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Hi I Usually Take A 25 Mg Atenolol In The

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Posted on Sat, 22 Feb 2020
Question: Hi I usually take a 25 mg Atenolol in the morning and in the evening. The other evening I woke up with a very strong bout of PVCs (palpitations) that kept going on for hours. I went to the ER and they checked blood work, did EKGs (which showed significant PVCs and a chest xray. My BP was 228/82 when I got there but finally dropped to 163/72. Usually my BP runs in the 130s and lower with an occasional 140s when I'm anxious. And I know I was extremely anxious at the ER. They upped my dose to 50 mg of Atenolol in the AM and 12 hours later 25 mg. I took it and it seemed to help although I did get a significantly strong pain in my chest once. However, the PVCs calmed down and I was actually able to sleep last night. However, I got up this morning and my heart rate was running from 42 to 64 throughout the night. I wear a smart watch. And I just took my BP and it was 111/68 with a heart rate of 65. Should I continue to take the 50 mg in the morning still or just go back to my 25 mg in the morning and 25 mg at night and take an extra if I need it.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on - Ask a Doctor - service!

I passed carefully through your concern and would like to explain that the decision of ER doctors to upper your daily 50 mg Atenolol dose seems rationale as it is more effective in a better control of PVCs arrhythmia.

Your recent BP and heart rate values confirm the treatment benefits.

I recommend to keep checking your heart rate values on your smart watch, as well as BP values.

In addition, I would advice discussing with your attending physician on the possibility of performing an ambulatory ECG monitoring (Holter) test for a better quantitative PVCs evaluation of the current therapy result and also some lab tests, like:

- complete blood count,
- thyroid hormones level,
- blood electrolytes level

to investigate for any potential imbalances.

In conclusion, I would strongly recommend continuing with your actual Atenolol daily dose (75 mg) and after the recommended tests results to discuss with your doctor whether a further dose increase (to 100 mg) is required.

Hope to have been helpful to you!

I remain at your disposal if you need a second professional opinion on any additional questions.

Wishing you are having a pleasant weekend,

Kind regards,

Dr. Ilir Sharka
cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9541 Questions

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Hi I Usually Take A 25 Mg Atenolol In The

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on - Ask a Doctor - service! I passed carefully through your concern and would like to explain that the decision of ER doctors to upper your daily 50 mg Atenolol dose seems rationale as it is more effective in a better control of PVCs arrhythmia. Your recent BP and heart rate values confirm the treatment benefits. I recommend to keep checking your heart rate values on your smart watch, as well as BP values. In addition, I would advice discussing with your attending physician on the possibility of performing an ambulatory ECG monitoring (Holter) test for a better quantitative PVCs evaluation of the current therapy result and also some lab tests, like: - complete blood count, - thyroid hormones level, - blood electrolytes level to investigate for any potential imbalances. In conclusion, I would strongly recommend continuing with your actual Atenolol daily dose (75 mg) and after the recommended tests results to discuss with your doctor whether a further dose increase (to 100 mg) is required. Hope to have been helpful to you! I remain at your disposal if you need a second professional opinion on any additional questions. Wishing you are having a pleasant weekend, Kind regards, Dr. Ilir Sharka cardiologist