Should I Continue My Heart Medication? My Condition

Do I still need to take the medication? Is my condition benign or malignant? Do I need to undergo cauterization? I'm very scared and troubled!

I have been experiencing pauses in my heartbeat for six years.
In the past, after losing weight, my symptoms decreased, but recently they have become more frequent.
Six months ago, I wore a 24-hour Holter monitor, and although I was prescribed medication, it was ineffective.
I missed a couple of doses due to time constraints, but my symptoms have been worsening, especially after social gatherings, poor sleep, and feelings of anxiety, irritability, and restlessness.
The symptoms fluctuate, and just a few days ago, after a company year-end party, I drank an energy drink the next day.
While lying down, my heart suddenly skipped a beat a few times, which startled me and made me feel a bit dizzy.
However, I felt much better that evening.
The next day, I visited a cardiologist at a clinic.
He reviewed my medical history, and I mentioned that my general practitioner during a health checkup said it was benign, but the cardiologist suggested it might be malignant.
What is the truth? The medication prescribed today finally seems to be effective; I felt better after just one dose.
Should I continue taking it? Most importantly, it's strange that while most people feel breathless when exercising, I feel more comfortable and my heart doesn't race as much.
Am I dealing with a benign or malignant condition? What should I do? Should I continue the medication for two weeks, or only take it when symptoms arise? Thank you for your help!

A Da, 40~49 year old female. Ask Date: 2019/01/08

Dr. He Dongjin reply Cardiology

Hello, I haven't seen your 24-hour Holter monitor results, but you should take your medication if you experience any episodes.
Changhua Hospital cares about you.

Reply Date: 2019/01/08

More Info

When it comes to managing heart conditions, particularly those involving arrhythmias or palpitations, it can be quite confusing and concerning for patients. Based on your description, it seems that you have been experiencing intermittent heart palpitations and have had a history of these symptoms for several years. You mentioned that after losing weight, your symptoms improved, but they have become more frequent recently, especially after stressful events or consumption of stimulants like caffeinated drinks.

Firstly, it's important to clarify the nature of your heart condition. The distinction between "benign" and "malignant" arrhythmias can often be subjective and depends on various factors, including the frequency, duration, and symptoms associated with the arrhythmias. Benign arrhythmias are typically those that do not pose a significant risk to your health and are often not associated with structural heart disease. Conversely, malignant arrhythmias can lead to serious complications, including sudden cardiac arrest. Your healthcare provider's assessment will depend on your specific symptoms, the results of your tests (like the 24-hour Holter monitor), and your overall health.

Given that you have been prescribed medication that seems to be effective after a long period of ineffective treatment, it is crucial to follow your healthcare provider's recommendations regarding the continuation of this medication. If the medication is helping to manage your symptoms and improve your quality of life, it is generally advisable to continue taking it as prescribed. Stopping medication abruptly, especially for heart conditions, can lead to a resurgence of symptoms or even more severe complications.

You mentioned that your symptoms tend to improve with exercise, which is a positive sign. Regular physical activity can enhance cardiovascular health and may help in managing anxiety and stress, which can exacerbate palpitations. However, it's essential to approach exercise cautiously and ensure that you are not overexerting yourself, especially if you experience palpitations during or after physical activity.

In terms of managing your symptoms and medication, here are some recommendations:
1. Follow-Up with Your Doctor: Regular follow-ups with your cardiologist or healthcare provider are essential. They can monitor your condition, adjust your medication as needed, and provide guidance based on the latest information about your heart health.

2. Medication Adherence: If your doctor has prescribed medication that is effective, it is generally advisable to continue taking it as directed. If you have concerns about side effects or the need for long-term medication, discuss these with your healthcare provider.

3. Lifestyle Modifications: Consider making lifestyle changes that can help manage your symptoms. This includes reducing caffeine and alcohol intake, managing stress through relaxation techniques (like yoga or meditation), and ensuring you get adequate sleep.

4. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their duration, and any potential triggers. This information can be valuable for your healthcare provider in managing your condition.

5. Emergency Plan: If you experience severe symptoms, such as fainting, chest pain, or prolonged palpitations, seek immediate medical attention. Having a plan in place can help alleviate anxiety about potential emergencies.

6. Education: Understanding your condition can empower you to make informed decisions about your health. Ask your healthcare provider for resources or information about your specific arrhythmia and its management.

In conclusion, while it can be challenging to navigate the complexities of heart conditions and medications, maintaining open communication with your healthcare provider and adhering to their recommendations is key. Your symptoms and their management are unique to you, and a tailored approach will help you achieve the best outcomes for your heart health.

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