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What Causes A Decrease In Heart Rate In A Patient With Stroke, Hypertension And Hypercholesterolemia?
Question: My father is a 76 y/old gentlemen with a history of stroke, hypertension and hypercholesterolemia, who lives outside of the US.
He has a asymptomatic bradycardia, initially around 45/min, now down to 40 beats per minute, if not lower.No dizziness, no feeling faint, no chest pain, and no shortness of breath, and tolerated physical efforts well( He get physical therapy daily, going up and down stairs and walking at fast pace) . His cardiologist hasn't suggested anything beside BP medication, Losartan, crestor and aggrenox.
I would like a second opinion.
He has a asymptomatic bradycardia, initially around 45/min, now down to 40 beats per minute, if not lower.No dizziness, no feeling faint, no chest pain, and no shortness of breath, and tolerated physical efforts well( He get physical therapy daily, going up and down stairs and walking at fast pace) . His cardiologist hasn't suggested anything beside BP medication, Losartan, crestor and aggrenox.
I would like a second opinion.
Brief Answer:
Should undergo Holter monitoring
Detailed Answer:
Hello,
Firstly, Is this lowest heart rate of 40 occurs during daytime or during sleep. If occurring only during sleep or rest then it's fine and needs no treatment. However, he should get one thyroid test done if not recently done.
If this occurring even at day time and during activities, then he should undergo Holter monitoring to look for the presence of heart blocks during the day. Usually, patients don't need a pacemaker if the heart rate is more than 40 and asymptomatic. However, if Holter shows evidence of block then may need a pacemaker.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Sagar Makode, Cardiologist
Should undergo Holter monitoring
Detailed Answer:
Hello,
Firstly, Is this lowest heart rate of 40 occurs during daytime or during sleep. If occurring only during sleep or rest then it's fine and needs no treatment. However, he should get one thyroid test done if not recently done.
If this occurring even at day time and during activities, then he should undergo Holter monitoring to look for the presence of heart blocks during the day. Usually, patients don't need a pacemaker if the heart rate is more than 40 and asymptomatic. However, if Holter shows evidence of block then may need a pacemaker.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Sagar Makode, Cardiologist
Above answer was peer-reviewed by :
Dr. Prasad
I suppose you are about a EKG holter monitor...
I will direct the physician to try that.
Thyroid testing was done, at several occasion, and was normal.
Lately his pulse hovers between 32 and 40 during the daytime, again he is completely asymptomatic, but this trend is worrisome, as you can imagine. Is that by itself an indication for heart pacing?
I will direct the physician to try that.
Thyroid testing was done, at several occasion, and was normal.
Lately his pulse hovers between 32 and 40 during the daytime, again he is completely asymptomatic, but this trend is worrisome, as you can imagine. Is that by itself an indication for heart pacing?
Brief Answer:
Yes, talking about EKG Holter
Detailed Answer:
Hi,
Yes, if his heart rate is ranging in this range then he ll need a pacemaker. But, we should get one holter monitoring done to confirm the heart rate and see the blocks. The doubt remains as he is asymptomatic, usually with this heart rate, one should be symptomatic with dizziness, syncope etc. So Holter will clarify the need.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Sagar Makode, Cardiologist
Yes, talking about EKG Holter
Detailed Answer:
Hi,
Yes, if his heart rate is ranging in this range then he ll need a pacemaker. But, we should get one holter monitoring done to confirm the heart rate and see the blocks. The doubt remains as he is asymptomatic, usually with this heart rate, one should be symptomatic with dizziness, syncope etc. So Holter will clarify the need.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Sagar Makode, Cardiologist
Above answer was peer-reviewed by :
Dr. Remy Koshy
Thanks for your input.
I can definitely tell you he is asymptomatic, i visited him last week, and personally checked his vitals myself. I am a physician , though not working in the clinical field at this time.
I can definitely tell you he is asymptomatic, i visited him last week, and personally checked his vitals myself. I am a physician , though not working in the clinical field at this time.
Brief Answer:
So Holter will be important here
Detailed Answer:
Hi,
Ok, so Holter monitoring will direct our future course. Also, ask to have plenty of water, avoid dehydration, too much straining during urination and passing stools, rest and assume the supine position immediately if gets dizziness etc.
Hope I have answered your query.
Regards,
Dr. Sagar Makode, Cardiologist
So Holter will be important here
Detailed Answer:
Hi,
Ok, so Holter monitoring will direct our future course. Also, ask to have plenty of water, avoid dehydration, too much straining during urination and passing stools, rest and assume the supine position immediately if gets dizziness etc.
Hope I have answered your query.
Regards,
Dr. Sagar Makode, Cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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