Resolved question:
I'm a 35 year old stay-at-home mom. Last week, I was diagnosed with sinus tachycardia after pulling my son on a sled through the snow landed me in the hospital. All bloodwork (including a d-dimer test since I had traveled twice in the past year) came back normal. I was unable to take a stress test because my HR went up to 162 just from standing! They did an electrocardiogram, which was completely normal. I was put on Bisoprolol 2.5mg, but two days later I was rushed to the ER again because of severe heart palpitations and symptoms similar to a heart attack. My dose was increased to 5mg. I also had a GI endoscopy due to upper abdominal pain. My HR went up to 200 while they were performing the procedure. I was also diagnosed with gastritis and put on PPI's twice daily.
My appointment with my cardiologist is next week, but I've been experiencing some different symptoms. I'm not tired, but I do get winded easily and a tightness in my chest...even when just talking on the phone. I get minor aches in my chest upon exertion, and feel like I have to stop. Waking up in the morning is the worst! I feel discomfort in my chest and feel almost as if my heart isn't beating at all (low HR?). Are these symptoms all related to the Bisoprolol?
Submitted:
4 Days
Category:
Cardiologist
Hello
Thank you for your query at doctorspring.com
You seem to be suffering from an arrhythmia which may be sinus tachycardia.
Usually sinus tachycardia occurs when there is exertion or anxiety. Ifit occurs in other situations it is inappropriate sinus tachycardia.
However the diagnosis of sinus tachycardia needs to be confirmed. A rate of 200 per min at age 35 is unusual for a sinus tachycardia.
A rate of 200 would fit in more with some supraventricular tachycardia.
An upload of the ecg with rate 162 would be helpful.
Bisoprolol may cause fatigue and weakness but not chest pain. You can easily confirm if yhe symptoms are bisoprolol related by just measuring your pulse rate. If tye pulse is below 60 then you are probably having an overdose of bisoprolol and needs to be reduced. If similar heart rates if 160 to 200 are documented then its more likely to be related to the arrhythmia.
Kindly upload the ecg which demonstrates the tachycardia if possible.
Regards
Dr Vivek Mahajan
Thank you for your response and insight. Unfortunately, I don't have the ECG results as they are in my file at the hospital. I should also add that I had an ultrasound of my heart, and they found no abnormalities. The 200 HR was during a procedure, so I think the doctor contributed that to anxiety. If I did have supraventricular tachycardia, would that show up on the heart ultrasound?
Hello
Of course the tachycardia could well have been a sinus tachycardia. Just that the features like rate of 200 although possible with sinus tachycardia is more likely with a supraventricular tachycardia. Yes and sinus tachycardia can occur along with the anxiety related to the procedure.
Its okay if you dont have the ecg.
What you could do is that whenever you get another such episode you could get an ecg done and upload it to us.
Beta blockers should be of help.
Supraventricular tachycardia cannot be diagnosed on echo.
Regards
Dr Vivek Mahajan
DM Cardiology