Is My Irregular Heartbeat Due to Increased Blood Pressure Medication?

Recently, my heart rate has been fluctuating rapidly, feeling like severe palpitations, similar to an earthquake. Could this be related to an increase in my blood pressure medication dosage?

Hello Doctor: I was originally taking 80mg of Dexamethasone once every night, but my blood pressure has recently become uncontrollable, spiking to 180-200 occasionally.
My doctor then increased my dosage to 160mg.
After taking it, my heart rate has been fluctuating between fast and slow, with significant palpitations that feel like an earthquake.
I have mitral valve prolapse and I'm wondering if the increase in my blood pressure medication could be causing these abnormal heart rhythms.
Thank you.

judy, 40~49 year old female. Ask Date: 2018/08/11

Dr. He Dongjin reply Cardiology

Hello, it seems that the palpitations and unstable blood pressure you are experiencing may be related to autonomic nervous system dysregulation caused by perimenopause.
Increasing the dosage of blood pressure medication may not necessarily be related; perhaps adding some medications that target the autonomic nervous system could help.
Changhua Hospital cares about your well-being.

Reply Date: 2018/08/11

More Info

Irregular heartbeats, or arrhythmias, can indeed be influenced by various factors, including changes in medication, underlying heart conditions, and fluctuations in blood pressure. In your case, it seems that the increase in your blood pressure medication dosage from 80mg to 160mg of Diovan (Valsartan) has coincided with the onset of your irregular heartbeat and palpitations.
Firstly, it is important to understand that Diovan is an angiotensin II receptor blocker (ARB) commonly used to manage high blood pressure and heart failure. While it is generally well-tolerated, any increase in dosage can lead to side effects, including dizziness, fatigue, and in some cases, changes in heart rhythm. However, it is less common for ARBs to directly cause significant arrhythmias.
Your mention of having mitral valve prolapse (MVP) is also crucial. MVP can lead to palpitations and irregular heartbeats, as the structural changes in the heart can affect how electrical signals are transmitted. In patients with MVP, the heart may be more sensitive to changes in blood pressure and medication, which could explain the increased frequency and intensity of your palpitations after the dosage adjustment.

Additionally, the sudden spikes in your blood pressure to levels between 180-200 mmHg are concerning. Such high readings can lead to increased workload on the heart and may exacerbate any underlying arrhythmias. It is essential to manage these blood pressure spikes effectively, as uncontrolled hypertension can lead to serious complications, including heart failure, stroke, and other cardiovascular issues.

Given your symptoms, it is advisable to consult your healthcare provider as soon as possible. They may recommend monitoring your heart rhythm through an electrocardiogram (ECG) or a Holter monitor, which records your heart's activity over 24 hours. This can help determine if the irregular heartbeat is related to the medication change, your underlying condition, or possibly another issue altogether.

In the meantime, here are some general recommendations to consider:
1. Medication Review: Discuss with your doctor the possibility of adjusting your blood pressure medication. Sometimes, a combination of medications may be more effective and better tolerated.

2. Lifestyle Modifications: Implementing lifestyle changes such as a heart-healthy diet, regular exercise, stress management techniques, and avoiding stimulants (like caffeine and nicotine) can help manage both blood pressure and palpitations.

3. Monitoring: Keep a log of your blood pressure readings and any episodes of palpitations, including their duration and any associated symptoms. This information can be valuable for your healthcare provider.

4. Follow-Up: Regular follow-up appointments with your cardiologist or primary care physician are essential to monitor your heart health and adjust treatment as necessary.

In conclusion, while it is possible that the increase in your blood pressure medication may be contributing to your irregular heartbeat, it is crucial to consider all factors, including your underlying mitral valve prolapse and the recent spikes in blood pressure. A thorough evaluation by your healthcare provider will help clarify the situation and guide appropriate management.

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