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Fast heart rate. Ultrasound of the heart and legs came normal. Blood work shows mild anemia. Advice

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Practicing since : 1966
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My heart continues to beat fast. Many times when I lay downt to sleep, I can hear it beating. At times, it beats 95-100 bpm. It scares me. I have been to two cardiologist and one put me on propranolol. But when I went to a second cardiologist, after mutliple EKGs done, she said to stop taking propranolol. Yes, I have had stress tests done, ultrasound of the heart and legs and all tests came back fine. Thus the doctors just tells me to lose weight. I have stopped drinking coffee and I dont smoke. Thyroid is fine and blood work only came back revealing slight/mild anemia. Are my two cardiologist missing anything? This fast heart beat gives me anxiety at times, its hard for me to go to sleep.
Posted Sun, 17 Nov 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 3 hours later
Brief Answer:
Relax / Reduce weight / Follow up -

Detailed Answer:
Hi friend,
Welcome to Health Care Magic

The rate is still in range / rates of 60 to 100 are the usual limits / no need to be scared!
Normal tests are really reassuring…
     Standard ECG records the electrical activity of the heart, for a few seconds. One generally needs Holter or event monitor done to analyse and plan for further management. It may also detect silent (no symptom) ischemia.
     Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / calcium, magnesium / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... /At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!

     Many cases are benign, especially when associated with normal ECHO and may not require treatment. If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
     If there are no clues and if the problem is still bothering to the extent of interfering with life style, Electro Physiological Studies (EPS) may be done in some > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.
     The first line medicine is generally beta blockers (like propranolol). It will benefit both anxiety and the rate. Anxiety causes fast rate – fast rate causes anxiety – a vicious cycle…
One may learn to ignore and be usual self…
Your doctor will give proper prescription and follow up
You just seem to need follow up…

Take care     
Wishing all well
God bless
Good luck
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