Ask general practitioner Maarten: Troubled by cardiac arrhythmias and slow heart rate
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
I have had cardiac arrhythmias since 2000. Against that I used tambocor and since 2013 concor 2.5 mg. This after an examination in Bangkok hospital.
From a few months ago I have an extremely low heart rate. At rest around 40, once this week 35. With normal functioning around 60. The blood pressure is highly variable, From 100/60 at rest to 120/85. These changes sometimes occur within minutes. The heartbeat is palpably irregular but never high during that irregularity. Looks more like a break in the rhythm.
The last heartbeat (6 months ago) film produced a normal image. Physical symptoms:
- sometimes slight pain in the left forearm, disappears after some time. Occurs several times a week.
- no chest pain.
- the day after a workout on the bike, a slight discomfort in the left chest, but no pain.
- no dizziness, but often very mild headache.
Weight 82 kilos, length 189 cm. Age 77 years. No alcohol, no smoking. No other medications. No family history of heart problems. Did endurance sports until the age of 65. Now cycling at pace 4 times a week, practicing with weights 2 times a week. Both for 45 minutes.
Please advice.
Regards,
K.
*****
Specifications,
Tambocor and Concor are different types of medication. Tambocor (flecainide) is a Class IC antiarrhythmic, which has an effect on heart rhythm. For example, you can see rhythm as a dance rhythm, a waltz is ¾, foxtrot 4/4, tango 3+3+2 etc.
It is often given for an irregular heartbeat and is quite toxic. Sometimes it is better to take an aspirin or another anticoagulant, but that depends on the type of arrhythmia.
Concor (bisoprololol) is a beta blocker, which regulates the rate of the heartbeat, in this case down. The low heart rate is probably caused by the Concor.
You must therefore stop the Concor and visit the cardiologist as soon as possible, preferably this week.
Yours faithfully,
Martin Vasbinder