How can episodes of near syncope be effectively managed?
Hello doctor,
The patient is a 17-year-old male with 6'1" in height and 185 pounds weight. The primary doctor ordered an ECG and an echocardiogram because of a couple of episodes of near syncope recently. The episodes occur after sudden standing, and we were told it might be due to dehydration and orthostatic hypotension. There is no loss of consciousness and not under any medications. Blood pressure and pulse are listed below. The details of the echo cardiogram are below. The ECG was normal. The echocardiogram reported the following. Borderline asymmetric left ventricular hypertrophy (1.2 cm), Borderline enlarged LVOT (LVOT 2.2 cm; LVOT velocity 1.97 m/sec), Increased mitral valve E to A ratio, consistent with the patient’s age, Trace-mild pulmonic valve regurgitation, there is an abnormal mosaic pattern over the pulmonic valve areas during the color flow Doppler examination and normal left ventricular, right ventricular, left atrial and aortic root diameters. The ECG is normal. BP when sitting is typically 110/61 mmHg, with a heart rate between 58 and 64 beats per minute. BP, when lying down, is 87/43 mmHg, with a heart rate between 42 and 45 beats per minute. My questions are what does the echocardiogram mean? What is this likely to be? Is it of short term or long term concern? What is the least aggressive treatment option? What is the most aggressive treatment option?
10 May 2024 - 1 min read
I have high blood pressure. Can I work out at a gym?
Hello doctor,
I am checking my blood pressure for a week now and it is mostly about 134/94 mmHg. A physician asked me not to work out at the gym. Can you please advise if I can join a gym? My parents and a few other relatives had high BP. I have done an ECG and chest X-ray last year and both were normal. Please provide your opinion.
26 Feb 2024 - 1 min read
Can surgery fix tetralogy of Fallot in a 1-year-old?
Hello doctor,
My 1-year-old child has been diagnosed with tetralogy of Fallot. She has been experiencing fast breathing, difficulty in feeding, failure to thrive, clubbed fingers but the cardiologist told me they will not be in a rush to fix the problem. I cannot stand what she is going through. What is her survival rate? Can I have the problem solved early? Of note, she is currently on Lasix and Aldactone.
26 Feb 2024 - 1 min read
What does 'first-degree atrioventricular block' mean?
Hello doctor,
I did my ECG today in which I got a first-degree atrioventricular block. What does this mean and is this a serious issue? What is its cause and treatment, please?
20 Feb 2024 - 1 min read
What are the risks of high-intensity cardio exercise?
Hello doctor,
I am a healthy 36-year-old. I run several times a week, often sprinting up hills for two to three minutes. In the past three years, I have had a few minor cardio-related symptoms, which I had checked out because I am motivated to stay in top physical condition. These include dizziness (drop in blood pressure) when standing up suddenly, feeling of shortness of breath during minor physical exertion (for example climbing stairs). That seemed out of character for my general level of fitness and a minor episode of palpitations that resolved in a week or so (last year). I have had two thorough cardio workups in the past five years to look into these issues, including a 24 hour Holter monitor, EKGs, and two cardio treadmill stress tests. Two cardiologists have told me my cardiovascular system is in excellent shape and they cannot find anything wrong. They seemed quite impressed I made the full 21 m on the treadmill. I have no current cardio issues. My question is this: what are the risks of intense cardio exercise? Basically, what are the risks if I try to sprint up a mountain? I have read about the dangers of long periods of running, one hour or more, but do not really see anything about the risks of dropping dead from sprinting too hard too long.
20 Feb 2024 - 1 min read
