Concerns About Morning Heart Rate Drops
A 30-year-old female, previously a smoker and abstaining from drugs and alcohol, seeks advice about a troubling situation regarding her heart rate. She has a history of various health conditions, including Hypermobile Type Ehlers-Danlos Syndrome, suspected Postural Orthostatic Tachycardia Syndrome (POTS), tachycardia, fibromyalgia, venous insufficiency, deep vein thrombosis (DVT), and superficial clotting, but no genetic clotting disorders have been identified. Currently, her medication regimen consists of: - In the morning: Metoprolol 12.5mg, Vyvanse 30mg, and Eliquis 5mg. - Midday and evening: Recently initiated low-dose Naltrexone, currently at 4.5mg. - At bedtime: Clonazepam 1mg and another dose of Eliquis 5mg. Since beginning the low-dose Naltrexone, she has experienced significant drops in her heart rate during the morning hours, sometimes falling to the low 50s and even the 40s. These episodes only occur shortly after waking, around 7-9am, with the most recent drop reported at 9am, where her heart rate plummeted to 35 beats per minute prior to taking her morning Metoprolol. During these episodes, she has experienced fleeting face tingling that dissipates within a few minutes. Throughout the remainder of the day, her heart rate fluctuates between 55 and 130 beats per minute, with these morning drops being a notable exception. She is grappling with whether this alarming drop in heart rate warrants a visit to the emergency room. Although she suspects this may seem trivial to some, her past experiences at the hospital have left her feeling hesitant, as her conditions are sometimes not taken seriously. She has attempted to reach her primary care physician for guidance but has not yet received a response. According to her pain management doctor, the Naltrexone is not likely to be the cause of her heart rate issues. With her complex medical history and the distressing symptoms she is experiencing, she is seeking advice on whether an emergency room visit is needed for further evaluation of her heart rate concerns, despite her reservations about being dismissed by medical professionals again.
Answers (1)
8/14/2025, 5:50:56 PM
OpenHealth AI
Experiencing significant drops in heart rate, especially to the 40s or 30s, can be concerning, particularly given your complex medical background. It's important to approach this situation carefully but also to validate your feelings regarding your health.
Explanation:
-
Understanding Heart Rate Drops: A heart rate that falls too low, especially into the 30s, is known as bradycardia. This can happen for various reasons, including medication effects (such as Metoprolol), autonomic nervous system issues (common in POTS and Ehlers-Danlos), or other underlying health conditions.
-
Symptoms to Observe: The tingling you are experiencing may also suggest something related to how your body is responding to these fluctuations. It’s crucial to monitor these symptoms carefully.
Next Steps:
-
Immediate Monitoring:
- Keep a detailed log of your morning heart rates, the times they drop, and any accompanying symptoms (like the tingling you mentioned). This information will be extremely helpful for healthcare providers when you are able to consult them.
-
Hydration and Movement:
- Since you have suspected POTS, staying well-hydrated can help manage blood flow and heart rate. Try to increase your fluid and salt intake (if not contraindicated).
-
Review of Medications:
- Consider the timings of your medications, especially Metoprolol and the recently added low-dose Naltrexone. While your pain management doctor suggested Naltrexone is unlikely the cause, it would be useful to discuss the interactions between your medications when you get a chance.
-
Seek Prompt Care if Symptoms Worsen:
- If you continue to experience heart rates in the 30s or any new severe symptoms arise (like fainting, severe dizziness, or significant changes in your overall condition), it would be prudent to visit the emergency room or a healthcare provider. Trust your instincts on this one; you know your body best.
-
Follow-Up with Healthcare Providers:
- Pursue contacting your primary care physician or consider seeking urgent care if you cannot reach them. Explain clearly the drops in heart rate and your experience, including how this is affecting your quality of life.
Remember, your health concerns are valid, and you deserve a thorough evaluation of your symptoms. The logs you keep and your ability to articulate your experience can help you receive better support and understanding from healthcare professionals. Please reach out for help when needed.
Related Questions
Need Help Identifying These Creatures
At 18 years old, I find myself in a somewhat awkward situation, as I believe I may have seen some unusual creatures emerge after an extensive cleaning experience. Normally, I pride myself on maintaining kitchen hygiene and have never encountered anything concerning in my stool, which makes me uncertain about labeling them as worms. Nonetheless, it's always wise to err on the side of caution, right? 🤷♂️
Removed a Mole at Home
I’m a 21-year-old female, and I’ve had a mole on my chest since childhood. It has been confirmed as benign, yet I’ve always felt uncomfortable about it because it was raised. This morning, I decided to take matters into my own hands and used an eyebrow razor to remove it. I realize that this wasn’t the safest approach, and it did result in quite a bit of bleeding. I managed to apply two band-aids to control it, but after taking one off for a replacement, I noticed that it’s still bleeding, albeit lightly. What should I do next?
Experiencing Sudden Jaw Discomfort and Facial Pain
As a 21-year-old male, I've developed a habit of cracking my jaw in a circular manner—something I've routinely done for years without any issues. Recently, however, I've found myself in significant discomfort. The area around my right ear and the side of my mouth are painful, making it difficult to open my mouth or even clench my teeth. This is an unusual experience for me, and I’m curious if this is something I should be worried about?
Optimal Timing for Taking Sucralfate with Other Medications
I'm a 54-year-old individual who has been on Pantoprazole, taking it twice daily for a year now. Recently, I received a prescription for Sucralfate. While I did use Sucralfate briefly last year, I was never quite confident about when to take it in relation to my other medications. During that time, which I discussed with my physician, my routine involved taking Pantoprazole one hour before meals, followed by Sucralfate prepared as a slurry thirty minutes later, with my meal occurring half an hour after the Sucralfate. Despite this plan, I keep encountering varying information on the subject and would appreciate a clearer guideline. If I plan to have dinner at 6 PM, I would like to know the ideal times for taking Pantoprazole and Sucralfate to ensure that I’m maximizing the efficacy of both medications. I’m concerned about the potential for timing to hinder their effectiveness. Thanks in advance for your help!
Availability of Rabies Vaccination in UK NHS A&E for Post-Exposure Treatment
After being bitten by a dog while traveling abroad, I completed the necessary rabies vaccination schedule as instructed (on days 0, 3, 7, and 14) and also received Human Rabies Immune Globulin (HRIG). Now that I'm back in the UK, I need to get my final vaccine dose after 28 days. Is it possible for me to visit an A&E department for this shot? Local doctor's offices do not provide this service, and the only clinics I've discovered are private travel clinics that charge upwards of £100, which is beyond my budget at the moment. My travel insurance covered the initial treatments I received in Thailand (minus the excess charge), but they will not pay for this last dose. Given that I am dealing with a post-exposure situation, isn't it reasonable to expect that I could receive this vaccine through the NHS? I was indeed bitten, and if the dog was rabid, not receiving this last dose could have severe consequences. I'm puzzled as to why the only option appears to be a costly private clinic. Can I access this vaccine through the NHS? If so, what steps should I take to obtain it? Personal details: Female, 48 years old, 172 cm tall, 70 kg in weight, bitten on the left leg by a dog, no known medical issues.