Question Title: re:re:fast heart rate

Thank you very much for your response on Nov 3 to my problem of persistent fast heart
rate possibly due to mycoplasma. You're expert advice was right on. I have
since seen a cardiologist but unfortunately he is also puzzled by my
condition. He IS treating me for heart failure based on the theory that my
fast heart rate (104-115 at rest) is causing fluid to backup. So, he is
slowing down my heart rate with diltiazem (240mg/day) and trying to get rid
of fluid with Lasix (40mg/day) The Lasix is working well. My coughing is
very sparse now although I do have occasional episodes. It gets a lot worse
again if I stop the Lasix (like when the prescription ran out).

3 weeks ago, I had a thallium stress test and this is my new concern. My
primary doctor and cardiologist seem to differ in their opinion of the
results. My primary doctor says there were small areas of ischemia or
possible infarction (he called me on a Saturday to tell me...talk about
being scared for the next 4 days) When I asked my cardiologist
about this on my visit the following Thursday, he said what was on the
pictures were small shadows on the initial pictures that disappeared on
the pictures they took after exercise. This fits my symptom pattern of
faster heart rate and coughing when i stand or exercise but he felt that
these areas were too small to be significant.

In your expert opinion, does this make sense or should I seek a second
opinion ? My cardiologist is taking a wait and see attitude and advised
me to take the diltizem and Lasix for the next 2 months (on the theory
that the mycoplasma infection would definitely be gone by then) He then
said if after going off the medicine at that time should the symptoms
persist, he would do a cardiac catheterization and biopsy. (the echo of 3
months ago was normal and in his opinion the thallium stress test is also
normal so he has no answers) Also, he tried increasing the diltiazem to
360mg since my heart rate at the last visit was still in the '90's (after
2 weeks on the 240mg/day) but it made my coughing worse.

Its been almost 4 months since this whole thing started and although I'm
not in any hurry to have a cardiac catheterization, I need answers and
I'm scared that if he's wrong, waiting 2 months could make matters
worse.

Any help or advice you can provide on this is greatly appreciated.

Thanks again,

Bill

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Dear Bill,

While we cannot comment on specific case management I would not think that waiting two months would cause any harm.

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist

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