instruction: hello doctor I am 25 years old I have palpitations for the past three months no anemia tit is normal mri abdomen and chest are normal echo shows atherosclerotic aortic valve with ejection fraction 60 hotter shows minimum he 120 and maximum he 190 I have associated fatigue at times tremor and difficulty in breathing chest pain is aching sometimes and pins and needles more often I have seronegative arthritis previously I had dengue cerebral malaria and typhoid I am currently taking betacap to 40 my be for one month then stopped clonazepam 5 my be for two months but no help
output: hello doctor I have thoroughly gone through your case and can well understand your genuine concerns first of all you have a high mi body mass index try to reduce the weight as you know it is high for this age and height ejection fraction of 60 shows you have aortic stenosis due to sclerosed aortic valve in this regard we have to keep in mind that this much back pressure on the left ventricle with every heartbeat is making the ventricular walls and interventricular septum more thickened and dilated improper output is making your heart beat faster and it also reduces the cardiac output stenosed aortic valve hindrance to outflow of blood cardiac angiography beta adrenergic blocking agents are the mainstay of treatment to reduce heart rate and control palpitation and to reduce cardiac oxygen demand that has increased due to increased heart rate maybe we need cardiac ablation and also there may be a need for valvular replacement sometime later in life avoid strenuous physical activity no junk foods caffeine tea coffee chocolates and energy drinks