Patient's Query
Hello doctor,
I am a 21-year-old, and I have had an increased heartbeat for four years. I feel anxious all day, and now I am having a blood pressure of 160/90 mm Hg. I had a checkup last year for the same reason for which my ECG (electrocardiogram) and thyroid were normal, and the doctor suggested a tablet of Alprazolam, but it is too addictive. Whenever I try to reduce the dosage, I start feeling like before. What should I do? Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern. Some of the common causes of palpitation at a young age can be due to strong emotional responses, such as stress or anxiety. Extra-cardiac stimulation of the sympathetic nervous system (inappropriate stimulation of the parasympathetic nervous system, particularly the vagus nerve, which innervates the heart) can be caused by anxiety and stress due to acute or chronic elevations in glucocorticoids and catecholamines hormones, overuse of nicotine and caffeine, overactive thyroid gland (hyperthyroidism), an abnormal heart rhythm (arrhythmia).
Arrhythmias may include very fast heart rates (tachycardia), unusually slow heart rates (bradycardia), or an irregular heart rhythm. Common abnormal heart rhythms are ectopic beat, premature atrial contraction, junctional escape beat, premature ventricular contraction, atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, and heart block. Palpitation may be associated with electrolyte imbalances of magnesium, potassium, and other salts in serum. Gastrointestinal distress, such as bloating or indigestion, along with muscular imbalances and poor posture, can also irritate the vagus nerve, causing palpitations. The above-mentioned reasons can be a cause of palpitation and lightheadedness in your case. Yes, you should definitely be concerned about it; a thorough investigation should be done to rule out the exact cause of palpitation.
I would suggest you get the following tests. A thyroid profile is done to rule out hyperthyroidism, and 24-hour Holter monitoring is performed, which will record the ECG (electrocardiogram) continuously during a 24-hour or 48-hour period. If palpitation occurs during this period, it will be recorded in ECG recording, and we can rule out the cardiac rhythm at the time. For this type of monitoring to be helpful, palpitation must be occurring at least once a day. If they are less frequent (you have not mentioned the frequency of palpitations), the chances of detecting anything with continuous 24, or even 48-hour monitoring are substantially lowered. More recent technology, such as the loop recorder, allows continuous recording for up to seven days. This is a very important and basic test for someone who presents with palpitation as the main symptom. It will rule out the possibility of arrhythmia, which is the most dangerous cause of palpitations and can sometimes be fatal.
Also, serum electrolytes, a disturbance in serum electrolytes can cause palpitations, but they can be corrected easily. The above-mentioned investigations are the basic tests that can be helpful in finding out the cause of palpitations. I suggest you do the following. Quit smoking and limit excess alcohol. Exercise daily for 45 minutes. Avoid oily, fatty, and spicy food for some days. Include fibers in your diet. In case of elevated anxiety levels, I suggest you consult a cardiologist, discuss with them, and take the medicine Benzodiazepine.
I hope this helps.
Please revert so I can assist you further.
Thank you.
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Answered byDr. Rishu Sharma
Medically reviewed byDr. K. Shobana
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