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Palpitations Can Signal Heart  Trouble

Dear Dr. Roach: I’m 66 years of age and fit. In 2012, I was admitted to a local hospital because I thought I was having a heart attack.

The doctor ran many lab tests, including a chest X-ray and EKG. I had palpitations during my hospital stay.

My blood pressure would fluctuated, as did my pulse rate. None of my tests showed any problems with my heart.

The doctor wanted to prescribe a beta blocker before going home. I refused.

My family doctor saw me the same day and ordered an event monitor, which I wore for one month, and a stress test, both of which were negative.

Two weeks later I was admitted to another emergency room for severe heart palpitations. The ER doctor ran many more tests, all normal.

He diagnosed me as having Lyme disease and asked me to make an appointment with my family physician, who prescribed doxycycline for two weeks.

I started keeping records of my episodes, and have noted that my palpitations occur when I’m having menopause symptoms — hot flashes, mood swings, sleeplessness, etc.

What can I do to decrease or stop my heart palpitations? Would you recommend magnesium, calcium and vitamin D? — A.

Answer: The sensation of palpitations is an unpleasant awareness of your own heartbeat. Some people are aware of their heart beating all the time, and some seldom, but palpitations by definition are different from the norm.

I do think a consultation with a cardiologist might be in order, since your degree of palpitations is greater than usual. (On the other hand, you’ve already had about every test known).

I am a bit concerned about the combination of Lyme disease and palpitations, since Lyme disease can affect the conduction system of the heart.

However, that should have been seen on the EKG.

You may want to consider treatment for your hot flashes, especially if your palpitations are so closely associated with them. Estrogen is by far the most effective, and generally is safe to use, at least for a short while.

Calcium, magnesium and vitamin D, while good for your overall health, may have only a minimal effect on palpitations/hot flashes. Some people get benefit, but most don’t.

Palpitations can be sign of heart trouble. The booklet on heart attack explains what happens, how they are treated and how they are avoided.

Dear Dr. Roach: My yearly blood test showed an alkaline phosphatase reading of 151. It was 69, 61 and 59 the previous three years. Anything over 130 is “high.”

My doctor ordered an abdomen ultrasound and all was normal, except that my gallbladder has a small polyp, which the doctor does not seem worried about. I had other tests, which were normal.

My doctor wants to recheck everything in six months. Any idea what may have caused the spike?

Answer: Alkaline phosphatase is an enzyme made predominantly in two organs — the liver and the bone.

It is released from the liver when the bile is obstructed.

Bone conditions, such as Paget’s disease, can cause a high alkaline phosphatase as well.

However, your level is not very high, and I agree that a wait-and-see approach makes sense.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.