Q: My doctor says I have too many heart beats on the lower part of my heart. I’ve been given metoprolol 25 mg for high blood pressure which lowered my pressure but the palpitations still remain. I get a spinning feeling when I lie on my left side only and it’s very scary. I’m told it’s anxiety. I don’t know what to do. I’ve had several tests for my heart and the only thing they found is that I have extra heart beats. What can I do to get some relief?
I also take travatin for glaucoma. Please help and thank you for your advice.
A: There are a number of reasons for a person to experience palpitations, including heart problems, anxiety, stress, specific medications such as cough or cold remedies that contain pseudoephedrine, using an asthma inhaler, caffeine, nicotine, hyperthyroidism and exercise. Some palpitations are symptoms of arrhythmias (problems with the rate or thyrhm of a heartbeat). However, less than half the people who have palpitations have arrhythmias. Your palpitations are felt when lying on your left side, yet they may also be felt in the neck, throat or chest, can be observed when standing or lying down, and when active or at rest.
An enlarged thyroid can be seen with both hypothyroidism and hyperthyroidism and palpitations are observed with hyperthyroidism. My guess is that your physician did that and ordered either a resting or stress electrocardiogram (EKG). He or she may also have ordered a Holter monitor. A Holter is essentially a 24-hour-a-day EKG device similar to a pager worn by ambulance personnel or fire department members. If you underwent that testing and no abnormality was detected, the next step might have been to use an event recorder. The device is worn on a belt or waist line as much as possible each day and for as long as it takes for symptoms to appear. In some instances, it may be necessary to wear the device for several weeks, unless symptoms present earlier.
Travatan has numerous possible side effects, including nervousness, lightheadedness when arising from a lying or sitting position, chest tightness, a rapid heartbeat for some and a slowed rate (under 50 beats per minute) for others. However, non-ocular side effects are quite rare, so it may be worthwhile to consult with your ophthalmologist to discuss the possibility of Travatan being related to your symptoms.
Because you have been told your palpitations are triggered by stress, you may choose to make some lifestyle changes. Take steps to avoid issues that trigger an attack. If you encounter a situation, find a safe spot in your home where you can relax and listen to soothing music, read a book, or meditate. Perhaps a walk around the block or a phone conversation with an understanding friend will get you back on track. Avoid stimulants found in such things as illegal drugs, energy drinks, caffeine, nicotine, herbal supplements, and over-the-counter cold remedies.
Finally, I recommend you take your paperwork to a cardiologist for a second opinion. If the second opinion concurs there is no underlying heart problem and anxiety is the probable cause of your palpitations, some lifestyle changes to reduce stress – along with some reassurance from your health care provider – should be your next step. All this may appear overwhelming but your doctors haven’t been able to help and your problem continues. If you are assured of your diagnosis and don’t suspect underlying cardiac concerns, you owe it to yourself to make necessary changes. Good luck.
