Managing Arrhythmia: Can It Improve Over Time?

Arrhythmia

Hello Doctor, I have been undergoing treatment for arrhythmia for two years and also have thalassemia.
I often experience chest tightness, palpitations, shortness of breath, and sharp, burning pain in my heart that can be unbearable.
I wake up at night feeling startled, and when the weather gets cold, I start to feel burning, cramping, and sharp pain, which leads to difficulty breathing and a lack of energy to walk.
I feel dizzy when walking.
I have been taking "Sotalol 10 mg." I would like to ask if my arrhythmia will improve, or will it persist (I was diagnosed in high school)?

th, 10~19 year old female. Ask Date: 2015/03/06

Dr. He Dongjin reply Cardiology

Hello, based on your description, it seems that the symptoms of arrhythmia may be caused by mitral valve prolapse combined with autonomic nervous system dysregulation.
Will the arrhythmia improve? It depends on the type, but there is a possibility of improvement.
Patients with mitral valve prolapse often experience palpitations, chest pain, discomfort in the chest, fatigue, shortness of breath, poor appetite, dizziness or fainting, arrhythmias, reduced exercise capacity, dizziness when sitting up, a sensation of something stuck in the chest or neck, and even neuropsychological symptoms.
As seen from the above, the symptoms are quite diverse, with most cases occurring in individuals aged 20 to 30 years.
If symptoms are pronounced, it indicates that the patient's autonomic nervous system is in an excited state.

Treatment is often complicated by the fact that non-specialized cardiologists frequently misdiagnose patients as having myocardial ischemia, psychological disorders, or what traditional Chinese medicine refers to as "heart weakness," leading to unnecessary distress for patients who undergo numerous tests without receiving a correct diagnosis.
This results in the consumption of substantial medical resources and the use of inappropriate medications, causing significant suffering for some patients.
Therefore, professional diagnosis and a thorough understanding of the condition, along with attention to hydration, are crucial.

Certain stimulants such as caffeine, cigarettes, alcohol, or medications containing adrenal hormones are not advisable.
A short-term, low-dose beta-blocker like Inderal can help control the autonomic nervous system, and a small amount of mild sedatives can alleviate symptoms in over 90% of patients.
Mitral valve prolapse is very common in cardiology clinics and often causes concern; however, this condition is relatively complex, making health education one of the important treatment methods.
Fortunately, the vast majority of patients fall into the low-risk category, so those with mild symptoms may not require medication.
Patients with more pronounced valvular changes can be monitored with echocardiograms as needed based on their condition.
Most importantly, having a solid psychological foundation is essential to minimize discomfort.

Reply Date: 2015/03/06

More Info

Managing arrhythmias can be a complex process, especially when they are associated with other conditions like thalassemia (Mediterranean anemia) and symptoms such as chest tightness, palpitations, and shortness of breath. It is essential to understand that while some patients may experience improvement in their arrhythmias over time, others may continue to have symptoms or even experience worsening conditions.
Arrhythmias can be influenced by various factors, including underlying health conditions, lifestyle choices, and medication adherence. In your case, the presence of thalassemia may contribute to your symptoms, as this condition can lead to anemia, which in turn can affect oxygen delivery to the heart and other organs. This can exacerbate feelings of fatigue, shortness of breath, and even palpitations.

The medication you mentioned, "生達心律錠" (likely a beta-blocker), is commonly prescribed to help manage arrhythmias by slowing the heart rate and reducing the workload on the heart. Beta-blockers can be effective in controlling symptoms related to arrhythmias, but they may not necessarily cure the underlying condition. It is crucial to take these medications as prescribed and to communicate any side effects or concerns with your healthcare provider.

In terms of whether your arrhythmia can improve over time, it largely depends on several factors:
1. Underlying Causes: If the arrhythmia is secondary to a reversible cause (like electrolyte imbalances or medication effects), addressing those issues may lead to improvement. However, if it is due to structural heart disease or chronic conditions, it may persist.

2. Lifestyle Modifications: Engaging in regular physical activity, maintaining a healthy diet, managing stress, and avoiding stimulants (like caffeine and nicotine) can contribute to better heart health and potentially reduce the frequency or severity of arrhythmias.

3. Regular Monitoring: Continuous monitoring of your heart rhythm through devices like Holter monitors or wearable technology can help track changes over time. This information can be invaluable for your healthcare provider to adjust your treatment plan as needed.

4. Follow-Up Care: Regular follow-ups with your cardiologist or healthcare provider are essential. They can assess your symptoms, review your medication regimen, and make necessary adjustments based on your current condition.

5. Potential for Improvement: Some patients report a decrease in the frequency and severity of their arrhythmias over time, especially with consistent treatment and lifestyle changes. However, others may find that their symptoms persist or fluctuate.

In summary, while there is potential for improvement in arrhythmias, it is essential to approach this condition with a comprehensive management plan that includes medication adherence, lifestyle modifications, and regular follow-up care. If you are experiencing significant symptoms such as chest pain, severe shortness of breath, or episodes of syncope (fainting), it is crucial to seek immediate medical attention. Your healthcare provider can help determine the best course of action tailored to your specific situation, ensuring that you receive the most appropriate care for your arrhythmia and any associated conditions.

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