Managing Rapid Heart Rate: Medication and Vaccine Considerations

Rapid heartbeat

Hello, Director Wu.
Since my heart rate usually ranges from 90 to 110, I went to the hospital for a cardiac ultrasound and ECG.
The results are as follows: No chamber dilation, adequate left ventricular systolic function (LVEF: 57.9%), no obvious regional wall abnormalities, normal left ventricular diastolic function, normal left atrial pressure (E/E’AVG 6.9), trivial mitral regurgitation, preserved right ventricular function, no pericardial effusion, inferior vena cava not dilated with respiratory collapse ≥ 50%.
Doppler results: lateral E’ velocity 10.2 cm/s, medial E’ velocity 8.05 cm/s.
2D mode: EF 57.9%, end-diastolic volume 97.3 ml, end-systolic volume 41 ml, left ventricular internal diameter in diastole 4.6 cm, in systole 3.2 cm, left ventricular posterior wall in diastole 1 cm, fractional shortening 30.4%, stroke volume 56.3 ml, aortic root diameter 3 cm, left atrial dimension 2.6 cm, interventricular septum/left ventricular posterior wall ratio 0.9, left ventricular septal diameter 0.9 cm.

The ultrasound results are as above, and the doctor prescribed Kankun 5 mg for me to take half a tablet a day.
After taking the medication, my heart rate has decreased to 80.
I am scheduled to receive the high-end vaccine next week and would like to ask if I can take Kankun while getting vaccinated or if I need to stop the medication first.

Additionally, I would like to know if any further tests are needed for my tachycardia.

Yang, 40~49 year old female. Ask Date: 2022/06/05

Dr. Wu Xueming reply Cardiology

1.
No need to discontinue medication.
2.
Consider performing a 24-hour Holter monitor test.

Reply Date: 2022/06/05

More Info

Managing rapid heart rate, or tachycardia, can be a complex issue that requires careful consideration, especially when it comes to medication and vaccination. Based on the information provided, it appears that you have a history of elevated heart rates, with your resting heart rate often ranging from 90 to 110 beats per minute. You have undergone various cardiac evaluations, including echocardiograms and electrocardiograms (ECGs), which have shown normal heart function without significant abnormalities.

Understanding Tachycardia
Tachycardia can be caused by a variety of factors, including anxiety, stress, physical exertion, or underlying medical conditions. In your case, it seems that your heart rate can increase significantly during moments of stress or anxiety, which is not uncommon. The heart's response to stress is a natural physiological reaction, often referred to as the "fight or flight" response, where adrenaline increases heart rate to prepare the body for action.

Medication Management
You mentioned that you are currently taking a medication called 康肯 (likely a beta-blocker) at a dosage of 5 mg, which helps to manage your heart rate. Beta-blockers are commonly prescribed for conditions like hypertension and tachycardia as they work by blocking the effects of adrenaline on the heart, leading to a slower heart rate and reduced blood pressure. It is important to follow your physician's instructions regarding medication, especially when preparing for a vaccination.

Regarding your question about whether to continue taking 康肯 before receiving the vaccine, the general consensus is that you do not need to stop taking your medication. It is crucial to maintain your medication regimen unless specifically advised otherwise by your healthcare provider. The vaccine should not interact negatively with your current medication, and continuing to take it may help manage any anxiety-related increases in heart rate during the vaccination process.

Vaccination Considerations
When it comes to vaccinations, particularly with mRNA vaccines like Moderna or Pfizer, there have been reports of myocarditis and pericarditis, particularly in younger males. However, these cases are rare, and the benefits of vaccination generally outweigh the risks, especially for individuals with underlying health conditions. Given your history of elevated heart rates and the fact that your heart function appears to be stable, it is advisable to proceed with vaccination as long as your chronic conditions are well-managed.

Additional Testing
As for further evaluations for your tachycardia, if you continue to experience episodes of rapid heart rate, it may be beneficial to undergo a 24-hour Holter monitor test. This test records your heart's rhythm over an extended period, allowing your healthcare provider to identify any irregularities or patterns that may not be evident during a standard ECG. Additionally, if you have not already done so, a consultation with a cardiologist specializing in electrophysiology may provide further insights into your condition.

Conclusion
In summary, managing rapid heart rates involves a combination of medication adherence, understanding the physiological responses to stress, and ensuring that any underlying conditions are monitored and treated appropriately. You should feel confident in proceeding with your vaccination while continuing your prescribed medication. If you have any concerns or experience new symptoms, do not hesitate to reach out to your healthcare provider for personalized advice. Remember, maintaining a calm mindset and managing anxiety can also play a significant role in controlling your heart rate.

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