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Ask Dr. Natasha Your Own Question
Dr. Natasha
Dr. Natasha, Board Certified Physician
Category: Cardiology
Satisfied Customers: 12910
Experience:  Training in cardiology emergencies.
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Having just been a patient under Dr Radvan in Bournemouth hospital

Customer Question

Having just been a patient under Dr Radvan in Bournemouth hospital for two weeks following emergency admission I seem to have received two conflicting opinions from his two Registrars which has left me very unsure and puzzled on the one hand there was the opinion that I would probably require a pacemaker and on the other hand it was felt that the drug Amlopidine 5mgplus Simvastatin 20mg plus a seven day tape (which I still have not received!)as an outpatient and an outpatient appointment to follow up. I have to say that I find this perplexing and for me personally very worrying.
Submitted: 3 years ago.
Category: Cardiology
Expert:  Dr. Natasha replied 3 years ago.

Dr. Cameron :

hello

Dr. Cameron :

welcome to the chat

Dr. Cameron :

how can I help you?

Dr. Cameron :

What type of arrhythmia were you diagnosed with?

Dr. Cameron :

hello- in order for me to assist you, What type of arrhythmia were you diagnosed with?

JACUSTOMER-v3j2nzb3- :

Trifasicular block and coronary artery disease

Dr. Cameron :

Did you faint?

JACUSTOMER-v3j2nzb3- :

After angiogram they put trifascular block and coronary artery disease

Dr. Cameron :

ok, but did you pass out?

JACUSTOMER-v3j2nzb3- :

They put trifasicular block and coronary artery disease

Dr. Cameron :

I understand. Did you faint ?

Dr. Cameron :

At any point from this?

JACUSTOMER-v3j2nzb3- :

No but almost strong willpower I guess!

Dr. Cameron :

Ha ha!. Well, the term trifascicular block is rather confusing. Because blockage of all three fascicules would be a complete heart block and this definitely requires a pacemaker. Trifascicular block is is the combination of a right bundle branch block, left anterior or posterior fascicular block and a first degree AV block (prolonged PR interval). The term “trifascicular block” is a misnomer term since the AV node itself is not a fascicle.

Dr. Cameron :

Progression of chronic bifascicular block and bifascicular block with a prolonged PR interval to complete heart block is probably infrequent. One large study followed 554 such patients and noted that 1 percent per year progressed to complete heart block

Dr. Cameron :

so, you do NOT need a pacemaker at present

Dr. Cameron :

If you fainted, you would. But if you are asymptomatic, you do not. While a trifascicular block itself does not require any treatment, high doses of AV blocking agents (like calcium channel blockers, beta blockers) likely should be avoided

Dr. Cameron :

The appropriate treatment is medication, plus the 7 day tape (the holter monitor) and close follow up

Dr. Cameron :

If you are super bored, you can read this:

Dr. Cameron :

http://content.onlinejacc.org/article.aspx?articleid=1138927

Dr. Cameron :

Are you still there?

JACUSTOMER-v3j2nzb3- :

Yes taking shorthand notes of your comments and want to ask you if it's normal to feel so tired and listless. Iam normally a 'whirling dervish'and suppose that now I need to take li fe a little more slowly what do you think?

Dr. Cameron :

You don't have to take notes- you can always cut and paste this or [email protected] for your chat.

Dr. Cameron :

It belongs to you

Dr. Cameron :

Yes, it is TOTALLY normal to feel tired after an angiogram. Your body went through a lot!

Dr. Cameron :

In fact, many hospitals have 'cardiac rehabilitation' services just for this

Dr. Cameron :

your body can get quite deconditioned

Dr. Cameron :

Don't stress about it. Give yourself some time to get back

Dr. Cameron :

It may take weeks. It may take months. But it will get better.

Dr. Cameron :

It is also a little depressing psychologically- for someone who was rather active before- so consider this as well.

Dr. Cameron :

that can also take a toll on you

Dr. Cameron :

Use this time to reprioritize, read a book you always wanted to get through and get in contact with some friends and family you never have time for

JACUSTOMER-v3j2nzb3- :

I much appreciate your close attention to detail but I would just say that I am very new to. This iPad lark and wonder how to cut and paste,any tips?

Dr. Cameron :

hold your finger down and then choose select all

Dr. Cameron :

then copy

Dr. Cameron :

then open up another program like word or even a mail program and then choose paste

Dr. Cameron :

or you can save to your clipboard

Dr. Cameron :

hello?

Dr. Cameron :

are you still there?

Expert:  Dr. Natasha replied 3 years ago.
Hi Jan
It appears that our chat did not close properly.
Did you have anything else you needed in this regard or did I provide you with excellent service? :-)?

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