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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hi, I'm A 23 Year Old Female, A Non-smoker, And

Hi,
I'm a 23 year old female, a non-smoker, and I drink occasionally at social events. I have and continue to suffer from anxiety and panic attacks. Also, I lost a lot of weight on a very strict diet. I went from being 230 pounds at the end of July in 2013 to 145 pounds at the beginning of January in 2014. Ever since then, I've been having large weight fluctuations. I constantly gain and lose anywhere between 15 to 30 pounds, sometimes in a relatively short period of time.

Several months ago, I went to my general practitioner and told him that I was experiencing:
- palpitations and a racing/pounding heartbeat when I climb stairs and when I'm in bed
- occasional chest pain, incidents of feeling dizzy and almost seeing double when I stand up from a lying/sitting position
- reduced exercise tolerance and more fatigue than I had previously
- an episode of collapsing/nearly fainting, although I was not completely unconscious

He gave me an ECG which showed that I had first degree AV block and told me not to worry about it. I proceeded to have the above symptoms for a while and requested a referral for a cardiologist at a later date.

When I met with the cardiologist, he arranged for me to have a 48 hour holter monitor, an echocardiogram, and an exercise stress test. I have results for two of the tests so far.

Holter Monitor Findings:
- Sinus Rhythm, Sinus Bradycardia, Sinus Tachycardia
- Nocturnal Wenkebach
- Few Premature Atrial Contractions
- Non-Sustained Atrial Arrhythmia (max 7 beats)
- Rare Premature Ventricular Contractions

Echocardiogram Abnormalities:
- Mild Tricuspid Regurgitation
- Akinetic w/scar (written in legend)
- Dyskinetic w/scar (written in legend)

Also, my first cousin who was a male passed away from a sudden cardiac arrest at the age of 24 and had no known heart disease. The autopsy found nothing wrong with his heart and said the death was unascertained.

My questions for you are:
- Do these results warrant any cause for concern?
- What does akinetic w/scar and dyskinetic w/scar mean?
- Are they all completely benign or should I be seeking treatment for anything?
- Do you think my weight loss/fluctuations have caused these conditions?
- Can the arrhythmias go away on their own or are they likely to get worse over time?
- Are any of these abnormalities a risk factor for sudden death or other complications?

Thank you for your time and expertise,

Stephanie
Sun, 1 Nov 2015
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Hi, I'm A 23 Year Old Female, A Non-smoker, And