What are the best strategies to manage palpitations?

Question

Hello doctor,

I am a 44-year-old female with heart issues and a family history of heart attacks and heart aneurysms. I have hypertension, and I have been treated with Amlodipine 5 mg and Metoprolol 25 mg in the morning and 12.5 mg in the evening. I also have PVCs (premature ventricular contractions), PACs (premature atrial contractions), and occasional SVT (supraventricular tachycardia). I quit smoking two years ago. I have no drug use. I am an occasional drinker, less than eight drinks a week. Although I have a past history of excessive alcohol intake up until a week ago, my blood pressure was normal.

In the past, I had a hiatal hernia, removal of the gallbladder, and GERD (gastroesophageal reflux disease). Currently, I am on Esomeprazole 40 mg, multivitamins, and a probiotic. I am also a pre-diabetic with lipase ranging from 74 to 114 over the past two years with no explanation. Over the past week, diastolic has run consistently from 88 to 100 mmHg, with an average of about 93 mmHg. I have increased palpitations that are erratic and in blocks of an hour or so, about four times a day, that have been occurring as well. What could be causing this? My cardiologist ordered a 24-hour Holter, but that seems to be dismissing this.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

The cause of your palpitations may be related to the use of GABA (gamma-Aminobutyric acid). One of the potential side effects of GABA is anxiety, which can contribute significantly to palpitations. This could explain why the Holter monitor has not detected any irregularities.

Regarding your diastolic pressure being as high as 100 mmHg, while this is a common occurrence, it is not necessarily dangerous. However, I strongly recommend you focus on losing weight, as this will greatly help you achieve more stable blood pressure and reduce your reliance on medication. If your weight does not decrease, your need for antihypertensive medications may increase over time.

Please consult with your physician about GABA, as they may be able to suggest an alternative with fewer side effects. Additionally, I recommend getting an EKG (electrocardiogram) to rule out any other potential causes. Please follow up with your EKG results.

Best regards.

Answer 2

Hello,

Welcome back to icliniq.com.

High blood pressure and SVT (supraventricular tachycardia) are common causes of palpitations. May I ask if you experience these palpitations while taking medications such as Metoprolol? Have you recently increased the dosage of Metoprolol? Have you been dealing with any psychological or emotional stress during these episodes? I recommend doing an electrolyte test and an ECG (electrocardiogram), as these tests can help identify the underlying cause of your palpitations.

Regards.