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Q&A with Australian Health Practitioners
Is it normal to cease heart failure medications?
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What's the significance of bundle branch block in recent syncope?
A 79-year-old patient with congested heart failure (approx. 7 years), has experienced 2/3 episodes of syncope in the past 6 months. She undertook a 24-hour Holter monitor, and the results were:
“Sinus rhythm with bundle branch block pattern. The average rate was 86, the minimum rate was 53 at 6.15pm, the maximum rate was 131 at 9pm. Frequent ventricular ectopic beats including 1 trigeminy run. Rare supra ventricular ectopic beats, including 2 (4-12 beats) atrial tachycardia runs, with rates up to 170bpm. No pause greater than 2 seconds. No patient triggered events.”
The patient was told to cease her Carvedilol and Imdur tablets but continue with her Atacand 16mg daily with no referral to a cardiologist.
Should she be seen by cardiologist?
Do these symptoms indicate any early warning signs of complete heart block?
Very concerned. -
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