Reader: I am a woman in my upper 60s and for years have had a faster-than-usual pulse, sometimes when I am at rest. Also, I have irregular beats that make me uncomfortable. I have seen a heart specialist who took an EKG but said it was nothing to worry about and that it was a "woman thing:' Should I ignore the irregularities or seek another opinion?

Dr. Zipes: There is an entity called "inappropriate sinus tachycardia' characterized by faster-than-normal beating of the normal pacemaker of the heart. This makes the EKG look normal except for the faster rate. For unknown reasons it occurs more commonly in women than men, which may have prompted your doctor's remark. The irregular beats may be related to the same disorder. I would recommend that you be evaluated by an electrophysiologist That specialist is a heart doctor with additional training in heart rhythm problems who should be able to diagnose your problem and treat it if necessary.

Premature Beats Are Quite Common

Reader: I developed premature beats from the top and bottom chambers of my heart about four years ago at age forty-five, several months after worrying about my husband's illness (he received two stents) and stopping smoking. I get about fifty a day, and they make me feel very nervous and scared. All tests check out fine. I take Sectral twice daily, which helps but doesn't eliminate all of the thumping. My questions are: How common is this, is there any reason, and will they go away?

Dr. Zipes: Premature beats as you describe are quite common in normal healthy individuals, particularly as they age, and tend to increase the older you get. As I have said before, the heart is not a Swiss watch and beats irregularly on occasion. It is likely that you will experience them from time to time for the rest of your life. However, in the setting of an otherwise normal heart (you said all tests checked out fine), they are only significant in that they make you feel uncomfortable. In your case, they should not be associated with an increased risk of heart attack, stroke, or death, and the best thing you can do is to learn to live with them. The most important thing you have done, however, is to have stopped smoking! Do not start again.

Please send your questions about heart health to: Ask Dr. Douglas Zipes, 1100 Waterway Blvd., Indianapolis, IN 46202.