Emad F. Aziz, DO, MB ChB, FACC

High Blood Pressure "HYPERTENSION" is a very common disease (~30%) of the population has it however so many undermined its detrimental effects. Hypertension IS A SILENT KILLER! patients need to take it seriously and get the right management. Normal blood pressure should be "120/80" any thing above that isn't normal and should be evaluated by a specialist (Cardiologist). High blood pressure is the culprit for kidney disease, eye disease, heart failure, and stroke.

During an EP study your doctor typically will introduce (3) small catheters (Wires) through a large vein from the leg (Femoral vein) to the heart and stimulate the heart either electrically or by utilizing medication (Adrenaline) to induce tachycardia and study its mechanism. During the EP study your physician will also be able to ascertain the need for a pacemaker or an ICD.

A Hole in the heart can be either an incomplete closure of the small membrane between the 2 upper chambers of the heart which are called atria this is typically called atrial septal defect or for short ASD or it could be a result of an incomplete closure of the members septum in between the 2 lower chamber the heart which are cold ventricles and is typically called ventricular septal defect. There is also a subsector of ASD which is called patent foreman ovale or for short PFO and it only occur after birth when the foreman ovale fails to close. And it is presence in about 25% of the population.

Best test to evaluate and diagnose any of these defects is an echocardiogram to start with which is an ultrasound of the heart during the test you can evaluate the size of the defect as well as the amount of blood flow that goes through it and if there is a reversal of the flow from the left side to the right side or vice versa.

Cardiac MRI can also be used to evaluate any congenital abnormality of the heart including any septal defects.

While the majority of PFO's does not require any closures larger one will require closure either by catheter or surgically because the can increase the risk of stroke by about 40 to 50%

will certainly use symptoms are alarming particularly with your strong family history of heart disease. However, what I'm getting from the brief note that you have high blood pressure and fast heart rate certainly that could be the result of an anxiety or it could be a problem with the thyroid gland which is very common in women in your age group. I suggest seated physician to at least run blood tests to rule out any thyroid problem ( thyroid hyperactivity) which could be treated. Also after these tests your physician might require to order blood testing to check on your cholesterol level and may be a CTA to check on your coronary calcium score. Best of luck!

tachycardia is a very generic term and a need to be more specific. There are multiple causes for tachycardia. That can range from abnormalities in the rhythm of the upper chamber the heart which can be further classified to atrial fibrillation or atrial flutter which are quivering of the left atrium of the heart or a more regular fast rhythms which are summarized as supraventricular tachycardias. There also tachycardias that originate from the lower chamber the heart which could also be a regular some of them are single premature contractions which we call in short PVCs or even ventricular tachycardia. All these tachycardias can have very effective therapies once diagnosed my suggestion is to see and electrophysiologist who then will order an event monitor for up to 30 days to be able to capture the arrhythmia and then establish a management plan for mom. Most common arrhythmia that happen and elderly is atrial fibrillation with an incidence of about 20 to 25% in that case blood thinners are prescribed and the option of medical management furthers catheter-based management which called ablation procedure can be offered

PVCs or premature ventricular contraction could be the culprit or the result of heart failure. High burden of these PVCs particularly more than 10,000 per day out associated with progression of the weakness of the heart and should be treated. Management could include the addition of special medication like beta blockers which could be tolerated and heart failure Patients, however if the PVCs burden is very high catheter ablation procedure can be very safe and very effective to eliminate these extra beats which could very well result in the reversal of your mom's heart failure. We have been very successful in such procedures with great success stories of reversal of the heart failure and improvement of the patient left ventricular function.

there are many causes of irregular heartbeat. Most common is atrial fibrillation which is an irregular heartbeat that originates from the left upper chamber the heart causing the upper chamber to beat chaotically that can cause symptoms of fatigue, tiredness, shortness of breath and is sustained for more than five hours can be the culprit for stroke. There is a strong correlation between atrial fibrillation and high blood pressure. I would suggest for mom to see a specialist [electrophysiologist] who then will likely order a prolonged monitor for up to 30 days to establish a diagnosis. Other causes of irregular heartbeat could be skipped beats either from the upper chamber of the heart or the lower chamber the heart those could be less harmful at times however also need to be evaluated and most of the time the patient would need a monitor to reach the diagnosis

I totally understand why you are petrified. However AVRT particularly in the presence of anomalous bypass tract can result in several tachycardias which can make it very difficult for the child to play study or runaround with children do. I certainly would not advise adding destruction to a nine-year-old, beta-blocker could be contraindicated if she has a bypass tract. Catheter ablation in an experienced hands is very safe and very effective when it's done in an experienced center

Absolutely, pregnancy can increase your heart rate and it's not uncommon for the basal heart rate to be around 100-110 bpm, which is quite normal. However it is worthwhile to visit your physician and have a baseline ECG done to confirm that this is appropriate sinus tachycardia. Best of luck with your pregnancy!