Dr. Ahmad Mustafa
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am concerned about the sodium blockade in my heart after using Amitriptyline and Diflucan. I am experiencing tachycardia, bradycardia, and shortness of breath. My heart rate is elevated upon standing. It increases up to 135 beats per minute. It settles down on sitting. At midnight, I wake up suddenly and my heart rate comes down up to 50 beats per minute. I went to emergency for four times and they could not identify the cause for the severity of TCA toxicity and drug interactions. I am terrified about the unidentified sodium blockade.
Hi,
Welcome to icliniq.com.
Changes in the heart rate can occur due to a physiological cause. But to be more authentic to know whether it is physiological or pathological, it is necessary to do some investigations. Serum electrolyte, ECG (electrocardiogram), 24-hour Holter monitoring, renal function test, and liver function test has to be done. We need to evaluate your issues through these investigations. If the breathing issues are correlated with your rhythm and rate issues, then we can say whether these rate issues are associated with Amitriptyline or there are some other rhythmic issues.
Patient's Query
Thank you doctor,
How is my respiratory health evaluated? Do I need to go to the ER? I am scared to sleep. How can I know whether I have sodium blockade or not? I am trying to save my life and I do not know what to do.
Hi,
Welcome back to icliniq.com.
If this drug is causing sodium blockade, then it can cause certain rhythmic problems. These rhythmic disorders can be manifested through ECG (electrocardiogram) and 24-hour Holter monitoring. If the breathing issues are related to sleeping, it can be physiological or it can occur due to decreased pumping power of the heart which has to be evaluated through an echocardiogram. If there is some electrolyte imbalance, it is seen on RFT (renal function test) and LFT (liver function test). Please feel free to ask me if you do not understand even now.
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Cardiology
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