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Suggest Treatment For Hypertension, Anxiety And Bradycardia

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Posted on Mon, 5 Oct 2015
Question: I am a 67 year old male. I have had hypertension for many years but most of the time it is controlled. I do have bracicardia (55-60 at rest ). I am a runner. Between 20-25 miles a week. Here is my concern; I go to sleep and after 2-3 hrs wake up with my heart pounding but not excessively fast (65-70 ).I will fall back to sleep and the process begins all over again. I have no dizziness, shortness of breath etc.I do suffer from anxiety.
doctor
Answered by Dr. Ilir Sharka (36 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

I understand your concern, and would like to explain that in elite runners like you it is quite normal to have that slightly bradycardia (55-60 bpm).

In addition, during those bouts of heart pounding when waking after falling asleep, the heart rate is 65-70 bpm; so again a normal heart rate. Furthermore no associating complains (dizziness, shortness of breath, etc) are present.

Facing the above clinical scenario, I would like to assure you that it doesn't seem to be cardiac related (no any cardiac rhythm or conductance disorders, no hemodynamic compromise, etc). The previous cardiac monitoring has also confirmed that.

These episodes of heart poundings when suddenly waking up during sleeping, seems to be a kind of nightmare from an anxiety disorder.

I recommend you to consult with a specialist on the field of sleeping disorder (a neurologist) to address the exact component of sleeping disturbances and prescribe the best solution, as well as with a psychiatrist for your persisting anxiety.

I believe that properly management of the anxiety disorder will relieve also that sleeping disturbance.

You have to discuss with your attending physician about the above mentioned issues.

Hope to have been helpful to you!

In case of further uncertainties, do not hesitate to contact me!

Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (4 hours later)
Hello Doctor : Thank you for your quick response. Two things ; 1- Every so often, I do feel as though my heart skips a beat. Is this normal ? 2- With regard to my sleeping problem, I do notice that I dream a lot, which I never use to experience as much and then I wake up with this strong heart beat. Does this tend to fit the pattern of anxiety ?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
There is nothing to worry about your heart, it is just a sleeping disorder.

Detailed Answer:
Hello again!

Regarding your sleeping patterns (a lot of dreams), it is exactly what I explained you about.

You are experiencing nightmares, which are sleep disorders related to anxiety. They are normally associated with autonomic signs (anxiety, pounding heart, palpitations, sweating, chest tightening etc).

As I said before, you need to consult with a neurologist for this sleeping problem.

Those rare ectopic beats that you have been experiencing are normal findings in these clinical conditions. There is nothing to worry about.

Your heart is not suffering from any rhythm or conductance disorders (as confirmed also by your one month cardiac monitoring).

Hope to have been helpful!

If you have further concern, you can contact me directly at any time at the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best regards,

Dr. Iliri
Note: For further follow up on related General & Family Physician 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 : 9536 Questions

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Suggest Treatment For Hypertension, Anxiety And Bradycardia

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I understand your concern, and would like to explain that in elite runners like you it is quite normal to have that slightly bradycardia (55-60 bpm). In addition, during those bouts of heart pounding when waking after falling asleep, the heart rate is 65-70 bpm; so again a normal heart rate. Furthermore no associating complains (dizziness, shortness of breath, etc) are present. Facing the above clinical scenario, I would like to assure you that it doesn't seem to be cardiac related (no any cardiac rhythm or conductance disorders, no hemodynamic compromise, etc). The previous cardiac monitoring has also confirmed that. These episodes of heart poundings when suddenly waking up during sleeping, seems to be a kind of nightmare from an anxiety disorder. I recommend you to consult with a specialist on the field of sleeping disorder (a neurologist) to address the exact component of sleeping disturbances and prescribe the best solution, as well as with a psychiatrist for your persisting anxiety. I believe that properly management of the anxiety disorder will relieve also that sleeping disturbance. You have to discuss with your attending physician about the above mentioned issues. Hope to have been helpful to you! In case of further uncertainties, do not hesitate to contact me! Greetings! Dr. Iliri