise or exertion? If yes, it means the heart is functioning normally, and chances of heart block are rare. Regards.
Investigations to be done
Patient's Query
Thank you doctor,
I have attached an audio file I recorded. If you can hear it, does it sound normal?
Hi,
Welcome back to iclniq.com.
I heard the attachment sent (attachment removed to protect the patient's identity). There is a lot of background noise, but heart sounds (both S1 and S2) are normal, and no murmur is heard. But heart rate was varying. It was normal at first, and then the rate increased suddenly (tachycardia). To find if this rate fluctuation is due to normal heart rate variation or some rhythm abnormality, we need ECG (electrocardiography). Do not worry. Such rate variations are many a time just due to anxiety or caffeine intake. Do you feel irregularity in heart rate or rhythm? Put two fingers index and middle of one hand on the pulse at the wrist of the other hand, count pulses per minute, and regularly assess. If the regular rate is between 60 and 90 at rest, this is normal. If there are occasional irregularities, they can be premature beats. If the rate is continuously irregular, this can be atrial fibrillation. Please do not be scared. I am telling you this to relieve your stress or anxiety. All irregularities require ECG with a long rhythm strip to diagnose. Regards.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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