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DEAR DR. ROACH: I am 82 years old and still very active. I have had an irregular heartbeat for four years, and sometimes I feel lightheaded, dizzy or tired. I worry about it getting worse. Would you please give a detailed explanation about irregular heartbeat, including how or why it happens? What should I do to prevent it from getting worse? Is it life threatening? Will it become atrial fibrillation?
Also, I am a chocolate lover and eat dark chocolate every day. But I was told that cocoa will make my irregular heartbeat worse and I should stop eating dark chocolate. Is that true? – Q.Y.
ANSWER: Everyone has irregular heartbeats from time to time. Early beats can come from electrically active areas anywhere in the heart, and an electrocardiogram can tell whether they are from the atria (the top chambers) or the ventricles (the bottom chambers) of the heart.
An average person may have 500 or so of these a day – some people have many more. Most are seldom aware of them. Having patients with this concern over and over during my career, I can reassure you that most cases turn out to be nothing to worry about.
However, the fact that you are having symptoms, especially the lightheadedness and fatigue, is a warning sign, and I recommend you get an evaluation. Start with your regular medical provider, after which you may be referred to a cardiologist. The EKG in his or her office is a first step, but you may need a longer evaluation, such as wearing a 24-hour EKG (a Holter monitor) or newer technologies that allow longer readings.
Atrial fibrillation is a concern, because most people will need treatment to reduce stroke risk or to return the rhythm to normal. Nevertheless, there are many other kinds of irregular heart rhythms, and you need a diagnosis first. If no cause is found, there are medications to reduce the irregularity, but they are seldom used. My experience is that when a person knows they are not dangerous, they can be lived with more easily.
Chocolate does contain theobromide, a substance that can make the heart a little more irritable, but it takes a lot of chocolate to have a significant effect. It’s related to caffeine in coffee. Interestingly, a recent study found that chocolate lovers are less likely to develop atrial fibrillation, so the situation is more complex than just one chemical.
DEAR DR. ROACH: I read that drinking warm lemon water with honey has many health benefits, partially because lemons are an alkaline food. Is this correct? – B.W.
ANSWER: I think I saw the same article. Lemon water may have some health benefits, but it is not an alkaline food, and drinking it has almost no impact on the acidity of your blood or urine, because the body’s buffer systems (the chemical processes used to keep the pH carefully regulated) are so effective. Lemons have a pH of about 2, so they are highly acidic. Ascorbic acid (vitamin C) makes the urine more acidic.
There is no consistent evidence that the foods we eat have a health benefit due solely to their effect on body pH. Many of the foods recommended for their supposed alkaline effects are indeed healthy, but for other, complex reasons apart from pH.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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