I was born with an ASD that was repaired when I was 2 years old. I was discharged from a cardiologist when I was much younger with no indication that it was necessary to return. I am now 30 years old and have 2 kids. When I was pregnant with my first child, I asked my OBGYN if it was necessary to see a cardiologist. They said no. I had a couple of episodes of heart palpitations during the pregnancy but my OBGYN did not think it was necessary to get checked out if they did not continue. I did not have palpitations with baby #2. I recently went to get a routine physical and the med student performing the test told me that I had atrial fibrillation. The doctor later dismissed this as problems with the machine. He then heard an irregular heartbeat on ascultation. He said it was not anything to be concerned about but that I should probably check in with a cardiologist in the next couple of months. I am very concerned that something may be wrong so I have several questions. What could be causing the irregular heartbeat and why is he dismissing this as no big deal? How can he know that the atrial fibrillation was a machine error when they did not repeat my EKG? What kind of cardiologist should I see? A pediatric cardiologist will have experience with ASD but not with adults and an adult cardiologist is not necessarily going to have experience with ASD.
It should be noted that my blood pressure and cholesterol were great. In fact my blood pressure and pulse have always been low (but not so low that anyone ever worried).
Causes of irregular beats:
Most common are early beats from the atrium or ventricle. Atrial fibrillation is another common cause of irregular beats. People with a history of ASDs are at increased risk for atrial fib, especially if there is any residual hole where the ASD was. An echocardiogram is the easiest way to assess this. Your EKG was probably normal and the doctors thought it ok to wait.
Any general cardiologist if fine for an initial visit. If they find that there is something wrong, they may send you to an adult congenital heart disease specialist depending on where you live. Most adult cardiologists do have experience with ASD, but experience does vary.
The starting point is probably an echocardiogram to assess your heart function and look for a residual hole and a Holter monitor to determine what is causing the irregular beats.
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