Heart Palpitations and Cholesterol Concerns: A Guide

Cardiac issues

Hello Doctor, I would like to ask for your advice.
Recently, I have been experiencing frequent palpitations and irregular heartbeats.
Sometimes, I feel sharp pain in my chest and around my heart area, and I also have pain in my left shoulder and back, although I'm not sure if it's muscular pain.
I recently had a health check-up, and some of my results showed total cholesterol at 262 (highlighted), triglycerides at 293 (highlighted), low-density lipoprotein (LDL) at 153 (highlighted), and high-density lipoprotein (HDL) at 58.
The resting electrocardiogram indicated no significant issues (the resting ECG report from two years ago showed first-degree atrioventricular block).
My average blood pressure is 120/80 (within range), and my pulse sometimes drops below 60 (generally does not exceed 100).
The pulse wave analysis (vascular elasticity analysis) is at grade two, 100% (highlighted), and my thyroid T3 level is slightly low (other thyroid tests were normal; another doctor mentioned it might be a data error and suggested monitoring it again in three months).

Doctor, what is the likelihood of me having a myocardial infarction? I live alone at home and have a three-month-old baby, so I am very afraid of suddenly collapsing and not being able to wake up, even while sleeping.
Is the frequent feeling of fear related to palpitations? I often need to take deep breaths to feel more comfortable, and sometimes my heart beats very hard.
What additional tests can I undergo? Is it true that myocardial infarction cannot be prevented? Also, are dietary supplements that claim to lower cholesterol and LDL effective? Thank you, Doctor, for your analysis and answers.

Ms. Chen, 40~49 year old female. Ask Date: 2019/01/26

Dr. He Dongjin reply Cardiology

Hello, for women of this age, experiencing palpitations and pain in the heart area is likely due to autonomic nervous system dysfunction, and the probability of a myocardial infarction is low, so there is no need to worry.
Pain in the left shoulder and back is more likely to be muscular pain.
Myocardial infarction can be prevented by managing the three highs (hypertension, hyperlipidemia, and hyperglycemia), exercising, and taking health supplements, which are just foods and have limited efficacy.
Only medications have proven therapeutic effects.
Changhua Hospital cares about you.

Reply Date: 2019/01/26

More Info

Understanding heart palpitations and cholesterol concerns is crucial for maintaining cardiovascular health, especially given your symptoms and recent health check results. Let's break down your concerns and provide a comprehensive overview.

Heart Palpitations and Symptoms
Heart palpitations are sensations that feel like your heart is pounding, fluttering, or beating irregularly. They can be caused by various factors, including anxiety, stress, caffeine intake, or underlying medical conditions. In your case, the combination of palpitations, chest pain, and discomfort in the left shoulder and back could be indicative of several issues, ranging from anxiety to potential cardiac concerns.

Given your history of first-degree heart block and the current symptoms, it is advisable to monitor your heart closely. While your static electrocardiogram (ECG) did not show significant abnormalities, the presence of palpitations and chest discomfort warrants further investigation. You might consider a Holter monitor, which records your heart's rhythm over 24 hours, to capture any irregularities that may not be evident during a standard ECG.

Cholesterol Levels and Cardiovascular Risk
Your cholesterol levels indicate that you have elevated total cholesterol (262 mg/dL), triglycerides (293 mg/dL), and low-density lipoprotein (LDL) cholesterol (153 mg/dL). High cholesterol is a significant risk factor for coronary artery disease (CAD) and can lead to heart attacks if not managed properly. The high-density lipoprotein (HDL) level of 58 mg/dL is considered protective, as HDL helps remove cholesterol from the bloodstream.

To assess your risk of myocardial infarction (heart attack), it is essential to consider not only your cholesterol levels but also other risk factors such as family history, smoking status, blood pressure, and lifestyle choices. Given your average blood pressure of 120/80 mmHg, which is within the normal range, and the absence of diabetes or smoking history, your immediate risk may be lower, but elevated cholesterol levels still pose a concern.

Anxiety and Heart Health
Your feelings of fear and anxiety about your health, especially with a newborn at home, are understandable. Anxiety can exacerbate palpitations and create a cycle of worry that may lead to more physical symptoms. It is essential to address both your physical and mental health. Techniques such as mindfulness, relaxation exercises, and possibly counseling could help manage anxiety levels.

Preventive Measures and Lifestyle Changes
1. Dietary Adjustments: Focus on a heart-healthy diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Reducing saturated fats and trans fats can help lower LDL cholesterol levels. Consider consulting a nutritionist for personalized dietary advice.

2. Regular Exercise: Engaging in regular physical activity can help improve cardiovascular health and lower cholesterol levels. Aim for at least 150 minutes of moderate aerobic exercise each week, such as brisk walking or cycling.

3. Medication: If lifestyle changes are insufficient to manage your cholesterol levels, your healthcare provider may recommend medications such as statins. These can significantly reduce LDL cholesterol and lower the risk of heart disease.

4. Supplements: While some supplements claim to lower cholesterol, their effectiveness can vary. Omega-3 fatty acids (found in fish oil) and plant sterols may help, but it is crucial to discuss any supplements with your healthcare provider to ensure they are safe and appropriate for you.

5. Regular Monitoring: Keep track of your cholesterol levels and heart health through regular check-ups. This will help you and your doctor make informed decisions about your treatment plan.

Conclusion
While your current symptoms and cholesterol levels raise valid concerns, proactive management through lifestyle changes, regular monitoring, and possibly medication can significantly reduce your risk of heart disease. It is essential to maintain open communication with your healthcare provider, who can guide you through the necessary tests and treatments tailored to your specific situation. Remember, addressing both physical and mental health is vital for overall well-being.

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