I have thyroid problem, my HR and BP fluctuates often. Why?
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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 had a highly varying HR (63 to 128 beats per minute at rest) and BP (109/78 mmHg to 154/104 mmHg at rest) for around three days. I consulted my doctor on the third day and started taking Propranolol 20 mg thrice daily for seven days and twice a day after seven days. Yesterday night onwards, I was having discomfort and slight pain in the chest. Please help.
Hi,
Welcome to icliniq.com.
As seen in your brief history, there are some fluctuations in your blood pressure as well as heart rate. I would advise you to get an ECG done as soon as possible as we have to see what sort of heart rhythm are you on. The doctor who has suggested you Propranolol must have done your ECG. So, if it is a sinus rhythm (normal fluctuating rhythm), then it is not much to worry about. But, if it is some sort of abnormal rhythm (arrhythmia), then it has to be taken care of. Secondly, Propranolol 20 mg thrice a day is quite a heavy dose. Propranolol 10 mg twice a day should be started and should be increased every week if required. If you are having chest discomfort after having Propranolol, then just drop the medication for this morning and noon and see if you are normal. As of now, I would like to have a detailed history of you as cardiology suggestion can only be given after taking a detailed history. What is your age? Is there any history of early onset of cardiac disease in your family? From how long are you hypertensive? Are you an anxious personality? How is your sleep? Do you have heartburn or gastritis or or flatulence very often? Please explain your lifestyle? Do you smoke or drink alcohol? Do you have any history of arrhythmias in the family? Was Propranolol advised by your GP or cardiologist?
Patient's Query
Thank you doctor,
I had an ECG before Propranolol was prescribed and it was suggested by a retired professor of medical college, a general physician. I am 31 years old. In my family, my father has undergone gone heart bypass at the age of 59 and my paternal grandmother is living on pacemaker. And, several others in the paternal family suffered with heart related problems. I am a vegetarian and I do not smoke or drink. Usually, I have good sleep, but mostly at late night. Nowadays, I am having nearly 4 to 5 hours of disturbed sleep. I am not under any kind of medication except Thyronorm 75 for thyroid for the past 3 years.
Hi,
Welcome back to icliniq.com.
When we treat a patient for hypothyroidism, we use to monitor the TSH (thyroid-stimulating hormone) level for every three months. Elevated levels of TSH can cause palpitations. Do not go for any cardiac test right now. Send me all your previous reports of thyroid profile. Your palpitations are most likely because of elevated TSH. Keep taking Propranolol 20 mg twice a day and get a thyroid profile done.
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