Dr. Isaac Gana
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 31-year-old male. Eight months ago, I was diagnosed with arrhythmia, but as I am living in a different place from my native, I could not understand my doctor's explanation clearly because of the language. My first symptom was eight months ago were after a very stressful few months, I suddenly felt I was losing consciousness then after a sting rush of adrenaline, I was able to call an ambulance. A 24-hour holter monitor revealed three extrasystole beats in a row and 18 PVCs. An echocardiogram and chest X-ray revealed no abnormalities. Blood tests for thyroid showed "nothing major." I have prescribed Bisoprolol 2.5 mg and a statin to take daily and Alprazolam 0.4 mg to take as needed up to 3 times daily. It would be great to get an explanation of the arrhythmia in English (I can send EKG photos). Also, I would like to know if the drugs I have been prescribed are really necessary. I am an occasional marijuana and tobacco smoker. Kindly give your opinion.
Hello,
Welcome to icliniq.com.
I checked your cholesterol is slightly increased (attachments removed to protect the patient's identity). Do you still smoke? Are you still taking statins? You are experiencing dizziness because the Bisoprolol is bringing down your blood pressure. Are you still experiencing palpitations? Please answer the questions to give better help.
Patient's Query
Hi doctor,
Thank you. I stopped smoking but occasionally smoke vaporized tobacco about once a day. I have stopped drinking alcohol entirely. I am still taking statins. For about two months now. I feel a palpitation maybe 3 to 4 times a day. It generally feels like an extra-strong beat. Because of the dizziness, I reduced the dose of Bisoprolol to half a pill daily with the intention of stopping them in a week, but is this safe? Is it necessary to take beta-blockers for extrasystole? Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Vaporized smoking has a similar effect as cigarettes. Have you checked your cholesterol since after you started taking statins? The decision to stop your Bisoprolol depends on how bad the palpitations affect your daily life. What is the exact dose of Bisoprolol you are taking 1.25 mg or 2.5 mg? Kindly answer the questions for better help.
Patient's Query
Hi doctor,
Thank you. So I should stop smoking altogether. I have not taken a blood test yet since starting statins, but I plan to next month. I have prescribed Bisoprolol 2.5 mg, which because of the side effects, I started cutting the pills in half, so 1.25 mg. Suppose the arrhythmia is not a dangerous one. I would prefer not to take Bisoprolol. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Yes better to stop smoking entirely. You did not post a picture of the ECG (electrocardiogram). So I do not know exactly the type of arrhythmia it is. Have you ever tried stopping Bisoprolol? What happened when you reduced the dosage? Were the palpitations worsened? Kindly answer the questions for better help.
Patient's Query
Hi doctor,
Thank you. Here is a picture of my ECG. I believe it is called extrasystole. Since lowering the dose, I have not felt any increase in palpitations, and my blood pressure is normal. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Did you experience any chest pain around the time you had this ECG, especially pain that radiates to the arm or back? Or any pressure in the chest area? Is it possible to get another X-ray done? Are you still out of your country? Kindly answer the questions for better help.
Patient's Query
Hi doctor,
Thank you. I did not experience any pain during this ECG, just palpitations. I am still out of my native, but I can ask for another chest X-ray. Also, I purchased a smartwatch for the ECG feature. I am not sure how accurate it is, but here is today’s ECG. As you can see, the line dips towards the end of the reading, this happens often, but I am not sure if it is because of my heart or the watch. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
I have gone through the ECG (attachments removed to protect the patient's identity). It is borderline normal. What this means is that it is not totally normal. Smartwatch ECG is not reliable because it is set to only detect a few abnormalities, like the common ones. There are U waves present in the ECG. This change is most likely from the use of Bisoprolol, as you did not report any issues with chest pain or shortness of breath. I would prefer if you did another ECG and checked your potassium and calcium levels. I hope this was helpful.
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Cardiology
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