Dr. Chibitam Hope Obia
General Practitioner
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
Hello doctor,
My heart rate exhibits irregular fluctuations. I am prescribed Amlodipine 5 mg, Hydrochlorothiazide 25 mg, and Metoprolol 25 mg. I researched and found that Metoprolol has contraindications with both Amlodipine and Hydrochlorothiazide. Over the past five days, I have consulted four doctors, including a cardiologist, who confirmed that my heart is not the source of the problem. I have suffered from a rapid heart rate for two years, with no prior history of such issues. I was administered a bag of fluids and prescribed 10 MEQ potassium daily. I am experiencing symptoms of low potassium, low sodium, and dehydration despite engaging in a daily routine of walking two to five miles and losing 20 pounds. Seeking alternatives, I consulted a physician who reduced the Hydrochlorothiazide dosage to 12.5 mg. However, upon abstaining from the medication today, my heart rate escalated. My current blood pressure reading stands at 124/77 mm of Hg. Repeated visits to urgent care or the emergency room occur every few weeks due to medication contraindications. I am eager to discontinue these medications. Please help.
Thank you.
Hello,
Welcome to icliniq.com.
We feel glad that you reached out to us.
Based on your symptoms, you may be dealing with a metabolic syndrome, given the observed low levels of potassium and sodium along with dehydration. Metabolic syndrome is a cluster of conditions, including high blood pressure, elevated blood sugar, excess body fat around the waist, and abnormal cholesterol levels, which collectively increase the risk of heart disease, stroke (a sudden interruption of blood flow to the brain), and type 2 diabetes (high blood sugar levels). These imbalances in electrolyte levels have likely contributed to heart arrhythmias (irregularities in the heart's rhythm), leading to an elevated heart rate.
I suggest against resuming any of the medications you previously mentioned, as they are used for primary heart diseases originating from the heart itself. Instead, I suggest the following:
Take one tablet of KCL (Potassium chloride) 50 meq/l orally once a day.
Begin an intravenous normal saline (NaCl) infusion with a one-gram start. Consult your doctor and take medications accordingly.
Additionally, I urge you to schedule another appointment. This will allow us to discuss various therapeutic options tailored to your specific conditions thoroughly.
I hope this helps.
Revert in case of other queries.
Thank you.
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General Practitioner
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