Managing Rapid Heartbeat: When to Seek Emergency Care and Medication Safety

If you are experiencing rapid heartbeat, palpitations, and chest tightness, you may consider taking Inderal (propranolol)?

I have been experiencing rapid heartbeat, palpitations, chest tightness, and frequent numbness in my hands, feet, and face lately.
I'm not sure what's going on, and I've almost had to go to the emergency room several times.
Could you please tell me what situations really require a visit to the emergency room? Two months ago, I was diagnosed with autoimmune vasculitis affecting my heart, and earlier this year, I was found to have pericardial effusion.
My cardiologist suspects I have pulmonary hypertension, and I have had Graves' disease for over ten years.
Recently, due to a drug allergy, I have not been taking my hyperthyroidism medication, and the pandemic has made me hesitant to visit the hospital frequently.
Many of my questions remain unanswered, and I am grateful to have found this website.
Thank you to all the hardworking medical staff.
Currently, I am taking the following medications: an anticoagulant "Aspirin" 5 mg once daily, a steroid "Metizone" 4 mg once daily, and "Chuan Ning" 200 mg every other day, along with one tablet of "Inderal" in the morning and evening.
I forgot to ask my doctor if Inderal can be taken with my current medications and if there are any potential interactions.
I also saw in previous responses that the dosage of Inderal can be adjusted based on my condition.
Is this true? Additionally, I found information online stating that taking 400 mg of Chuan Ning daily could harm the retina.
Should I return to the hospital to ask my doctor if I can lower the dosage? (I am really afraid to go to the hospital during the pandemic...)
To summarize my questions, I would appreciate your help in clarifying the following:
1.) Can I take Inderal with my current medications, and are there any potential interactions? Is it safe to adjust the dosage myself and only take it when I experience rapid heartbeat or shortness of breath?
2.) Is it necessary to follow up with my doctor to discuss whether I can lower the dosage of Chuan Ning?
3.) What situations truly require a visit to the emergency room?
4.) I also remembered that since I have been taking anticoagulants, I forgot to ask my doctor if I should stop taking my previous cholesterol-lowering medication, "Rosuvastatin." I later stopped taking it on my own (10 mg every other day).
Is it okay for me to not take Rosuvastatin? Thank you!

DD2, 60~69 year old female. Ask Date: 2021/06/22

Dr. He Dongjin reply Cardiology

Hello, I am experiencing a rapid heartbeat, palpitations, chest tightness, and numbness in my hands, feet, and face.
I am worried that these symptoms may be caused by stopping my thyroid medication.
Should I quickly resume taking Inderal? Can I take it alongside my current medications and adjust the dosage myself? I would not recommend that.
This includes Inderal, as well as other medications like Suan Ning and Guan Zhi Tuo.
It is not advisable to change your medication dosage, especially since you are already feeling unwell.
It is better to stick to the original dosage recommended by your physician.
If your symptoms do not improve with Inderal, please return to your primary care physician as soon as possible.
An outpatient visit is safer than going to the emergency room.
You don’t need to go to the emergency room.
Take care, and we are concerned about you at Ping An Changhua Hospital.

Reply Date: 2021/06/22

More Info

Managing rapid heartbeat, or palpitations, can be a concerning issue, especially when accompanied by symptoms such as chest tightness, shortness of breath, and numbness in the extremities. Given your medical history, including autoimmune vasculitis, suspected pulmonary hypertension, and a long-standing diagnosis of Graves' disease, it is crucial to approach your symptoms with caution and awareness.

When to Seek Emergency Care
You should seek emergency medical attention if you experience any of the following symptoms:
1. Severe Chest Pain: If the chest pain is intense, feels like pressure or squeezing, or radiates to the arms, neck, jaw, or back, it could indicate a heart attack.

2. Shortness of Breath: If you find it difficult to breathe, especially if it occurs suddenly or is accompanied by chest pain.

3. Fainting or Severe Dizziness: If you feel faint, lightheaded, or lose consciousness.

4. Rapid or Irregular Heartbeat: If your heart is racing or beating irregularly and you feel weak or faint.

5. Numbness or Weakness: Especially if it affects one side of your body, which could indicate a stroke.

Given your history of heart issues and autoimmune conditions, it is essential to err on the side of caution. If you feel that your symptoms are worsening or if you are experiencing new symptoms, do not hesitate to go to the emergency room.

Medication Safety and Interactions
Regarding your current medications, including Inderal (propranolol), a beta-blocker often used to manage rapid heart rates and anxiety, it is generally safe to take it alongside your other medications. However, you should always consult your healthcare provider before making any changes to your medication regimen.
1. Inderal and Current Medications: Inderal can typically be taken with anticoagulants and steroids, but it is essential to monitor for any unusual side effects. You should not adjust the dosage of Inderal without consulting your doctor, even if you feel the need to take it more frequently during episodes of rapid heartbeat.

2. Adjusting Dosages: While some patients may adjust their beta-blocker dosage based on symptoms, this should only be done under medical supervision. Self-adjusting medication can lead to complications, especially in patients with complex medical histories.

3. Concerns About Other Medications: If you are worried about the potential side effects of your other medications, such as the risk of retinal damage from the medication you mentioned (瘡寧), it is advisable to discuss this with your healthcare provider. They can assess your risk and determine if a dosage adjustment is necessary.

Conclusion
In summary, your symptoms warrant careful monitoring, and you should seek emergency care if they escalate. It is crucial to maintain open communication with your healthcare provider regarding your medications and any changes in your symptoms. Given your complex medical history, regular follow-ups are essential to ensure that your treatment plan remains effective and safe. If you have concerns about visiting the hospital during the pandemic, consider telehealth options to discuss your symptoms and medication management with your doctor. Your health and safety should always come first.

Similar Q&A

Managing Rapid Heartbeat: Understanding Triggers and Solutions

Hello Doctor: I am from Hong Kong. In early June of this year, due to work and life stress, I often felt my heart racing. During one episode, I went directly to the hospital for an electrocardiogram, where my heart rate was over 120. I also had blood tests for thyroid function an...

Dr. Wu Xueming reply Cardiology
Due to your young age and lack of chronic diseases, your risk of developing heart disease is low. Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages. It is advisable to adju...

Understanding Heart Rate Issues: When to Seek Immediate Medical Attention

Hello, Doctor. A few years ago, I underwent catheter-based medication treatment for cardiac spasms and have been taking autonomic nervous system medications long-term. I use a ventilator at night due to sleep apnea and also take cardiology medications including Eplerenone and Dig...

Dr. He Dongjin reply Cardiology
Hello, this symptom does not seem to indicate a heart problem and should be monitored. For heart spasms and chest pain, sublingual tablets should be administered first, followed by observation. Changhua Hospital cares about you.

Managing Fast Heart Rate: When to Seek Medical Attention?

Hello, Doctor. I am a patient with hyperthyroidism and currently manage it with regular medication. Previously, I experienced episodes of rapid heartbeat, exceeding 130 beats per minute, which made me feel extremely uncomfortable and almost faint. I have since stopped consuming c...

Dr. Wu Xueming reply Cardiology
If the heart rate frequently exceeds 100 beats per minute while at rest, it is considered tachycardia over the long term. It is advisable to consider adjusting the medication for hyperthyroidism.

Understanding Rapid Heartbeat: Causes, Concerns, and Solutions

Hello Doctor: I have palpitations just like my mother. Recently, my heart has been beating faster, which makes me feel very uncomfortable. Additionally, with exams approaching, I often feel fatigued, which is quite frustrating and makes it hard for me to study. Could this be rela...

Dr. Lin Liangyu reply Cardiology
Hello, patients with similar symptoms often come to the outpatient clinic, and usually, we cannot find a specific cause. Most cases can be classified as autonomic nervous system dysfunction. Medication can help, and improving lifestyle habits is also beneficial. It is advisable t...