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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pounding In The Heart?

About 3 years ago I started getting a malignant HTN (at age 40, I am 43 now). It could be fairly labile, but I am and had been walking around at 170/120. I am a PA and had some good friends, but everyone I saw would say Depression or Stress and I argued over and over that I am neither, that I am anxious 24/7. Insomnia beyond anything imaginable and eyesight started getting worse and worse. Last April my mentation(very confused, always manic, yet overwhelmingly fatigued) worsened, as were my s/s of insomnia, which was VERY bad, HTN skyrocketed , HR 140+, and I ended up in the ER (my s/s really had begun in November just after I got the swine flu - and I had it bad). They found hyperthroidism, and further labs always reveal a low cortisol, low potassium, low calcium, and low testosterone. No cause of thyroid issue foound on MRI s scans etc (including pituitary). Hyperthyroidism resolved on it s own a month or so ago. I though, am ashamed, yet did not really know what I was doing, last Dec-March stole from and urgent care employer I was working for out of our onsite scripts some soma and vicodin. I confessed and lost alot - no criminal, but board. I had been going and going to the doctors trying and trying to find out and theONLY thing ever found was when I was in the hospital in Lubbock for heart and BP in late 2008 and they found an enlarged heart. The cardiologists PA saw me one night on rounds said I needed to have my thyroid checked and the doc said no, that s not it... and never anything found. My heart pounded so hard at night and my head always felt like it was going to explode, I thought at any moment I was going to have a stroke. I functioned on my subconscious, but I was always confused cognitively - i had been a great student, good grades, never stole ANYTHING in my life, have no speeding tickets, no malpractice, no complaints and yet I did this stupid thing while sick. Some background. The very severe s/s hit in Nov/Dec 2009 after I had the swine flu, but they all had been there. In 2008 I had 3 concussions, fell out of a tree putting a swing up for my 6 kids, in a rollover MVA and earlier fell doing pull ups when the bar came down. Had CT but ok. Also one AM late 2008 wife heard me fall . I remember being in front of the mirror feeling fine..and then nothing. I woke up 8 hours later with no memory. Small town EMS came out, told my wife my BP was okay, and did not take me to hospital . I could only mumble to EMS - sounds post ictal but nothing since. Dizzy, nauseated, sometimes, still insomnia, but not as bad, headaches and STILL very high and labile BP, BUT I am incredibly mentally clear since thyroid normalized. Also for these 3 years had flu every year - even with shot - and get sick for a week if I even have a cold. I think my drug issue was mostly a psychosis, but I am manning up and doing what I need to do to make sure it NEVER happens again. But the illness, very perplexed. Gluten test negative. Maybe I have a pheochromocytoma? Have a younger brother with PAGETS dx and dad is 63 and healthy. I was the only athletic one, and incredibly active in sports to this day. Never even held a cigarrette and except for my stupid foray never ever used any drugs, legal or illegal (narcotics I should say). On clonodine, a BB but we have to change the dose on the BB due to the HR dropping into the 40 s, and an ACEI. Kidney tests okay, but last time did have some proteind and microalbumin for the first time. Glucose test negative. I do have a documented hx at the docs of hypoglycemia, meaning I would eat lunch, came in 1 hour later and sugar was still 60. Though I felt okay. Repeated this many times and always low after a meal Ugh...where do I go. Have a beautiful wife - even after my syupidity - and 6 wonderful kids. Need to solve this
Tue, 16 Jun 2020
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Cardiologist 's  Response
Hello There

After going through your medical query I understand your concern and I would like to tell you that anxiety disorder, dehydration are the common causes of pounding heart. If you have not any Out of these, then get a basic cardiac evaluation done which includes ecg, echocardiography and a Holter( ambulatory ecg). Consult with reports


Hopefully this information will guide you properly.

Kind Regards
Dr Bhanu Partap
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What Causes Pounding In The Heart?

Hello There After going through your medical query I understand your concern and I would like to tell you that anxiety disorder, dehydration are the common causes of pounding heart. If you have not any Out of these, then get a basic cardiac evaluation done which includes ecg, echocardiography and a Holter( ambulatory ecg). Consult with reports Hopefully this information will guide you properly. Kind Regards Dr Bhanu Partap