Answer:

The most common cause of a loud or strong heart beat while lying down is extra beats. We can get extra beats from the upper heart chambers (atrium) called premature atrial contractions (PACs) or from the bottom chambers (ventricles) called premature ventricular contractions. When we get an extra beat that comes early, the heart will pause before the next normal beat is delivered. This allows the heart to have extra time to fill up with blood to make up for the early extra beat. The heart that has extra time to fill up can give a much stronger beat that in can be felt and cause a lot of symptoms.. We all experience extra beats, but some people can have a lot of them to the point they can occur every other beat. We usually use a heart monitor that you wear overnight to see what is causing the symptoms, and if it is extra beats, how many you are having and from what location they arise. These beats often occur throughout the day, but a night there are less distractions and you may be more aware of them. Also, when we lie down our hearts fall against our chest walls (particularly when we lie down on our left side) and then the strong beat, after the early extra beat, can be felt in the chest wall.

Answer:

Typically we don’t hear our hearts without the help of an instrument. For this reason as physicians we use a stethoscope. People that have certain mechanical heart valves often can heart their hearts and others in the room may be able to as well. Mitral valve prolapse alone cannot be heart outside of the body. Heart specialists can recognize a certain heart sound that suggests prolapse, but this takes a stethoscope, a quite room, and years of experience. In some people that have prolapsed the valve can leak, a sound we call a murmur. Most murmurs require a stethoscope. An ultrasound of the heart (echocardiogram) can help your physician understand your mitral valve, the extent of the prolapsed, and if the valve leaks. The most common cause of a loud heart beat at night is extra beats. We can get extra beats from the upper heart chambers (atrium) called premature atrial contractions (PACs) or from the bottom chambers (ventricles) called premature ventricular contractions. When we get an extra beat that comes early, the heart will pause before the next normal beat is delivered. This allows the heart to have extra time to fill up with blood to make up for the early extra beat. The heart that has extra time to fill up can make a much stronger sound that in thin people or in a very quiet room can sometimes be heard outside the body. We all experience extra beats, but some people can have a lot of them to the point they can occur every other beat. We usually use a heart monitor that you wear overnight to see what is causing the symptoms, and if it is extra beats, how many you are having and from what location they arise.

Answer:

Atrial fibrillation does not increase your fathers risk of death if we take the appropriate steps to treat it. The first is that we need to prevent stroke. In your father, this was already being done since he has artificial heart valves. Next, like an muscle in our bodies, the heart muscle if it beats too fast can fatigue and develop what we call heart failure. We can prevent this by using medications that slow his heart rate at rest to below 100 beats per minute or as in the case of your father shocking the heart to restore his heart rhythm to normal. If we prevent stroke and heart failure, then atrial fibrillation treatment is largely to reduce symptoms and improve quality of life.

Answer:

It is a good idea to see a heart specialists. When young children have symptoms such as your sisters, we need to get a basic understanding of her electrical and mechanical heart function. We do this with an electrocardiogram and an echocardiogram. If these are normal, then we often use a heart monitor that she can activate when she feels her symptoms. These monitors help us to understand if an abnormal heart rhythm is causing her symptoms.

Answer:

I hope your grandmother is doing better and recovering from her stroke. A stroke can be caused from many different sources. A heart attack is typically not one of them. If a heart attack does lead to a stroke, it often is because of the heart attack causing atrial fibrillation of a severe weakening of the heart muscle. In our center, if somebody has had a stroke with often look at the heart function and monitor the heart rhythm looking for atrial fibrillation. We also do imaging of the head and neck to see if there are abnormalities (narrowings) in the arteries that may have resulted in the stroke. Depending on what is found, there are different treatment approaches. For example, if your grandmother has atrial fibrillation then we often start an anticoagulant such as warfarin to minimize risks of having more strokes. We can only use this type of therapy if there is not bleeding or fall risks. If she has a narrowed artery in her neck, then the treatment would be to try an open the artery.

Answer:

Success rates after ablation are lower if you are in persistent atrial fibrillation. However, in centers that are comfortable with ablation in those with persistent atrial fibrillation they are often 60-70%. In our center, we usually have a cut-off of 3 years to exclude patients for ablation. We will consider doing an ablation in patients with a longer history of persistent atrial fibrillation, but we often do a cardioversion on our strongest drug (amiodarone) to see if we can restore sinus rhythm before considering an ablation. From my perspective, you have only been in persistent atrial fibrillation for 8 months and the cardioversions did work, although for a short period, so an ablation is a viable option for you.

Answer:

Thank you for your question. In most of us, the left side of brain typically controls the right side of our body and important in our ability to speak and understand language. He may not only be experiencing difficulty expressing his own needs and wants, but understanding what you want and how to interact with you. His recovery will depend on how early treatment was started and care in a specialized center for stroke rehabilitation. Your father may have long-term limits as a result of his stroke. The goal in rehabilitation is to make him as independent and productive as possible. Recovery can be slow with potential improvements up to a year from the stroke.

Answer:

Thank you for your question. When our hearts become weaker, in particular, when the function declines more than 50%, we are at risk for many different types of abnormal heart rhythms. The most common rhythm is in the upper chambers of the heart, the atrium. When our hearts get weak, the pressure inside the heart goes up. This causes the upper chambers to become larger and stretch out. When the upper chambers stretch out they are more likely to experience a very fast chaotic heart rhythm called atrial fibrillation. If your father is experiencing atrial fibrillation there are medications and procedures (such as catheter ablation) that can be used to treat the atrial fibrillation and minimize the occurrences. More importantly, your father needs medications to prevent stroke if he is experiencing atrial fibrillation that he should use long-term. Also, when our heart gets weaker (>50% decline) then we are at risk from abnormal heart rhythms from the bottom chambers, the ventricles. These abnormal rhythms can cause sudden death. The best way to prevent sudden death if these rhythms have occurred is for your father to receive an implantable cardioverter defibrillator (ICD). This is a device similar to a cardiac pacemaker, but also has the ability to deliver a shock to the heart and stop these fast heart rhythms from the ventricles. The best approach is to have your father see a cardiologist who has additional training in the management of decreased cardiac function and the associated abnormal heart rhythms in the upper and lower heart chambers. Medications can be used to help strengthen the heart function or stabilize it, treat the abnormal heart rhythms, and as mentioned if atrial fibrillation is present to minimize risk of stroke.

Answer:

Thank you for your question. The best option is to contact your doctor and request a heart monitor. These monitors are designed to wear in the day and night and record abnormal heart rhythms both when you activate the monitor and automatically. Understanding what type of heart rhythm your husband is experiencing is very important. The most frequent heart rhythm we see if called atrial fibrillation. This heart rhythm can increase risk of stroke and often occurs at night. When is occurs at night your husband will also need to be screened for sleep apnea. Sleep apnea often occurs in people that snore at night, snore and hold their breath at night, and have fatigue and difficulties with high blood pressure in the daytime.