ASK THE NURSE
Arrhythmia & Palpitations
Question: I've experienced heart palpations before, but now I'm pregnant
and have been having them more frequently. When I have them I get
light headed, experience chest and throat pain and start sweating.
They last anywhere from 5 to 15 minutes and I've had three in the
past month. My doctor said not to worry, but to see him if they won't
stop. Should I be concerned?
Answer: If these symptoms are bothering you, which it sounds as if
they do, I would suggest you see your physician for an evaluation.
Question: I have mitral valve prolapse which I seem to manage fairly
well with rescue remedy for the panic though I've been to the ER 5
times in the last year... do you think prempro might be causing my
depression and or palpitations? I refuse to take atenolol it gave me
asthma and depression and calcium channel blockers gave me chronic
slowness. Also I had a TIA in January and am wondering about this prempro.
Answer: If you had your depression
and palpitations prior to taking PremPro, the answer is no. It does
not sound as if atenolol is a good
drug for you because of the depression and asthma. However, calcium
channel blockers (CCB) should help....but you complain of "chronic
slowness" . There are many CCBs on the market. If one doesn't
work, there are others to try. Was your TIA evaluated? What are you
wondering about PremPro? Did you think it caused a TIA? If you have
been on this drug for more than 2 years, then stopping it due to a
TIA is not necessary. However, if you recently started PremPro and
then had a TIA, there is a good argument for stopping it. I hope I
answered your questions. -JRS
Question: Has there been any evidence or studies that tie panic attacks
to premature ventricular contractions?
Answer: Anyone who experiences anxiety/panic has an outflow of stress
hormone called adrenalin. This can cause fast heart rates and possibly
premature atrial or ventricular beats. -JRS
Question: I am a nursing student looking for information on SVT. I
am looking for the actual signs to look for and what is going on with
the heart physiologically.
Answer: It is admirable that you are curious about the pathophysiology
of SVT, signs and symptoms, and management of SVT. I would advise you
to refer to Braunwald's textbook of Heart Disease. It is very interesting
reading. Good luck. -JRS
Question: Hi. I'm 23-years-old and have been diagnosed with PAC's.
I have had them for 4 years now. I was wondering is it safe to become
pregnant with this or is there complications that can occur?
Answer: PACs are not a contraindication for pregnancy. However, if
you are taking medication for the PACs, please discuss this with your
doctor/gynecologist before you get pregnant. -JRS
Question: I was placed on Rhymol about a year ago for a very fast heart
rate (prompting a visit to the ER in an ambulance) and since that time
have felt light headed from time to time. Last Friday I had several
episodes and when checking by blood pressure it was 106 systolic. Can
Rhymol lower your blood pressure so that you could have light-headedness?
Is there another drug that would be effective with fewer side effects,
Answer: There are multiple medications
for fast heart rates...finding the "right one" is tricky.
You need to discuss your lightheadedness and blood pressure with the
cardiologist who put you on Rhythmol. Then
a decision can be made if this is the best drug for you. -JRS
Question: I am a 26-year-old female
who was diagnosed with paroxysmal atrial tachychardia June of 2001.
I had had an anxiety attack from March 8th to March 10th of 2001.
I am 5'2" and 190lbs. I have
a large bone structure, so I am not petite in any way, except for
my height. I take 50 Mg of Zoloft and Orthotricyclene 28 each morning.
Before I started taking the Zoloft, I weighed 155lbs. I have 7 questions.
First: What is the exact cause(s) of paroxysmal atrial tachychardia?
Second: Which would come first, PAT, or anxiety? Third: What are
the ways of dealing with PAT? Fourth: What is the procedure for ablation?
Fifth: Is there any complications with the ablation to be concerned
about? Sixth: Is there any way of taking the weight off by changing
my Zoloft to another medication? Seventh: Will the anxiety subside
once the ablation is preformed? Thank you for your time.
Answers: Question #1: There are many
causes for paroxysmal atrial tachycardia (PAT) Please refer to all
of the previous questions and responses regarding
palpitations. Question #2: I don't know. You need to ask yourself that
question. Question #3: Please refer to #1. Question #4: Ablation is
a procedure in which the abnormal electrical tissue in the heart, which
causes the erratic heart beat, is eliminated by a radio frequency current
coursed through the tissue. It is usually done by threading small catheters
into the right side of the heart via a vein in the groin. The electrical
tissue in the heart is "mapped". When the abnormal tissue
is located it can be eliminated by radio frequency catheter ablation.
Question #5: There is a small risk of infection, bleeding, damage to
the heart valves, perforation of the heart, inflammation around the
heart, or the need for a pacemaker. Question #6: Changing medication
may not be effective in weight loss. The only method of weight loss
that I suggest is decreasing the number of calories you eat and exercising.
Question #7: If the palpitations are causing the anxiety...maybe. However,
you may need to further investigate other possible causes of anxiety.
Question: I am a 50-year-old woman
with a 20-year history of mitral valve prolapse. During the last 4mos
I have been going through a very stressful time with job layoff etc.
I have always had palpitations etc. symptoms & taken low dose beta-blockers. Lately, however,
I was feeling extremely tense like in waves. I noticed if I took 1
or 2 Excedrin migraine tablets a day I felt much better. I am no longer
drinking any coffee or other caffeine. I still was feeling very anxious & saw
my GYN. She felt I am probably in menopause & prescribed low dose
birth control. About a week after starting this I started having terrible
palpitations & skipped beats. After a couple of days of this I
stopped the birth control & it got better. Then yesterday at about
day 15 of my cycle it started up again with the palpitations. Especially
bad when I first stand up in the AM & move around or change positions.
I am pretty good while sitting. My Dr. gave me an EKG & listened
last time to my heart. Said was OK. I don't know what this position
thing is all about. I know this is very long, but could you please
give me a clue. I am currently on 100Mg Toprol. Increased from 50mg
atenolol about 2mos ago. Like I said maybe it is hormones due to menopause,
or the anxiety of a buyout and new job at this time. I also have a
9 yr old child. Thanks a Lot.
Answer: All of the things you stated can cause palpitations. However,
Excedrin Migraine has caffeine in it... and, as you are aware caffeine
can increase palpitations. For unknown reasons, during perimenopause,
palpitations can become more pronounced. -JRS
Question: Please tell me what you think continued irregular heart beating,
elevated white blood count and low (2.9) potassium levels are symptoms
of. I will be seeing my doctor for an explanation as well.
Answer: The first question that needs to be posed is: why is your potassium
so low??? Low potassium can cause erratic heartbeats. Are you taking
diuretics? Do you have high blood pressure? Are your WBCs high due
to infection or is there a more serious cause? These problems need
to be evaluated ASAP. Good luck, -JRS
Question: I've been having heart
palpations since 1995, I've had many EKG's and they come out normal.
I've worn the 24-holter monitor for 24 and 48 hours as well and they
came out normal. I'm having more episodes recently and last night I
was sitting eating dinner with my husband and I had a dizzy spell which
almost knocked me out. Also, I have been experiencing the chills as
well for many years. Do you have any suggestions? Could these three
issues be related? I'm 33 years old. I have a long history of allergies
and asthma. I think my doctor thinks I'm crazy. I just had a CBC/diff
done and all numbers came back normal. Thanks.
Answer: Did you have palpitations when you wore the Holter monitor?
If you didn't the test was not diagnostic. Did you feel palpitations
when you became dizzy? I cannot determine from the information I have
what is causing your symptoms. Sorry, -JRS
Question: I have started having rapid heart rate. I am not taking any
medications (prescription or over-the-counter). In just a few minutes
my heart rate can range from 98 to 158 then back down to 121 with no
changes in action, this does happen sometimes when I am lying in bed.
I also often times but not always, have the feeling that something
heavy is laying on my chest. I have been to a Cardiologist and was
hospitalized once for testing. Always, the results show that I am not
and have not had a heart attack. What is the explanation!!
Answer: Rapid heartbeats can be annoying. There are many things that
can cause rapid heartbeats (tachypalpitations). You stated that you
are not taking any over-the-counter or prescription drugs. Are you
taking any illicit drugs (amphetamines, stimulants) or ephedra - located
in some food supplements? Caffeine and chocolate can cause rapid heartbeats
also. Thyroid functions tests need to be done to determine if an abnormality
in your thyroid gland could be causing these rapid heartbeats. I would
assume that the blood tests were already done. Once the above causes
of rapid heartbeats are eliminated, other steps could be taken. If
the rapid heartbeats become too annoying or cause other symptoms (e.g.
fainting) you could be evaluated by an electrophysiologist (a heart
doctor who specializes in disturbances in heart rhythms). Good luck,
Question: I am 35 years old, with
a family history of heart disease. In April, I felt as though I had
a lump in my throat, and was subsequently diagnosed with reflux. The
pump inhibitor medicines they gave me did not work, and addition to
this I noticed heart palpatations. I dismissed the connection, but
also got off the medicines, and had been trying to make due without-hence
the palpitations stopped. The discomfort was so great that I again
tried the medicine weeks later-Aciphex to be precise-, and once again
the palpitations returned. THIS time they will not go away. For three
weeks now, I have been fighting this. In addition, I have left chest
pain, dizziness, lightheadedness, heaviness in my lower legs, and tingling
all over. With my family history of heart disease, you can imagine
my concern. I was told that I did not need an EKG because I had one
about a year ago, and it was normal. I wore a monitor for 24 hours
which showed an abnormal heartbeat----"but
don't worry about it." They put me on atenolol. I already have
low blood pressure, and felt worse! Now, I am on acebutenolol-third
day-, and of course see no improvement. I am told this medicine may
take weeks to show improvement. They actually had me scheduled for
a recheck in October-I changed it to next month, but wonder if I should
demand more tests now. I teach aerobics, and am considering quitting
because I am so lightheaded during my classes. The nurse said that
some people live with this forever, and it is really more of a nuisance
than anything. I have a news flash for her...it is MORE than a nuisance,
my quality of life has been greatly reduced in just three weeks, and
I am about to quit the job I love and have been doing for over 15 years!
Stress?? YES, anyone would have stress if their heart skipped a beat
24 hours a day, and each time it happens you feel the throb!! I do
not recall being stressed BEFORE this happened. Thanks.
Answer: I am sure that your symptoms
concern you. You sound as if you are at your wits end. Most irregular
/ skipped heart beats are not
dangerous.....but they are very annoying. Some people describe a feeling
of fullness in their throats when they occur. This could, in fact,
be diagnosed as reflux. Beta-blockers such as acebutolol (Sectral)
which you have been prescribed needs to be started at a low dose and
increased gradually. Keep in mind that stress can actually increase
the number of "skipped" beats. Other things that can cause
them are caffeine, chocolate, stimulants (ephedra in diet/food aids),
decongestants and decongestant nasal sprays. I would hope that you
don't smoke (given your committment to aerobics).....but if you do,
with your family history of heart disease, a stress echocardiogram
should probably be done. Good luck.......exercise usually decreases
the "skipped" heart beats. -JRS
Question: I am 32 yo female who has experienced PAC's prior to my monthly
menstrual cycle for as long as I can remember. It gets worse when I
am under stress, but as soon as my period comes, they pass. Also, when
I was pregnant they were frequent at the end of my pregnancy. Do you
recommend any vitamin that may alleviate theses PAC's. I have a total
workup/stress test, etc. that indeed confirmed that they are PAC's.
Is there a reason they occur prior to one's period? Is something low
at that time that makes them more frequent?
Answer: Frequently women complain about palpitations prior to their
menses. So, fear not, you are not alone. Needless to say, these symptoms
can be annoying. The cause is unknown. I am not aware of any vitamin
or food supplement that has been shown to eliminate or decrease PACs.
Caffeine and chocolate can precipitate palpitations. Medications which
are stimulants, such as Sudafed and neosynepherine nose spray, can
also cause irregular heart beats. So it would be wise to avoid these
things substances. -JRS
Question: Why do people's hearts' rates speed up and slow down?
Answer: Heart rates
increase and decrease in order to deliver the appropriate amoun of
ocxygen to the tissues of the body. Heart rate speeds up in
response to activity, emotions, fever, to name a few reasons. The heart
rate slows when less oxygen is needed by the body, such as, during
sleep, rest. However, some fast & slow heart rates may be a sign
of disease. -JRS
Question: Hi, I am 16 years old. Today is exactly 1 month since I have
been having my heart palpitations. I have been in and out of the hospital
but they don't know what is wrong with me until today. I went back
to the hospital and they told me that I might be having heart palpitations
due to my thyroid gland. They came to that conclusion because I took
a blood test two months ago when my knees where hurting and something
in my throat came up and the doctors called my house and asked did
I have a sore throat that day and I didn't and then I haven't heard
anything about it until now. I am going back to the hospital tomorrow
to do more blood test. But if it were possible would you please explain
to me how the thyroid gland is connected to me having palpitations?
Answer: Thank you for this insightful question. The thyroid gland has
a great influence on the heart. The hormone the gland produces controls
metabolism. Too much of this hormone results in increased heart rate
(palpitations), fatigue, irritability and muscle weakness, and weight
loss. If not controlled hyperthyroidism can lead to heart complications,
especially if you have any underlying heart disease. It is wise to
find out the underlying cause of the hyperthyroidism and treat it.
Question: Another question on palpitations! I am 34 and do have mitral
valve prolapse, hashimotos, and recently told I have the anti-body
that can turn to Graves. My thyroid has been in check 2.2 TSH for almost
a year now. My biggest concern is feeling skipped beats during exercise.
I have had extensive work ups, short of an EP study. They don't always
occur, but when they do it is usually at higher intensity aerobic exercise.
If it is too hot outside and I am running, they appear. I never noticed
this until the last couple of years. I have always been an athlete.
I also have a very slow heart rate 50 to 55 at rest. But when I start
exercising it shoots up quickly to 120. I don't go much over 160 for
fear of palpitations. Do some people just experience skipped beats
during exercise; do you know of any one? I do feel them at rest but
not everyday. I do notice an increase during ovulation and right before
my cycle. I miss exercising without fear.
Answer: You stated the palpitations occur when you exercise when it
is too hot outside. Perhaps you are dehydrated when they occur. Try
drinking a diluted sports drink, such as Gatorade, prior to hot weather
Question: My heart has a tendency to skip beats and it causes chest
pain that can last all day or only a little while. When it skips I
can't breathe and then after it feels as though I need to catch my
breath. When my heart skips it speeds up then slows dramatically within
20 beats. What is wrong with me?
Answer: "Skipped heat beats" occur
in many people without any heart disease. They are annoying and can
cause a sensation of breathlessness.
Skipped beats and rapid heartbeats can be caused by stimulants such
as caffeine, decongestants, chocolate; anxiety, abnormal thyroid function,
and structural heart disease can also cause this problem. You ask is
anything wrong with you.... I don't have enough information to answer
the question. However, I am concerned that you said the heartbeat dramatically
slows down when the skipped beats stop. This should be evaluated by
your physician. -JRS
Question: I have what feels like an extra heartbeat or a skipped beat...my
echo was normal...but my electrolytes were low...and my cardiologist
prescribed potassium since I am on vaseretic 10/15 once a day...but
after reading the side effects of potassium...I am afraid to take them...drink
orange juice almost everyday.... but recently they started again. Also...I
am almost 49...and have noticed that these start a day before.or the
day of my period...continue off and on for several days...then begin
again at onset of next cycle...also. I have felt these on rarely since
I was about 33...and was not too concerned even though they showed
up on my ekg when I wasn't feeling it.dr told me this was normal alot
of times for people who have high blood pressure...I wore the holt
monitor for 24 hr. which picked up a few.then the other night I sent
in some readings from the king of hearts monitor...haven't heard from
that yet...it scares me and I'm just wondering if you think it would
be to my advantage to try the pot. tablets...and how dangerous could
this be if my echo is normal...thank you
Answer: It sounds as if the low potassium is causing your abnormal
heartbeats. Please take the potassium as prescribed. It would take
8 feet of bananas or a half-gallon of orange juice to get the minimum
daily requirement of potassium (and that's a lot of calories!). Often
palpitations or skipped heartbeats seem worse prior to menses. The
mechanism of this is not fully understood...however, low levels of
potassium could make your symptoms worse. -JRS
Question: I am a 28 year old who is currently obese by about 80 lbs
but recently have lost 30lbs.I am doing it right and walking and eating
better... weight gain was cause by norplant, death in family, depression,
anxiety and pregnancies on top... well I have panic disorder and recently
have beginning to experience heart palpitations almost daily now...the
doctor has done ekg, chest xray, been to hormone doc etc.they most
frequently occur after eating a meal and when I am quiet or resting...
I feel like I am going to lose my mind as I am always focusing on I
am going to die a cardiac death... I am in therapy and I DO TRY NOT
TO LET THE PALPS BOTHER ME AS THEY DO SEEM TO PUT ME IN full-blown
panic... Do you have any information of heart palpitations and diet
like linking it to monosodium glutamate or additives like BHT in food
etc.? The last few times, they have been 20 minutes to 1 hour after
eating... I hate feeling this way and no one will listen to me... I
am told I am healthy for being overweight, low blood pressure, no sugar...very
mild elevated cholesterol. I am just looking for answers. Thank you
Answer: There are many
women who have asked questions about palpitations. Please refer to
any one of the questions and answers in the "Ask
the Nurse" file of Q& As. As for your question if monosodium
glutamate and bht can cause palpitations...I don't know. But, if you
think they are the culprits, eliminate these food additives from your
diet. Good luck -JRS
Question: I am a 37 year old woman - I went to my physician because
I was having what I thought was heart palpitations and pain on the
left side of my chest. She performed an electrocardiogram and discovered
Multiple Atrial Premature complexes. I then went to see a male cardiologist
who said because I was so young everything should be fine. He then
prescribed me on 20mg of Corgard and said come back in a month, only
if I did not feel better. Should I be satisfied or concerned??
Answer: Palpitations caused by premature atrial contractions
can be very upsetting. So, I understand your concern. However, most
are harmless. They can be caused by excess caffeine, chocolate, stimulants,
decongestants, or stress. Other causes of palpitations can be due to
thyroid disorders or structural heart disease. These problems can be
evaluated through a physical examination, blood work, echocardiogram,
or Holter / Event Monitoring (at-home heart monitors). From what you
said your cardiologist did not seem too concerned with your palpitations.
He gave you Corgard, which is a good medicine for the palpitations.
If you are not feeling better in a few weeks, make another appointment.
Then other evaluation and treatment options can be explored. Feel better!
Question: I am an asthmatic and have been prescribed aticand and triamter
due to heart palpitations a year and a half ago. I also have had high
blood pressure, which seems to be controlled. I am in perimenopause
and notice that all things considered, I feel better if I take a multivitamin
with B-levels for stress, calcium (1000-1500 mgs daily), magnesium
(450mg, vitamin E (400I.U.), fish oil (1000) and flax oil capsules
daily. I also take COQ10 and arginine. Are these safe? Do they cut
risk of inflammation and heart attack? There is a history of heart
problems on my paternal side, whether individuals are fat or thin,
and my mother's eldest brother died of a cerebral hemorrhage at 45.
Answer: Palpitations can be quite annoying... and frightening. Too
much caffeine (e.g. coffee, tea, cola, chocolate), medicines such as
decongestants (taken by mouth or by nose spray) and asthma inhalers,
mitral valve regurgitation (leakage) and stress can all contribute
to palpitations. If you have not had a complete evaluation already
to rule out dangerous causes for your palpitations, then this must
be done. If the palpitations make you feel dizzy or lightheaded, you
should ask your doctor for an evaluation by an Electrophysiologist
as well. An Electrophysiologist is a cardiologist (heart doctor) who
specializes in the evaluation and treatment of abnormal heart rhythms
and abnormal heartbeats. Use of over-the-counter supplements may react
with other medicines you are taking. Check with your doctor or pharmacist.
Question: When it is suggested to
take an "aspirin", should
that aspirin be chewed or swallowed?
Answer: It depends on the circumstance for which you are taking the
aspirin. It is suggested to chew the aspirin IF you are having chest
pain/angina or think that you are having a heart attack. Theoretically,
the aspirin will get into your system faster when it is chewed. - JRS
(Unless advised by your practitioner, women should not take a daily
aspirin. Aspirin use is not without risk)
Question: I am inquiring if it's safe enough and healthy enough to
take an aspirin every day, some say yes some say no, doctors and reports
seem to contradict themselves, which is it, safe or not. Also... if
a person has high blood pressure, are there any symptoms to indicate
Answer: There are usually no symptoms of high blood pressure until
it starts to cause kidney damage, strokes, and heart attacks. The jury
is still out on the benefit of aspirin in the prevention of first heart
attacks. However, there is a decreased risk of experiencing a second
heart attack and ischemic (clotting) stroke when a person takes aspirin.
Aspirin can cause stomach bleeding, hemorrhagic (bleeding) strokes
(especially in people with high blood pressure). This occurs more frequently
in the elderly. -JRS
Question: Is there such an illness as asthmatic heart and is it life
Answer: You asked what
is an "asthmatic heart" and is it
dangerous. Wheezing due to heart failure/pulmonary edema (an asthmatic
is due to fluid "backing up" into the lungs from the left
side of the heart. This is serious and needs to be evaluated and treated
by a cardiologist. This condition is different from (lung) asthma.
Pulmonary (lung) asthma causes wheezing (a sound caused by restricted
airways) due to constricted, inflamed, or mucous-filled airways. -
Question: My daughter, aged 15, suffers from asthmatic disease. The
doctor initially said that the disease could be healed but through
the years, it's getting worse. She has started using an inhaler. She
frequently suffers from chest pains and I'm wondering if there's any
other medicine available in store. I'm currently based in Italy, Rome.
Do you know of specialist doctors in Rome who we can visit?
Answer: You sound concerned about your daughter's asthma. I am sorry
to say that I do not know any physicians in Rome. However you do need
to find a pulmonologist (lung doctor). Prescription inhalers are not
all the same. Some help prevent inflammatory reactions to allergens
and some help open constricted airways. There are other medications
for asthma beside inhalers. However, these need to be prescribed by
a physician. Sometimes just controlling allergies can help asthma.
A lung function test needs to be done to determine what type of airway
disease your daughter has before specific drugs can be given. Yes,
asthma can cause chest pain. -JRS
Blood Pressure Management
Question: Is there a table of blood pressure vs. age both for the systolic
and diastolic pressures? Is there a table that links blood pressure
to the pulse? This is just for information and I would appreciate your
Answer: No on both questions. Blood pressure should be less than 140/90.
In diabetics it should be less than 135/80. -JRS
Question: I have very erratic blood pressure readings. They usually
follow a pattern with very high readings between 8 a.m. and ll a.m.,
with readings as high as 210/110. At other times I have low readings
with readings as low as 70/50. Most of the time the readings are in
normal ranges. The instrument, which I use to take the readings, is
accurate. I have Parkinson's and take Sinemet, Requip and Wellbutrin.
I am seventy-one years old. My physicians are baffled. Do you have
any possible explanation? If you require further information, please
Answer: Ambulatory blood pressure monitoring should be done. This test
is done with a calibrated machine over a period of time (24-48 hours).
You can keep a diary of your activities during the monitoring period.
Then the range of your blood pressures can then be evaluated. -JRS
Question: Hello...what would a healthy blood pressure be after jogging
or exercise? I know around 80-120 is a healthy resting ...but mine
goes to 190/100 after exercise...is this normal?
Answer: Your peak exercise
blood pressure is a bit high. It should be evaluated. Tell your doctor
what you told me. An (ordinary) exercise
stress test could give more information about your blood pressure response
to exercise...and it would be evaluated in a "safe" environment.
Question: My blood pressure is 170/110. My family doctor has put me
on Aticand. Is this blood pressure really high? What is the range for
a 39-year-old, 5'0, 132 lb woman?
Answer: Blood pressure should be below 140/90 for ANY adult. -JRS
Question: I am a female 66 years old. I am 50 pounds overweight, have
High Blood Pressure (on medications) I have high Cholesterol (on medications)
My doctor has recommended a low salt diet (2 grams sodium), how much
is that equivalent to? She also wants me on a low fat, low calorie
diet. She also said that I should buy water-based Salad Dressing? Do
you know of any such dressing, or recipe? Also are there recipes on
this site that would address all of the above health problems that
I have? Thank you for reading and addressing my problem in advance.
Answer: There are a few recipes on this site (go to newsletter page
and link to recipes). I would advise you to buy an American Heart Association
cookbook. A two-gram (sodium) salt diet is equivalent to 2000 mg. Read
the labels on the foods you eat. The salt content per serving is on
the label. Avoid canned or processed foods including luncheon meats,
snack foods (especially chips). The cookbook has information on label
reading. If you loose some weight and walk every day your blood pressure
will decrease. Water-based salad dressings are no oil dressings (every
tablespoon of oil is 100 calories!). The flavor comes from vinegar
and spices. -JRS
Question: I am 53 female with some problems with blood pressure and
my heart. I have had hypertension for 25 years and horrible blood fat
problems. Triglycerides 5000 without med. Cholesterol 900 without meds.
I am not overweight do not do drugs and am active but shortness of
breath and fatigue have really slowed me down. I am on Lopid 600mg
2x daily and Zocor 20 mg once daily Tiazac 240mg daily and Toprol xl
12 and a half mg a day. I also take Accolate for mild asthma estrogen
patch 0.025 mg and Previcid 30 mg for gerds. My echocardiogram showed
mitral regurgitation moderate, and left ventricular hypertrophy mild
concentric. my question is this I take my blood pressure 2xs daily
with a very accurate machine and the morning pressure and pulse are
always very high, I feel very relaxed when I take it but I don't understand
this, pulse is anywhere from 100 to 120 and pressure is 160 over 98
on an average, later in the day it is a lot better why is this, Any
help would be mostly appreciated. Thanks for your time.
Answer: Your BP and heart rate are probably elevated because your morning medications
have not yet taken effect......or perhaps the tiazac/toprol need to be adjusted.
Please keep a log of your blood pressure and heart rate. Share this information
with your cardiologist (I hope you have one). This along with your symptoms of
shortness of breath and fatigue need to addressed very soon. The shortness of
breath could be due to your asthma, mitral regurgitation, or elevated blood pressure...to
name a few reasons. Good luck, -JRS
Question: I recently went to the doctor for a check. This time my blood pressure
first reading was 160 over 90. Then it was 160 over 80 and the last was 155 over
80. My first thought was I had not eaten since 9:00 a.m.. This was 3:00 p.m.
I had just finished a 32oz. coke, plus I was kind of nervous. I had never had
a reading like that. She was not real concerned, but wanted me to monitor it
for 2 months. I did go to Wal-Mart to have it checked this evening, but I got
a couple readings, 145 over 90 and then 150 over 85, so I am really confused
and worried. What are your thoughts? My blood pressure is evidently fluctuating,
but I dont know why. Given the things I have told you let me know what your think.
Answer: Blood pressure varies, so the range of your blood pressure over the period
you specified is not uncommon. Yes, you should keep a close watch on your blood
pressure...it is a bit too high and may need to be treated if it does not stay
below 140/90. Weight loss and daily walks can help decrease blood pressure without
Question: Every time I have my blood pressure taken it is very
low (100/55), but my pulse rate is high. Usually, 88 to 92 beats per minute.
It seems to me that this doesn't appear to make sense. Is there a reason for
the differences or is this normal. I've always been in great shape. Although,
the last two years I have dealt with a pretty severe anemia problem. I was wondering
if this could have had anything to do with it and if my heart is at any risk?
Answer: Anemia can cause a fast heart rate and low blood pressure. -JRS
Question: Re: Blood Pressure readings
... I've seen numerous sites that describe the procedure for taking blood
pressure readings. Most agree that a person should be seated and at rest
3-5 minutes prior to the reading and Women's Heart Foundation indicates
that you should initially take pressure in both arms, etc. However, something
that SEEMS sensible, I've only seen mentioned once and that is that:
for accuracy, BP readings should be taken at least twice in a row, with
the readings being taken at least two minutes apart and those readings
then averaged to arrive at a more accurate result. I've been told that
BP readings taken one right after another (with NO "minutes" in
between) will cause the SUBSEQUENT readings to be inaccurate. Can you shed any
light on these issues? Thanks. Regards, GAR
Answer: You are correct in all of your statements. Quite a few years ago a study
was done. It stated that 95% of the people observed taking blood pressure did
it incorrectly. Frightening, isn't it? -JRS
Question: I have high blood pressure and in the early morning it reads about
190/80. I am presently following a doctor's prescription, using Acupril 20 mg.
Is there anything further that I can do? I am a female 80 years of age.
Answer: There are many medications that can be added to your Accupril to help
control your blood pressure better. Keep a record of your blood pressures 3 x
a day for a week and show it to your doctor. -JRS
Question: How serious is a blood pressure of 161/115 and a pulse rate of 118
Answer: It is a serious problem. -JRS
Question: I am a 78-year-old woman taking blood pressure medication. Dr keeps
changing it due to shortness of breath. Is their any blood pressure medication
I can take that would not cause me shortness of breath? I do have some emphysema,
but need to see if blood pressure medication would make this worse.
Answer: Thank you for asking me the most insightful, intelligent question which
has been posed to me so far on this FAQ! Blood pressure that is NOT in control
can cause shortness of breath. Your physician may be changing your medications
for optimum blood pressure control therefore trying to help decrease your shortness
of breath. Unfortunately some blood pressure medications may cause increased
wheezing and consequent shortness of breath. This can occur when some patients
are given beta-blockers, particularly those with asthma/COPD (Chronic Obstructive
Pulmonary Disease - also known as emphysema). But keep in mind that this particular
category of drugs does not usually cause shortness of breath. There is a lot
of trial and error when it comes to prescribing blood pressure medicines....
everyone responds differently to each medication. I would hope that you have
undergone an echocardiogram, pulmonary function tests and a stress test with
imaging in order to more thoroughly define the causes of your shortness of breath
and high blood pressure. If you have any further questions, please feel free
to ask. Good luck, -JRS
Question: I am a 42-year-old woman with high blood pressure. I have no way to
go to a doctor for this. I walk 2 miles everyday and that hasn't helped. Is there
anything else I can do? I eat a low fat, low salt diet. Please help. My blood
pressure goes from 150/107 to 170/110.
Answer: Blood pressures at that level are too high...and dangerous. It can lead
to stroke or heart attack or kidney damage. See a doctor, please. If you cannot
afford one, go to a local clinic. -JRS
Question: I have been going to the same doctor now for about 15 years. When I
first visited him I was about 30 and he told me my blood pressure was a little
high. He told me to cut back on salt and come back in 30 days for a follow-up
visit. With no other advice about changes in diet or exercising, after 30 days
he said my pressure was borderline high and prescribed some medication. Over
the past 15 years he has changed my medications at least 6 times and he always
says my pressure is high. Approximately 6 months ago he changed the medication
again and added a diuretic, Vitamin B-12 and Folic acid. Over time I started
to experience more dizziness and fatigue and dry mouth. I had finally had enough.
I stopped taking the medication, cut salt intake to less than 2000 mg per day
and started walking 45 minutes daily and reduced my total intake of all foods
and began to eat more fresh fruits and vegetables. I also eliminated caffeine
and alcohol and began checking my blood pressure twice daily. My digital monitor
consistently gives me readings of 125-130/75-80 and I feel much better. Everything
I read says do not stop taking your medicine, but if the medicine is making you
sicker and the doctor just seems to always want to change the medicine and conduct
more tests (which never turn up anything), what should one do? It is very frustrating.
Answer: It is commendable that you have been
able to control your blood pressure with a HEALTHY LIFE STYLE. Exercising regularly
and losing weight by eating healthful
foods can improve high blood pressure. Drugs are NOT always the "answer" for
this problem. Unfortunately, many people would rather take a "magic pill" than
try life style modification. You, on the other hand have taken the "road
less traveled" and have clearly been successful. Congratulations! - JRS