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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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High Pulse. History Of Palpitations. Taken Provigil. Have PVCs, Light Headedness, Fluttering Heart. Want Opinion

My pulse has been between 120 and 135 all day. I took provigil for the first time. But I also have a history of heart palpitations. My the heart monitor results came back normal. They said some pvcs but nothing to worry about. I always get light headed from climbing stairs and when I bend down for anything. My heart flutters after I eat. My neurologist noticed my pulse increases and blood pressure decreases when standing up so I had a tilt table test and my blood pressure dropped to 64/52. She said I should go back to the cardiologist with my history. I just wanted an opinion because I feel like I'm getting nowhere.
Fri, 10 May 2013
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Cardiologist,  's  Response
Dear sir/madam
Thanks for your query to HC magic.
You had PVCs on monitoring which when associated with a normal heart on ECHO do not carry any significance.
Your history and HUTT shows that you have ?postural hypotension/ ? POTS. I am surprised that why she sought a cardiologist opinion on this issue. If you don't have a structural heart disease (on ECHO), then it is a matter pertaining to neurologist and not the cardiologist. Generally in a case of postural hypotension, we look for any medication which can cause it. General conditions like anemia, dehydration, low salt intake should be corrected. Patient is instructed to get up from recumbent position slowly and move his limbs in bed before getting up. He/She can wear compression stockings to prevent pooling of blood in legs.Specific measures include drug therapy.
Lightheadedness while bending down can be because of various reasons and it may be normal in certain inidiviaduals specially after certain age.
Sincerely
Sukhvinder Singh
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High Pulse. History Of Palpitations. Taken Provigil. Have PVCs, Light Headedness, Fluttering Heart. Want Opinion

Dear sir/madam Thanks for your query to HC magic. You had PVCs on monitoring which when associated with a normal heart on ECHO do not carry any significance. Your history and HUTT shows that you have ?postural hypotension/ ? POTS. I am surprised that why she sought a cardiologist opinion on this issue. If you don t have a structural heart disease (on ECHO), then it is a matter pertaining to neurologist and not the cardiologist. Generally in a case of postural hypotension, we look for any medication which can cause it. General conditions like anemia, dehydration, low salt intake should be corrected. Patient is instructed to get up from recumbent position slowly and move his limbs in bed before getting up. He/She can wear compression stockings to prevent pooling of blood in legs.Specific measures include drug therapy. Lightheadedness while bending down can be because of various reasons and it may be normal in certain inidiviaduals specially after certain age. Sincerely Sukhvinder Singh