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What is the permanent treatment for sinus tachycardia ?

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General & Family Physician
Practicing since : 2005
Answered : 2295 Questions
Dear sirs,

i m 30 years old male, and i was having high pulse rate ( sinus tachycardia ) , which was mainly caused by stress and anexiety

My pulse at home was in the range of 90 - 100 bpm , but in the doctor clinic it goes up to 120 Bpm as i feel versy stressed at doctors clinic. so i did full check up on heart , and the Holter moniter showed a blood pressure average 130 - 80 and pulse rate 94 bpm

the doctor told me that the heart is fine and valves are ok , but he prescrived me a beta blocker to calm the heart down: half pill of Nebivolol 5 mg,and after i used the medication the pulse became in the range 70 - 80 bpm and i play regular sports and i feel i have bettter energy

The problem is that although my pulse is normal , but still till now when I go to doctors it goes up to 110 bpm , but once I leave the doctor office its back to normal.

Does my case require surgical intervention ?? or beta blocker is enough? And when does surgery would be needed..i just feel my doctor is not happy to see my pulse rising at his clinic to the level of 110 bpm there a chance he would recommend me a surgery or as long as my pulse all over the day is fine with beta blocker so no need for another procedure

Thanks a lot for your help and support .

Best regards,

Sherif el kaissy
Posted Wed, 11 Apr 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Prasad 1 hour later
Dear Sherif,

Thanks for your detailed query.

Surgery is necessary if a structural abnormality such as an accessory pathway or dysarrhythmia (Rhythm changes) were detected on physical examination / EKG / Holter monitoring or Echocardiogram. In the absence of such structural problems, treatment is based on treating the cause and use of negative chronotropes such as betablockers.

now reviewing your history the fact that pulse automatically switches back to normal as as the causative factor is removed (you coming out of the clinic) is highlighting anxiety as a significant or probably the lonely cause. Physiological response mediated by transient fluctuations in hormones and neurological factors is believed to be theory behind this. You could get your thyroid hormones assessed just to see if it could be a factor hiding behind anxiety and contributing to some extent – though I confess, I give this less than 5% possibility.

Hence I agree with your doctor in prescribing you betablocker as pulse rate above 100 is not to be neglected. Discuss with your doctor if it is worth getting thyroid tests. Perhaps a small dose of anti anxiety medications could benefit you to a great extent.

Physical exercise, yoga, transcendental meditation and other relaxation techniques have proved to bring nerves down and thus treating your concern.

Hope I have answered your query adequately. If you feel my answer has helped you, then request you to accept it.

If there are any clarifications on these issues, I am available to answer them as well.

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