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Recently I’ve been having
heart palpitations which
wake me at night. Most worrying
is when my heart misses a beat
and I lie there and fear it will stop
altogether. could you shed some
light on this?
Michael Byrne, Carlisle.
This must be unsettling and
my suggestion is that further
investigation is needed to get to
the bottom of the cause, so appro-
priate treatment can be offered.
in your longer letter you explain
that you have been advised to call
an ambulance if the sensations
persist for more than 20 minutes,
which is far from reassuring.
A resting electrocardiogram
(ECG) — a test that measures the
electrical activity of the heart to
check rhythm — showed that your
heart was normal at the time of the
tracing. however, this type of one-
off check is limited because it can’t
exclude coronary heart disease —
furring up of the arteries, which may
cause palpitations. Nor can it tell
you anything about the cause of the
episodes you have experienced.
Doctors need to capture and iden-
tify the rhythm of your heart during
one of the episodes, using a 24-hour
ambulatory ECG recording, some-
times known as a holter monitor.
At the innocent end of the
spectrum are ectopic beats, or
extrasystoles, which are normal,
but excessive runs may indicate a
thyroid problem. Other possibilities
include more significant rhythm
abnormalities, such as atrial
fibrillation, when the heart beats
too rapidly and irregularly.
in the meantime, you indicate
you have been prescribed statins
as your doctor has calculated you
have a 33 per cent risk of suffering
a heart attack or stroke in the next
decade (given your cholesterol
(^) Daily Mail, Tuesday, March 3, 2020
We aRe at a pivotal moment
in the discussion on whether
the UK should legalise
medically assisted dying.
From 2015 to 2019, 233 Brits
were forced to go abroad to
seek an end to living in pain,
and nearly 90 per cent of UK
people now favour a change
in the law to allow adults of
sound mind who are facing
profound suffering to opt
for a dignified death.
the Hippocratic oath, often
distilled down to ‘first do no
harm’, also enshrines a
commitment to alleviate
suffering. last year, the
Royal college of Physicians
adopted a neutral stance.
I received a survey on this
issue from the British Medi-
cal a ssociation last month.
But, now that medicine has
shifted away from paternal-
istic decision-making, to
involve the public in this
question is surely crucial.
write to dr SCUrr
n WRITE to Good Health, Daily
Mail, 2 Derry Street, London W8
5TT or [email protected]
— include your contact details.
Dr Scurr cannot enter into
personal correspondence. Replies
should be taken in a general
context and always consult your
own GP with any health worries.
in my view...
Let’s ask the
public about
assisted dying
i worry at night
as my heart
keeps racing
Dr Martin
SCUrr
aSk the gp
a
Q
levels). This may or may not relate
to the cause of the palpitations,
but do accept this advice.
Is tHeRe any cure for cold
sores or any likelihood of
one in the near future? I get them
intermittently and not only find
them embarrassing, but fear
passing on the virus responsible
to my grandchildren.
Bill Adair, by email.
COlD sores are caused by the
herpes simplex virus. More
than 60 per cent of adults are
infected at some point in their lives,
and it is transferred by infected
oral secretions, such as saliva.
Following an infection, the virus
establishes itself in local nerve
tissue. Once it’s in you, it is there
for ever. in up to 40 per cent of
cases, the virus reactivates through-
out life, usually as a cold sore.
Triggers include exposure to
sunshine and minor illnesses such
as colds. Other conditions that
undermine the immune system
can also initiate attacks.
Most people have warning symp-
toms a day or so before the cold
sore erupts, with pain, burning or
tingling at the site; blistering then
occurs, rapidly evolving into an
ulcer which crusts.
You are right to be concerned that
you could pass it on to others, and
the only way to prevent transfer is
to avoid skin-to-skin contact when
a cold sore is apparent.
There is no cure — not yet — and
no vaccine to protect against pri-
mary infection. The only treatment
is anti-viral drugs, which keep the
virus locked in a dormant state.
Z o v i r a x ( a c y c l o v i r ) c r e a m ,
available over the counter, is an
effective drug that stops the virus
becoming fully active — if applied
promptly at the start of an episode,
the momentum is interrupted
and the duration is shortened.
There have been trials looking
into preventative treatment for
those with recurrent attacks.
Acyclovir pills, when taken twice
daily for up to a year, have been
found to help people who experience
six or more attacks per year — but
there are concerns about using
antiviral drugs continuously.
i am sorry to be the bearer of not
very helpful tidings about the
possibilities of a cure.
a
Q