When I walk I often feel “dizzy,” like I’m about to pass out. I think it’s called presyncope.
I have a pacemaker but my pulse can vary between 150 and 180. It may be due to stress.
Could it be related to my medications (apixaban, Forceval, bisoprolol, atorvastatin)?
I am 83 years old, ex-para and have always been in very good shape.
Anthony Appleby, Exeter.
dMartin Scurr responds: The episodes you describe must be alarming and I believe they deserve investigation.
A fast heartbeat (where the heart beats more than 100 times per minute) is called tachycardia; There are different types and an electrocardiogram (ECG), which measures the electrical activity of the heart, will identify what type it is (this is important as treatment varies).
A rapid heartbeat can be caused by consuming too much caffeine along with prescription medications.
Two of the most common types are supraventricular tachycardia (where the heart suddenly beats much faster than normal for minutes or even hours) and rapid atrial fibrillation (an erratic heartbeat).
Sometimes tachycardia is caused by too much caffeine or prescription medications (usually for heart conditions or asthma), but none of the medications you are taking are involved.
It sounds like your problem may be the heart’s own pacemaker.
He previously had a pacemaker fitted because his heart rate was too low and the implant maintains his heart rate.
If the pulse drops below 60 beats per minute, it will stop and ensure a faster pace.
Now what seems to be happening is that sometimes (when you exercise or when you are stressed) your heart races.
If you have a very rapid tachycardia, there is not enough time between each heart contraction (that is, each heartbeat) for the heart chambers to fill completely with blood.
As less blood is pumped through your body, you experience a drop in blood pressure, which is why you feel weak (called presyncope; syncope is the term for actual fainting).
The type of tachycardia you have can be diagnosed with a continuous ECG recording (either a 24-hour recording or perhaps a seven-day recording) to capture one of your episodes.
Once the type has been determined, your doctor may increase your dose of bisoprolol, a beta blocker that slows the heartbeat.
I recently returned from a vacation with no sense of taste. My GP diagnosed me with long Covid. When I went to get my Covid shot, he said if my taste doesn’t come back this year, it never will. I’m 73 years old and I don’t want to spend the rest of my life eating cardboard.
Alec Rawlinson, via email.
Dr Martin Scurr responds: Let me assure you that there are good reasons for cautious optimism.
As you probably know, long Covid is the label given to Covid symptoms that continue for more than three months after the original infection and includes a wide range of physical, cognitive and emotional changes.
But despite the enormous amount of research carried out since the pandemic began, the cause of these long Covid symptoms remains an enigma and several mechanisms are likely to be involved.
The loss of the sense of taste (ageusia) will be accompanied by a loss of smell (known as anosmia) because the two senses are inextricably linked.
Most patients who lose them with Covid infection recover them within three months.
But if you don’t experience any improvement, olfactory training is worth trying; You can access it online.
It involves exposure to four different odors, twice a day, for six months. The goal is to recycle the sense of smell by reestablishing neurological connections.
If you still don’t see any improvement, I would ask your GP to refer you to an ear, nose and throat specialist who can assess whether specialist treatments, such as corticosteroids, can help you.
In my opinion…
Don’t assume the AI doctor is trustworthy
Artificial intelligence may not be so smart after all, based on a friend’s recent experience.
He has long suffered from back pain and was diagnosed with osteoarthritis of the facet joints (in the lower part of the spine): his specialist recommended a procedure to destroy the nerves in these joints to reduce the pain.
But first he needed an MRI to see which area he should focus on: since my friend is agoraphobic, they scheduled him for an MRI in an upright position (easier for agoraphobic patients to endure), using a 0.5 Tesla scanner.
However, a little research suggested that the image quality and definition provided by this scanner is lower than others.
He asked me if he should complain and I told him he should talk to his surgeon.
He called again an hour later: he had been researching scanning technology using ChatGPT and found that the information he had been given about the poorer quality of the 0.5 Tesla was misleading. ChatGPT had invented higher definition scanners.
This is a warning to everyone. Check critical medical information coming from artificial intelligence very, very carefully.
