Managing Heart Health: Concerns About Medication and Symptoms

Q: Managing Heart Health: Concerns About Medication and Symptoms

Hello Ms. <br>Chen： The sensation of vibration in your body is most likely related to your heartbeat. <br>For example, after consuming coffee or exercising, you may experience palpitations or a twitching sensation in your scalp due to increased sympathetic nervous system activity

Medication issues

I previously visited a doctor due to insomnia caused by palpitations.
An electrocardiogram and blood tests were performed.
I have mild fatty liver, and my thyroid-stimulating hormone levels are normal.
The doctor mentioned that I have slightly elevated blood pressure, so for the first week, I was prescribed 1.25 mg of Concor (Bisoprolol) to take once in the morning and once in the evening, along with 0.25 mg of Xanax (Alprazolam) at bedtime.
I was also advised to exercise more and lose weight (as I am quite overweight).
By the following week, the prescription changed to one Concor in the morning, and I could take Xanax at night if I had trouble sleeping.

I reported to the doctor that during the past week, I often felt a vibration sensation in my body, although I wasn't sure if it was a true vibration or just the feeling of blood flow.
The doctor just smiled and told me not to be too sensitive, suggesting it was likely my heartbeat.
I was instructed to return for a follow-up in a month.

Now, it is the first week of that month, and I have been feeling dizzy and occasionally experiencing a sensation of fullness, along with the persistent vibration feeling, which is causing me concern.
I have also heard that long-term use of Xanax can lead to dependence; is that true? I still experience some insomnia but prefer not to take Xanax.

I would like to ask the doctor if feeling dizzy and having a sensation of fullness while taking Concor is normal.
What could the internal vibration sensation indicate? Is it just a feeling of blood flow, or could it be something else? Should I return for a follow-up appointment directly, or would it be better to go to a larger hospital for further examination (and which department should I consult)? Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2018/10/13

Dr. Huang Yinghe reply Cardiology

Hello Ms.
Chen: The sensation of vibration in your body is most likely related to your heartbeat.
For example, after consuming coffee or exercising, you may experience palpitations or a twitching sensation in your scalp due to increased sympathetic nervous system activity and accelerated blood circulation.
In fact, many factors can cause similar symptoms, such as stress, tobacco and alcohol use, or even changes in temperature.
Certain medical conditions are also commonly associated with palpitations, including arrhythmias, mitral valve prolapse, or hyperthyroidism.

Propranolol is a beta-blocker that primarily works by slightly reducing heart rate, which can help alleviate palpitations and may also lower blood pressure, potentially causing a feeling of lightheadedness.
Xanax is a benzodiazepine that acts as a sedative; however, the dosage is relatively low, and occasional use for insomnia should not lead to significant side effects.
Long-term or excessive use of benzodiazepines can lead to tolerance, and discontinuation may result in withdrawal symptoms such as anxiety and irritability, so it is advisable to discuss long-term use with your physician.
I recommend starting with lifestyle adjustments to manage stress, maintain a regular sleep schedule, incorporate exercise, and avoid stimulants such as tobacco, alcohol, and coffee.
Many people find that medications can help control symptoms, but if you continue to feel uncomfortable while taking medication, I suggest scheduling an earlier appointment to discuss further treatment options with your doctor.
Wishing you all the best.

Reply Date: 2018/10/13

More Info

Managing heart health is a multifaceted process that involves understanding your symptoms, medication effects, and lifestyle changes. Based on your concerns regarding the medications you are taking, particularly 康肯 (Cankin) and 贊諾安 (Zanolan), as well as your symptoms of dizziness and internal vibrations, let's break down your situation.

Firstly, it’s important to recognize that both medications you mentioned serve different purposes. 康肯 (Cankin) is typically used to manage hypertension and may have side effects such as dizziness, especially when you first start taking it or if your dosage changes. Dizziness can occur if your blood pressure drops too low, which can happen when starting a new antihypertensive medication. It’s crucial to monitor your blood pressure regularly to ensure it remains within a safe range. If you experience persistent dizziness, it would be advisable to discuss this with your healthcare provider, as they may need to adjust your medication or dosage.

On the other hand, 贊諾安 (Zanolan), which is often prescribed for anxiety and sleep disorders, can also lead to side effects such as sedation, dizziness, and a feeling of being "out of it." Concerns about addiction or dependence on this medication are valid, especially if it is used for an extended period. While not everyone who takes it will develop a dependency, it is essential to use it as prescribed and to communicate with your doctor about any concerns regarding its use. If you find that you are still experiencing insomnia, it might be worth discussing alternative treatments or therapies for sleep issues that do not involve long-term medication use.

Regarding the sensation of "internal vibrations," this can be a perplexing symptom. It may be related to anxiety, especially if you have a history of anxiety disorders. Anxiety can manifest in various physical symptoms, including sensations that feel like vibrations or tremors. However, it’s also important to rule out any cardiovascular issues, particularly since you have a history of palpitations and hypertension. If the sensation persists or worsens, it would be prudent to consult your healthcare provider for further evaluation. They may recommend additional tests, such as an echocardiogram or a Holter monitor, to assess your heart's function and rhythm more closely.

As for your concerns about dizziness and the "fullness" sensation in your head, these could be related to several factors, including medication side effects, dehydration, or even anxiety. It’s essential to stay hydrated and maintain a balanced diet, especially since you mentioned having fatty liver, which can be influenced by diet and lifestyle. Regular exercise, as advised by your doctor, can also help manage both your weight and blood pressure, contributing positively to your overall heart health.

In terms of follow-up, if your symptoms are concerning or if you feel they are worsening, it is always better to err on the side of caution. You can return to your current doctor for a follow-up appointment or seek a second opinion at a larger hospital, particularly in the cardiology department if you feel that your heart health needs further investigation.

In summary, managing your heart health involves a combination of medication management, lifestyle changes, and regular monitoring of your symptoms. Open communication with your healthcare provider is key to ensuring that your treatment plan is effective and that any side effects or concerns are addressed promptly. If you continue to experience troubling symptoms, do not hesitate to seek further evaluation. Your health and peace of mind are paramount.

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