Question: My doctor says my weakness is due to cardiomyopathy. He has given me tablets but no explanation. Can you help?
Most medical problems that have long fancy names can have those names dismembered into their Latin and/or Greek origins to reveal their meaning. Cardiomyopathy means heart muscle disease (cardio = heart, myo = muscle, pathy = disease). Diseases and weakness of the heart muscle are very common in older people due to the ageing process. Medications such as digoxin, ACE inhibitors and a number of others, may be prescribed to strengthen the heart muscle and make it contract more efficiently.
Almost any disease from an infection to a heart attack can cause cardiomyopathy, and so the term is often used when the exact nature of the heart disease present is unknown. I am sure that your doctor will have prescribed something to help your heart, and therefore ease your lethargy.

Question: I have an irregular pulse (1-2 seconds silence every few beats), and and I can hear the pulsation in my ears. Why would this be so? My pulse rate is 90 to 100.
Your heart is showing signs of strain, and a poor conduction of nerve impulses. In most cases, dropping the occasional heart beat is of no consequence, and only reassurance is required from your general practitioner, but in other patients, particularly in those with a relatively rapid heart rate, there may be cause for concern.
Most cases can be corrected by taking one or two tablets a day that strengthen and regulate the heart rate. You should discuss this problem further with your doctor. To ensure that if treatment is necessary, it is given sooner rather than later.
Hearing the pulsing of your heart in your ears is normal, but most of us block out that noise subconsciously. Anyone who concentrates in a quiet environment can hear their heart beating. It may be louder in those who have hardening of the arteries, and so older people tend to complain quite frequently about hearing their heart beat.

Question: What causes the heart to miss a beat now and then? Is it dangerous?
If a piece of heart muscle is taken from the body and kept alive in a nutrient solution, it will spontaneously contract at about 40 beats per minute.
There is an area near the top of the heart that is made from a complex network of nerves. This is the natural pacemaker of the heart, and it sends electrical signals to the heart muscle to contract at faster rate of approximately 70 beats a minute. This pacemaker is itself controlled by nerves running to the brain, so that anxiety and exercise can cause the heart to beat faster. Certain chemicals in the blood stream can also act on the pacemaker, and the heart muscle itself, to alter the rate at which the heart contracts. It is therefore a very complex process. The occasional dropped (missed) heart beat is due to a blockage of the nerve signal to the heart muscle, a lack of signal from the pacemaker, chemical disturbances in the body and many other factors. Alcohol, smoking, drugs, caffeine, high blood pressure and several diseases can all cause missed heart beats.
If the dropped beats occur only once every minute or so, there is no cause for concern, as this is a common phenomenon, particularly in older people. If you find that every third or fourth beat is being missed, you should be under regular medical care and probably on medication. Patients with problems within these extremes should discuss the matter further with their doctor. S/he will almost certainly perform an ECG (heart electrical test) and probably order blood tests to exclude any serious disease. The treatment will depend on the result of these tests.
Missed heart beats are not in themselves dangerous, unless they become very frequent.