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What is Holter monitoring?

Q: I am a 38 year old male, 5'8'', 74 kgs in weight. I was diagnosed as having hypertension (150/100) around 6 years back and was having Enalapril maleate for 2 years after which for 3 years now I am having Atenolol 50 mg once in the morning and Alprazolam 0.5 mg every night as advised by my doctor. I invariably feel exhausted and fatigued, and also irritable and have slight memory loss and slight slurring. There is numbness in the extremities and tingling on one side sometimes. I have been monitoring my blood pressure for 2 months regularly now and it seems to be at 130/74 on an average though it rises to 140/85 after dinner. My pulse rate, which was around 90 before I started taking Atenolol, is now 68 or so and falling to 58 sometimes after rest. I am a vegetarian and my cholesterol levels are normal. I chew tobacco occasionally. Recently, when I went to get my BP checked the doctor felt there was some irregularity and said that I may have to take a holter test. I have learnt that holter test is a 24 hour monitoring of the heart rythm. What is this condition, is it serious and is my medication OK? Is it affecting my brain? I was asked to get a CT scan done sometime back, when I reported weakness and tingling on one side of the body, but then when I went for a second opinion, another physician told me that it may not be necessary. What should I do under the present circumstances? I worry and brood a lot by nature, and feel depressed sometimes. I also have acute acidity for which I take Omeprazole occasionally, also with the advice of the physician.

A:It is very likely that you are not tolerating Atenolol (beta blocker) very well, many of the symptoms you have described could be drug induced. ACE inhibitors like Ramipril or Enalapril which you were taking earlier may be more suited. You should get in touch with your treating physician with this suggestion. Regarding Holter monitoring, it is a simple 24 hrs monitoring of the ECG which may help in quantitating the irregular heart beat and diagnosing the kind of missed beats you get.

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