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Q. Could you advise on my tiredness, weakness and faint feeling following viral infection?


 

Hi doctor,

Three weeks ago, I was admitted to hospital with a viral infection and stayed in the hospital for two nights. During viral infection, I woke up early in the morning shaking uncontrollably and my heart rate was 152, so the ambulance took me to the hospital. I was told that I have a viral infection and chest infection. One and a half weeks later, I went to work and started getting very bad palpitations. So, I went straight to hospital where they kept me in for five nights. They put me on Propranolol to calm my heart rate down when it starts to race. What happens is that I will get an ectopic beat which feels very uncomfortable in my chest and causes me to panic, then my heart rate goes very high, and that cycle continues for a while. So, the Propranolol is helping with that. I also have an echocardiogram.The problem I have is that for the past four weeks I keep on getting random bouts of extreme tiredness, weakness, feeling a little faint and sick. I cannot understand the reason for this. I never used to feel like this and I have been relaxing and hardly doing much for over three weeks. I am doing nothing to exert myself. I really cannot understand why I am getting this tiredness, weakness and faint feeling. Can you please advise me? It is really important to get this problem resolved as I have my first baby on the way. Please help.


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Dr. Sadaf Mustafa
MBBS., RESEARCH FELLOWSHIP., MD (INTERNAL MEDICINE) RESIDENCY COMPLETION., DIPLOMATE IN AMERICAN BOARD OF
General Medicine, Internal Medicine

Hello,

Welcome to icliniq.com.

Two points are very important here. They are abnormal heart rhythm and tiredness.

Which type of abnormal heart rhythm are they trying to treat with Propranolol? It seems like you have supraventricular tachycardia and the type depends upon the EKG and EP study. Did you have any of these?

The tiredness is very classical with Propranolol. How much are you taking?

The other possibility for tiredness could be viral myocarditis, which could be seen on the echocardiogram.

Revert with the details to an internal medicine physician online -->https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

 

Hi doctor,

I had an EKG which did show some SVT, but they told me my heart was completely healthy. They just wanted to treat the fast heart rate, which was caused by the ectopic beats and panic. The other thing I forgot to mention is for at least three to four weeks I have wheeze and phlegm on my sternum. When I cough to release it, however, it will be back within a few hours. I am taking 40 mg Propranolol twice a day, one in the morning and one in the evening. The other thing is that the feeling of tiredness and weakness was there before starting of Propranolol.

 

Dr. Sadaf Mustafa
MBBS., RESEARCH FELLOWSHIP., MD (INTERNAL MEDICINE) RESIDENCY COMPLETION., DIPLOMATE IN AMERICAN BOARD OF
General Medicine, Internal Medicine

Hello,

Welcome to icliniq.com.

  • The wheezing can happen due to hyper-reactive airway, which could be due to asthma, chronic bronchitis (if smoking cigarettes) or again Propranolol.
  • Propranolol is a beta blocker, which can cause spasm of the airways and result in wheezing.
  • Again, I am not convinced that the increased heart rate was just a simple sinus tachycardia since your heart is not programmed to stay in sinus rhythm beyond 150. Did you see a cardiologist?
  • Please avoid caffeine containing drinks. Obtain thyroid test (TSH - thyroid stimulating hormone), vitamin D levels and urine metanephrines to rule out pheochromocytoma, electrophysiology (EP) study and echocardiogram.
  • Consult your cardiologist and consider switching the Propranolol to Cardizem (Diltiazem) or other calcium channel blockers if your blood pressure can tolerate.
  • Congratulations on the baby and welcome to parenthood. Do not stress out.

For further information consult an internal medicine physician online -->https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

 
 
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