Q. What is causing racing heartbeat and arrhythmia with swelling of legs?

Hello doctor,

Elevated blood pressure first detected at age 18 (runs in family on maternal grandmother's side). Never really treated until age 72 (anesthesiologist requirement prior to cataract surgery). Lisinopril 20 mg and Amlodipine 10 mg. Continued until age 76 with doctor altering dosage and frequency as that medication gradually seemed to lose effectiveness. At that point, intermittent racing heart beat and arrhythmia began to develop, accompanied by total loss of stamina (and sometimes near-fainting and nausea) after about five minutes of any sort of physical exertion. Based on his ECG tape, PCP diagnosed that as a-fib and did a cardiologist referral. Cardiologist looked at that same tape and said it is not a-fib. Might be any one or six or seven other things, but I cannot diagnose it when it is not happening. Next time it happens, go right over to your PCP and have them do an ECG, then come back here with the tape. That did not seem to make much sense. Thinking that might have been caused by the long-term use of Amlodipine, the PCP switched medications to Verapamil 180 mg and Carvedilol 6.2 mg. Those symptoms then seemed to go away for a while. Meanwhile, I experienced a ruptured Achilles tendon, and a minor Lacunar stroke (which permanently disrupted the pressure sensitivity of the skin on my left side from head to toe.) When the racing heartbeat and arrhythmia began to return intermittently about a year ago, I then discontinued all medication. The racing condition is now more or less constant, with the arrhythmia seeming to come and go (I can observe this using a mirror to view the right-side of my neck), the lack of stamina now seemingly permanent, a slight swelling of the lower legs and feet, shortness of breath upon reclining, and chronic insomnia. I am reluctant to get involved with the PCP again, expecting the same routine, rushing in for a quick examination (they give him 11-minutes), scheduling a bunch of laboratory tests at the local hospital and maybe another referral to the cardiologist, all with the same ultimate result, since these providers, well-intentioned as they might be, are not really allowed enough time to evaluate the problem and make a studied diagnosis..