Periodic Rapid Heartbeat in Elderly Patients

Periodic increase in heart rate?

Hello Doctor: My father is 82 years old and lives in a rural area.
He was in good health until his seventies.
About last summer, he suddenly had difficulty eating for several days (approximately 3-4 days), then returned to normal for about 7-8 days.
After that, he experienced another 3-4 days of not being able to eat, followed by another 7-8 days of normal eating (during which his appetite was still quite good).
This cyclical pattern has been ongoing for more than six months.

Upon observation, during those 3-4 days, my father's heart rate is very fast, usually exceeding 120 beats per minute, and sometimes accompanied by wheezing.
In addition to a lack of appetite, he also experiences chills, wearing multiple layers of clothing and still shivering, even in sunny weather with temperatures around 20 degrees Celsius, where he wears 4-5 layers (woolen undershirt + ...
+ sweater + jacket).
His walking is also unsteady.

Furthermore, my father seems to have symptoms of gout, and I wonder if this is related.
About two years ago, his finger joints and the soles of his feet would become red and swollen, and when severe, he would limp while walking.
This condition also occurs cyclically, lasting about 3-4 days when painful and about 15 days when not.
Recently, it has improved somewhat, occurring about once a month (I have been helping him manage his diet).

Since my father is quite stubborn and refuses to seek medical examination or discuss his health condition, I can only ask based on external observations.
I apologize if the information provided is insufficient, and I appreciate any insights you can offer.
Thank you!

A Chang, 40~49 year old female. Ask Date: 2007/02/26

Dr. Zhuang Junbin reply Cardiology

1.
According to your description, your father may be experiencing paroxysmal arrhythmia, which could explain the periodic recurrence of symptoms.
His cardiac function may not be optimal, raising concerns about low cardiac output.

2.
The symptoms appear to be indicative of gout.
Is his serum uric acid level elevated? Is there a correlation with his poor cardiac function? Further examination is necessary to determine this.

Sincerely, Dr.
Chuang Chun-Pin, Internal Medicine.

Reply Date: 2007/02/26

More Info

Understanding periodic rapid heartbeat in elderly patients, especially in the context of your father's symptoms, requires a comprehensive approach that considers various potential underlying causes. Given your father's age (82 years) and the symptoms you've described, including episodes of tachycardia (heart rate exceeding 120 beats per minute), shortness of breath, chills, and periodic loss of appetite, it is essential to evaluate these symptoms in the context of his overall health.

Potential Causes of Rapid Heartbeat
1. Atrial Fibrillation: This is a common arrhythmia in older adults, characterized by an irregular and often rapid heart rate. It can lead to symptoms such as palpitations, shortness of breath, and fatigue. Given your father's age, this is a possibility that should be considered.

2. Hyperthyroidism: An overactive thyroid can lead to increased metabolism, resulting in symptoms such as weight loss, increased heart rate, and heat intolerance. The fact that your father feels cold and wears multiple layers could suggest a metabolic imbalance.

3. Anemia: Low red blood cell counts can lead to increased heart rates as the body attempts to compensate for reduced oxygen delivery. Symptoms may include fatigue, weakness, and shortness of breath.

4. Heart Failure: Given the history of rapid heartbeat and shortness of breath, heart failure could be a contributing factor. This condition can cause fluid buildup in the lungs, leading to difficulty breathing, especially during exertion.

5. Pain and Stress Response: The episodes of gout you mentioned could also contribute to the rapid heartbeat. Pain can trigger a stress response in the body, leading to increased heart rate and blood pressure.

6. Psychological Factors: Anxiety or panic attacks can also manifest as rapid heartbeats and may be exacerbated by physical health issues.

Importance of Medical Evaluation
Given the complexity of your father's symptoms and their potential implications, it is crucial to encourage him to seek medical evaluation. A healthcare provider can perform a thorough assessment, including:
- Electrocardiogram (ECG): To check for arrhythmias.

- Blood Tests: To assess thyroid function, complete blood count (CBC), and other metabolic panels.

- Echocardiogram: To evaluate heart structure and function.

- Holter Monitor: To record heart rhythms over 24-48 hours for a more comprehensive understanding of his heart rate patterns.

Management and Lifestyle Considerations
While waiting for a medical evaluation, consider the following supportive measures:
- Dietary Adjustments: Since your father has a history of gout, maintaining a low-purine diet may help manage his symptoms. Encourage hydration and a balanced diet rich in fruits, vegetables, and whole grains.

- Regular Monitoring: Keep track of his heart rate, blood pressure, and any changes in symptoms. This information can be valuable for his healthcare provider.

- Encouragement to Seek Help: It may be beneficial to involve family members or friends who can help encourage your father to visit a healthcare provider. Sometimes, having a companion can ease the anxiety associated with medical visits.

Conclusion
In summary, your father's periodic rapid heartbeat, coupled with other symptoms, warrants a thorough medical evaluation to determine the underlying cause and appropriate treatment. While there are several potential explanations for his symptoms, only a healthcare professional can provide a definitive diagnosis and management plan. Encouraging him to seek help is vital for his health and well-being.

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