Seeking Answers for Worsening Tachycardia
At the age of 23 and weighing 140 pounds, I am currently prescribed metoprolol, varying between 12.5 and 25 mg daily. Recently, after a five-day course of an inhaled steroid (Trelegy), I have been experiencing worsening tachycardia without any clear explanation from multiple specialists, including those in primary care, cardiology, electrophysiology, endocrinology, and neurology. Today, I took 37.5 mg of my medication but lie in bed wide awake, as my heart rate exceeds 100 beats per minute. This ongoing situation feels unbearable; I frequently experience deep-seated anxiety alongside intense palpitations and fluttering sensations. Typically, my medication alleviates these symptoms, but today, it seems ineffective. All conducted tests—such as echocardiograms, Holter monitors, EKGs, stress tests, complete blood counts, thyroid evaluations, and ANA tests—have returned normal results. The only exceptions were my failure on the tilt table test and some irregular lab findings indicating elevated DHEA and an abnormal aldosterone/renin ratio. However, the endocrinologist stated that a definitive diagnosis cannot be made at this time. I would greatly appreciate any suggestions for additional tests or insights into what might be causing these troubling symptoms.
Answers (1)
6/23/2025, 4:40:40 AM
OpenHealth AI
It sounds very distressing to be experiencing worsening tachycardia, especially after consulting multiple specialists without clear answers. Managing your heart rate and addressing your anxiety are essential, and I admire your proactive approach in seeking insights. Let’s break this down to understand your situation better and provide some actionable steps.
Main Points
- It’s crucial to manage both your tachycardia and anxiety.
- Your recent symptoms may potentially be influenced by medication, especially with the inhaled steroid and metoprolol dosage adjustments.
- There’s a need to monitor specific symptoms and consider practical self-care strategies.
Explanation
Tachycardia, or an elevated heart rate, can have various causes, including medication side effects, anxiety, dehydration, and other metabolic or hormonal imbalances. Given your history of normal tests except for elevated DHEA and the abnormal aldosterone/renin ratio, it’s understandable these symptoms remain puzzling. Additionally, recent changes in your medication or the inhaled steroid could trigger or exacerbate these symptoms.
Elevated DHEA (dehydroepiandrosterone) and abnormal hormonal tests can suggest an adrenal response that might influence heart rate and anxiety. Understanding how these play into your overall health could be key.
Next Steps
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Monitor Your Heart Rate and Symptoms:
- Keep a diary of your daily heart rate, noting times of high rates and any activities or stressors coinciding with those spikes. Include your feelings of anxiety, as this can help in understanding triggers.
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Evaluate Medication Effects:
- With any new symptoms, consider discussing the interactions between your metoprolol and Trelegy with your healthcare provider, particularly regarding how this combination affects your heart rate.
-
Anxiety Management:
- Incorporate relaxation techniques to help manage anxiety, such as deep-breathing exercises, mindfulness, or gentle yoga. These can help reduce heart rate during stressful episodes.
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Stay Hydrated:
- Ensure you are drinking enough fluids, as dehydration can lead to elevated heart rates. Aim for at least 2 liters of water daily unless otherwise directed.
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Consult with Your Endocrinologist:
- Given the abnormal gender hormone levels, follow up with your endocrinologist regarding the elevated DHEA levels. Further testing could be necessary to explore possible conditions related to those findings, such as adrenal gland function.
When to Seek Immediate Help
- If your heart rate continues to exceed 100 beats per minute consistently, or if you experience severe symptoms like chest pain, shortness of breath, or fainting, please reach out for immediate assistance.
Remember that managing your health can require patience, and it’s important to be gentle with yourself during this time. Each small step can lead to greater clarity and relief in how you feel. If you have more questions or need further clarification, feel free to reach out.
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