Hypertension and Heart Rhythm Issues: A Patient's Journey

Hypertension and cardiac issues?

Hello Dr.
Huang: About three years ago, one day I suddenly experienced a rapid heartbeat (over 100 beats per minute while sitting still).
At that time, my blood pressure was 160/100.
This condition persisted for about three days.
I visited Shin Kong Hospital and consulted with a cardiologist.
After blood tests, everything came back normal.
The doctor prescribed me CONCOR 5MG, to be taken once daily.
Gradually, my blood pressure decreased and my heart rate slowed down.
However, there was an incident where I suddenly experienced arrhythmia, which occurred three to four more times afterward, with the episodes lasting longer each time.
I noticed that each episode was triggered when I suddenly squatted down or transitioned from being still to moving (for example, running to catch a bus).
Additionally, I sometimes feel a strange sensation in the upper right abdomen near the rib cage; it doesn't feel like real pain but rather a sense of bloating.
This has been occurring intermittently for about 1 to 2 years.
I have undergone an echocardiogram, and the doctor said everything was fine.
Sometimes, I also experience a bloated and painful sensation on the right side of my neck, which seems to extend in a straight line down to the upper right abdomen, causing discomfort.
Occasionally, I also feel this sensation in the tendons of my right arm.
When I experience these sensations, any movement causes my heart rate to increase, and it feels like arrhythmia is about to occur.
However, there are times when I feel completely fine with no symptoms at all.
This cycle has been ongoing for three years, and I have been troubled by this issue for a long time, unsure of what the problem might be.
Every time I speak to a doctor, it seems like they don't really listen...
I hope Dr.
Huang can provide some answers.
If I need to see a specialist, which department should I consult? Thank you.

A-Kai, 20~29 year old female. Ask Date: 2006/06/09

Dr. Huang Guosheng reply Cardiology

Arrhythmia typically presents with irregular heartbeats, forceful heartbeats, or increased heart rate, and does not usually cause discomfort in the neck or right upper abdomen.
If discomfort radiates from the neck to the arm, it may indicate a cervical nerve issue, and a consultation with a neurologist is advisable.
Additionally, for discomfort in the right upper abdomen, further evaluation by a gastroenterologist is recommended.

Reply Date: 2006/06/09

More Info

Hello! Thank you for sharing your journey regarding hypertension and heart rhythm issues. It sounds like you've been through quite a lot over the past few years, and I understand how concerning these symptoms can be. Let's break down your situation and provide some insights.

From your description, it seems that you initially experienced episodes of rapid heart rate and elevated blood pressure, which led you to seek medical attention. The medication prescribed, Concor (bisoprolol), is a beta-blocker that helps to lower heart rate and blood pressure, and it appears to have been effective for you. However, the recurrence of irregular heart rhythms (arrhythmias) during sudden movements or changes in activity is noteworthy.

The fact that your heart rate spikes when you suddenly change from a resting to an active state could suggest a few things. First, it might be related to your autonomic nervous system, which controls involuntary bodily functions, including heart rate. Sudden changes in posture or activity can trigger a response from this system, leading to palpitations or arrhythmias. This is often seen in individuals with underlying anxiety or panic disorders, which can exacerbate heart rhythm issues.

The discomfort you describe in your upper abdomen and right side, along with the sensations in your neck and right arm, could be related to several factors. It’s important to consider that sometimes, gastrointestinal issues can mimic cardiac symptoms. Conditions like gastroesophageal reflux disease (GERD) or even gallbladder issues can cause discomfort that radiates to the chest and abdomen. However, the connection between these symptoms and your heart rhythm issues should not be overlooked.

Given that you have undergone echocardiograms and other tests that have returned normal results, it may be beneficial to explore further evaluations. A Holter monitor, which records your heart's activity over 24 hours or longer, could provide more insight into the frequency and triggers of your arrhythmias. Additionally, a consultation with a cardiologist specializing in electrophysiology might be warranted. They can assess your heart's electrical system more thoroughly and determine if there are any underlying issues that need to be addressed.

In terms of managing your symptoms, lifestyle modifications can play a significant role. Regular exercise, a balanced diet, and stress management techniques such as mindfulness or yoga can help improve overall cardiovascular health and potentially reduce the frequency of arrhythmias. If anxiety is a contributing factor, discussing this with a mental health professional could also be beneficial.

Lastly, it’s crucial to maintain open communication with your healthcare providers. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion or asking for a referral to a specialist who can provide a more focused evaluation of your symptoms.

In summary, while your symptoms are concerning, they are not uncommon in individuals with a history of hypertension and heart rhythm issues. With the right approach and thorough evaluation, it is possible to manage these symptoms effectively. Please continue to advocate for your health, and don’t hesitate to seek further evaluations to get to the root of your concerns. Thank you for sharing your experience, and I hope this information helps guide you on your journey to better health!

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