Heart Palpitations and Valve Issues: Symptoms and Treatment Options

Rapid heartbeat, chest tightness or pain, feeling shaky, weakness in the legs, speaking with a lack of breath, and increased irritability?

According to the doctor's diagnosis, there are symptoms of mitral and tricuspid valve prolapse with regurgitation, as well as coronary atherosclerosis.
The patient has been prescribed Norvasc for about 2-3 years, and the condition has been relatively stable.
However, in the past 2-3 months, the patient has experienced symptoms such as increased heart rate (around 95 bpm), chest tightness and pain, feelings of trembling, weakness in the legs, difficulty speaking due to lack of breath, irritability, loss of appetite, weight loss, feelings of depression, and a heavy heartbeat while sleeping, with some relief when lying on the right side.
The patient does not smoke or drink alcohol, is a working professional, weighs approximately 60 kg, is 173 cm tall, and engages in light exercise.
The patient is inquiring whether these symptoms are similar to those of arrhythmia.
They also ask if it is advisable to try a family member's "arrhythmia" medication for 1-2 days to see if there is any improvement.
The patient previously had a prescription for Inderal but did not continue it due to a history of asthma.
They are asking if there are alternative medications suitable for asthma patients.
Additionally, they want to know if asthma patients can take Inderal during periods without an asthma attack and stop the medication if they experience any discomfort.

Yuehan Xiansheng, 60~69 year old female. Ask Date: 2021/06/09

Dr. He Dongjin reply Cardiology

Hello, if you have asthma, it is safer not to take Inderal, as it is not recommended for symptoms that resemble arrhythmia but are more likely caused by autonomic nervous system dysregulation.
Generally, heart medications are not advised for such cases.
It is important to treat the underlying condition appropriately.
If you are unsure whether you have this condition, please do not use medication casually.
It is best to consult your attending physician to identify the root cause and receive targeted treatment.
Take care from Changhua Hospital.

Reply Date: 2021/06/09

More Info

Heart palpitations and valve issues, particularly mitral valve prolapse and tricuspid regurgitation, can lead to various symptoms that significantly affect a person's quality of life. Your symptoms, including rapid heartbeat, chest tightness, fatigue, and feelings of anxiety, may indeed suggest an underlying arrhythmia or other cardiac issues. Given your history of coronary artery disease and the medications you are currently taking, it's essential to approach this situation with caution.

Understanding Your Symptoms
1. Palpitations: These are often described as a feeling of having a fast-beating, fluttering, or pounding heart. In your case, a heart rate of around 95 beats per minute, especially if it feels irregular or rapid, can be concerning. Palpitations can be triggered by anxiety, caffeine, certain medications, or underlying heart conditions.

2. Chest Discomfort: Chest pain or tightness can be associated with heart issues, especially in the context of valve problems or coronary artery disease. It's crucial to differentiate between cardiac-related chest pain and other causes, such as musculoskeletal pain or gastrointestinal issues.

3. Fatigue and Weakness: Feeling weak or having low energy can be a result of inadequate blood flow due to valve dysfunction or arrhythmias. This can also lead to feelings of dizziness or lightheadedness, especially when standing up quickly.

4. Anxiety and Mood Changes: The psychological impact of living with a chronic condition can lead to increased anxiety, irritability, and even depression. These feelings can exacerbate physical symptoms, creating a cycle that can be difficult to break.

Treatment Options
1. Medication: You mentioned that you have been prescribed Inderal (propranolol), which is a beta-blocker. While beta-blockers can help manage heart rate and reduce palpitations, they may not be suitable for everyone, especially those with asthma, as they can potentially exacerbate bronchospasm. If you have a history of asthma, it is crucial to discuss alternative medications with your healthcare provider.

2. Alternative Medications: There are other classes of medications that can be used to manage palpitations and anxiety without affecting asthma. For example, calcium channel blockers or certain anti-anxiety medications may be appropriate. Always consult your doctor before trying any new medication, especially if you have underlying conditions like asthma.

3. Lifestyle Modifications: Incorporating regular exercise, maintaining a balanced diet, and managing stress through techniques such as mindfulness or yoga can significantly improve your symptoms. Avoiding stimulants like caffeine and nicotine is also advisable.

4. Monitoring: If you suspect that your symptoms are related to an arrhythmia, it may be beneficial to undergo further monitoring, such as a Holter monitor or an event recorder, to capture your heart's activity over time.

5. Follow-Up: Regular follow-ups with your cardiologist are essential. They can assess the severity of your valve issues and determine if any interventions, such as valve repair or replacement, are necessary.

Conclusion
Your symptoms could indeed be indicative of arrhythmias or complications related to your valve issues. While it may be tempting to try a family member's heart medication, it is not advisable without consulting your healthcare provider. Each individual's medical history and current medications must be considered to avoid adverse effects.
In summary, please reach out to your cardiologist to discuss your symptoms in detail. They can provide a tailored approach to your treatment, ensuring that any medications prescribed are safe and effective for your specific health needs. Regular monitoring and lifestyle adjustments can also play a crucial role in managing your condition and improving your overall well-being.

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