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Suggest Treatment For Sore Throat And High Heart Rate

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Posted on Sat, 9 Sep 2017
Question: hi! I am having an episode of sore throat. I also have a higher that usual heart rate. 105b/m vs 70 b/m. I am on holiday with my family. I am ophtalmologist. We are at the sea side. The second day we ve got here my sinuses bagan to drenate (maybe because of the aerosols). when we first got here the heart rate was about 70 b/m on rest. after 3 days the sore throat started. after that the heart rate stabilized at 105b/mmaybe because of the inflamation. There are no signs on the tonsils of bacterian infection (checked that with 2 ENTs doctors). they concluded that the sinusdranage must have caused the sore throat through leakage and immune stimulation with sinus secretions. As a treatment I ve had only bucal showers with simple tap water from shower (i try to avoid specialised antiseptic solutions for the reasons bellow). I have only mild pain when swallowing. No fever, no enlarged ganglya. No problems what s so ever until today when after the meal in the afternoon I got a strong adrenergic response with 135 b/m at reast and 150mmHg(sistolic)/100mHg(diastolic) after I ate (maybe from mecanic stress on the tonsils). the interesting thing is that the throat pain totaly was gone during this episode of adrenergic release (even for swallowing). i tooked a 1.25 bisoprolol and in 20 minutes or so I was ok. The throat pain when swallowing returned. after 2 hours of heart rate ok (heart rate of 80b/m, 110 diastolic, 70mmHg sistolic). I went to the bathroom and had another bucal shower with 28 degrees water. Another adrenergic episode was trying to restart but because of the beta blocker it stopped. Questions: 1. are inflammed tonsils more reflexogenic. 2. could they have triggered the adrenergic symptoms 3. are chronic inflammed tonsils more likley to trigger adrenergic responses when in contact with various chemichals like tooth paste, oral lotions containing strong additives (mentho, alcohol, etc..?), different smels like parfumes or even parfume propulsor gases like propane (bare in mind the sudden death from sneaffing syndrome described in chronic inhalers or first time inhalers for propane gas). The reason for the third question is that it seems i have adrenergic sensitivity for alcohol, alcohol vapors, tooth paste and parfumes with about four episodes of panic attacks (hospital diagnosed)/hyperadrenergic events triggered by bucal lotion containing alcohol and mint, alocohol vapors from car wind shield cleaning liquid (methanol 45%), parfume with propane and alcohol.
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Answered by Dr. Ilir Sharka (39 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that your reaction is quite normal.

It is true that both beta-adrenergic receptors and muscarinic-cholinergic receptors are present in the tonsils.

So, their irritation (inflammation) can cause an adrenergic response, leading the activation of the sympathetic nervous system and thus tachycardia.

Some studies have concluded that there is a higher adrenergic response (a higher quantity of chatecholamines ) released in persons with recurrent tonsillitis, compared to those who do not have recurrent tonsillitis.

From the other hand the activation of the sympathetic nervous system as a response to the pain (from the local irritation of the tonsills) is a common physiological reaction, which leads to a similar clinical scenario.

Alcohol and other substances (like you refer) can trigger an autonomic response too and mimic this clinical scenario in susceptible persons like you.

From the other hand an allergic reaction can also trigger your symptoms.

Have you performed any allergy tests?

I would strongly advice performing allergy tests (skin and blood) in order to avoid possible allergen agents, which can trigger your symptoms.

Trying taking an anti-histamine (cetirizine, loratidine) for some days (as you are on vacation) can help differentiate if your symptoms are related to an allergic reaction.

At the end, you should know that anxiety seems to play an important role in this situation too.

But, for the moment there is nothing to worry about! Your symptoms are not indicative of any cardiac disorders.

So, relax!

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

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 Sore Throat And High Heart Rate

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I passed carefully through your question and would explain that your reaction is quite normal. It is true that both beta-adrenergic receptors and muscarinic-cholinergic receptors are present in the tonsils. So, their irritation (inflammation) can cause an adrenergic response, leading the activation of the sympathetic nervous system and thus tachycardia. Some studies have concluded that there is a higher adrenergic response (a higher quantity of chatecholamines ) released in persons with recurrent tonsillitis, compared to those who do not have recurrent tonsillitis. From the other hand the activation of the sympathetic nervous system as a response to the pain (from the local irritation of the tonsills) is a common physiological reaction, which leads to a similar clinical scenario. Alcohol and other substances (like you refer) can trigger an autonomic response too and mimic this clinical scenario in susceptible persons like you. From the other hand an allergic reaction can also trigger your symptoms. Have you performed any allergy tests? I would strongly advice performing allergy tests (skin and blood) in order to avoid possible allergen agents, which can trigger your symptoms. Trying taking an anti-histamine (cetirizine, loratidine) for some days (as you are on vacation) can help differentiate if your symptoms are related to an allergic reaction. At the end, you should know that anxiety seems to play an important role in this situation too. But, for the moment there is nothing to worry about! Your symptoms are not indicative of any cardiac disorders. So, relax! Hope you will find this answer helpful! Kind regards, Dr. Iliri