Irregular Heartbeats: When to Seek Medical Advice

Irregular heartbeat?

Hello Doctor: I have been experiencing palpitations recently.
My heart rate was around 120 beats per minute, but after taking the Inderal prescribed by the doctor, it decreased to about 75 beats per minute.
However, after 2 to 3 days, my heart rate increased again to around 90 beats per minute, even though I have not stopped the medication.
Should I return for a follow-up appointment?

Ruoxin, 20~29 year old female. Ask Date: 2006/04/12

Dr. He Dongjin reply Cardiology

Dear Chingfen, based on your description, there may be several conditions such as autonomic nervous system dysfunction, endocrine disorders, or insufficient medication dosage.
It is recommended that you return to the outpatient clinic for further follow-up and treatment.
Changhua Hospital is concerned about your well-being.

Reply Date: 2006/04/12

More Info

When it comes to understanding irregular heartbeats, also known as arrhythmias, it's essential to recognize the symptoms and when to seek medical advice. Your experience of palpitations, where your heart rate increased to around 120 beats per minute and then decreased to approximately 75 beats per minute after taking Inderal (propranolol), is indicative of a condition that warrants further evaluation.

Firstly, it's important to understand that a heart rate of 120 beats per minute is considered tachycardia, which can be caused by various factors including stress, anxiety, caffeine intake, or underlying heart conditions. The fact that your heart rate decreased after taking Inderal, a beta-blocker, suggests that the medication is having an effect on your heart rate regulation. However, the subsequent increase in heart rate back to around 90 beats per minute, despite ongoing medication, raises some concerns.

In general, if you experience any of the following symptoms, it is advisable to seek medical attention:
1. Persistent Palpitations: If your heart palpitations are frequent or last for an extended period, it could indicate an underlying issue that needs to be addressed.

2. Dizziness or Lightheadedness: If you feel faint or dizzy, especially during episodes of rapid heart rate, this could signify that your heart is not pumping effectively.

3. Chest Pain or Discomfort: Any chest pain, pressure, or discomfort should be evaluated immediately, as it could indicate a more serious condition.

4. Shortness of Breath: Difficulty breathing, especially if it occurs suddenly or is accompanied by other symptoms, should be taken seriously.

5. Fatigue: Unexplained fatigue or weakness can sometimes be associated with heart problems.

Given your situation, where you have experienced fluctuations in heart rate while on medication, it is advisable to return to your healthcare provider for further evaluation. Your doctor may want to perform additional tests, such as an electrocardiogram (ECG) or a Holter monitor, to assess your heart's rhythm over a more extended period. This can help determine if there are any underlying arrhythmias that need to be managed or if your medication needs adjustment.

Moreover, it’s crucial to discuss any other symptoms you may be experiencing, your medical history, and any lifestyle factors that could be contributing to your heart rhythm issues. Factors such as stress, sleep patterns, and caffeine consumption can significantly impact heart rate and rhythm.

In summary, while occasional palpitations can be benign, the combination of your symptoms and the changes in your heart rate while on medication suggests that a follow-up appointment is warranted. Your healthcare provider can help determine the best course of action to ensure your heart health is monitored and managed effectively. Always prioritize your health and do not hesitate to seek medical advice when you feel something is not right.

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