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Can sleeplessness or Fluconazole cause tachycardia-like sensations?

DOCTOR OF THE MONTH - Jan 2017
Jan 2017
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Cardiologist
Practicing since : 2013
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Question
Hello, I am a healthy 40 year old nonsmoking female. In the summer I was suffering from bad anxiety and began having heart palpitations. I had appointments with a cardiologist. The tests I had include a 24 hour and 48 hour heart monitor, ECGs, chest X-ray, a lot of blood work, echocardiogram and stress test. The cardiologist diagnosed me with PVCs which he says are nothing to worry about. He says I do not require any medication.
The last couple of evenings I have felt like my sitting heart rate was feeling a little fast but when I would check my pulse it would be between 80 and 90 beats/min so I didn't worry about it. I had also had caffeinated coffee those days in the late afternoon/early evening so again I tried not to worry. By the morning my pulse would be around 70 beats/min so I felt better. However tonight I noticed my heart feels like it is beating fast. I checked and my pulse is about 120 beats/min and I have had no coffee today. I have had a yeast infection the last few days and saw the doctor today to receive medication for it as the Canesten I was using didn't work. I took the medication this evening (Mylan-Fluconazole 50mg). I am feeling very tired. I have not had a very good sleep in 3 nights. I am not sure if my medication or lack of sleep has anything to do with my incresed heart rate but I am concerned and am not sure what to do. Any help/advice would be appreciated. I am getting very anxious and as my anxiety is increasing I am noticing I am getting palpitations.
Thank you
Fri, 8 Jun 2018 in Hypertension and Heart Disease
 
 
Answered by Dr. Sagar Makode 35 minutes later
Brief Answer:
Its unlikely to to be cardiac issue, but secondary to anxiety

Detailed Answer:
Hello,
Just increased heart rate doesn't signify any heart disease. And you already being evaluated with normal results so I don't think there is anything to worry about regarding your heart. Regarding presence of vpcs, these are benign as evaluation was normal. So from heart point of view l think there is no need to worry. The cause for increased heart rate is anxiety only. Also, get your hemoglobin and thyroid function test done once as these also commonly cause tachycardia. Medicine do not have much effect on heart rate.
You can get prescribed Tab Ciplar (propranolol) LA 20 mg once a day which will take care of both heart rate and anxiety for 2-3 weeks.
Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by
 
Follow-up: Can sleeplessness or Fluconazole cause tachycardia-like sensations? 35 minutes later
Thank you so much for your answer. It is making me feel less anxious about my heart rate.
By any chance, could the increase in my heart rate be due to a build up of stress over the last few days? I have been a little worried about my heart rate over the last few days even though it has not really been that fast until this evening and I was also a little stressed about my yeast infection. I have just not been able to sleep well for the last few nights and I know stress has been a factor. I was just wondering if a build up of anxiety over the last few days could lead to increased heart rate?
Thank you!
 
 
Answered by Dr. Sagar Makode 21 minutes later
Brief Answer:
Yes, certainly anxiety can

Detailed Answer:
Yes, certainly anxiety can lead to this, infact it's probably the most common cause of palpitations. So do not worry about heart rate.
I don't know much about yeast infection but various options other than Fluconazole are candid pessary in case of vaginal yeast, and Terbinafine ointment if pessary is not effective. So you can discuss with your local doctor. All the best.
Above answer was peer-reviewed by
 
Follow-up: Can sleeplessness or Fluconazole cause tachycardia-like sensations? 22 hours later
I went to a clinic this evening as I was unable to see my family doctor to get some cream for my yeast infection. I told him about how my resting heart rate has been going as high as 120 beats per minute. I explained my history of having PVCs since August and going through several tests by the cardiologist. The doctor had me go for an ecg tonight but results will not be in until tomorrow at the earliest. He took my blood pressure and it was 104/76. He checked my pulse and said it was 80 beats/min. He wanted to give me medication to slow my heart rate but said it would lower my blood pressure which he was concerned about so he says we should wait until the ecg results are back. I told him I have been stressed recently and now that this is happening my stress is increasing. He said the stress could be causing my heart rate to increase but he wanted to make sure it is nothing more serious. I told him I went for an echocardiogram and other tests in August, stress test and 48 hour monitor in September and all they found were PVCs. He seemed to feel better about that fact. He told me if my heart rate is 120 beats/min or higher for one hour or longer that I should go to the emergency room.

Here are my questions for you:
I am just wondering if something serious was going on with my heart, is it possible that it would have shown up in the tests that were done in Aug/Sept?

I am very worried that my heart may have been beating at 120 beats/min for an hour or more over the last 24 hours. I can't keep checking it all of the time and I don't know what it is doing all of the time. Sometimes I feel like it is fast but I check and it is in the 80s. Other times it is higher and approaching 100. Other times, like when I wake up in the morning it is only in the 60s. There have just been a few times it feels pretty fast and it has been up to 120 but I don't know how long that has lasted. I hope I am not doing damage to my heart by not having gone to the emergency room. It is stressing me that I need to keep checking my pulse! I find I am almost afraid to lay down because I focus on my heart beating and it kind of scares me! Do you think it is necessary for me to visit the emergency room? Or do you think I need to get my anxiety under control and stop focusing on my heart rate? If I would have seen my family doctor (who knows me very well and knows how I suffer from anxiety), I am certain he would have agreed with you that anxiety is my bigger issue here. My family all thinks I need to stop worrying about this and focus on other things. They are certain my anxiety is my biggest problem as well. It is so hard to be an anxious person and my biggest fear is health problems so in times like this, my anxiety can get quite bad.

Thank you for listening to my problem and I welcome your advice.
 
 
Answered by Dr. Sagar Makode 1 hour later
Brief Answer:
No need to worry so much

Detailed Answer:
There are two types of heart rate elevation, sinus tachycardia which is normal and other is abnormal. The sinus tachycardia is normal reflex mechanism to anxiety, stress and other factors which is not dangerous. It can normally rise up to 150/160 per minute. So when trigger factors are there then heart rate will rise so that Doesn't mean there is abnormality. Only abnormal rise in heart rate and those associated with chest pain, severe shortness of breath, dizziness etc. So your elevation in heart rate is probably all sinus. So I don't think, you should worry much about it. If you are not convinced then you can get one more 24 hr holter done to document that this is sinus only. Hope this helps you. All the best.
Above answer was peer-reviewed by
 
Follow-up: Can sleeplessness or Fluconazole cause tachycardia-like sensations? 21 hours later
Thank you very much for explaining everything so clearly for me. I really appreciate it! Today I avoided caffeine and tried to keep busy and not focus on my heart beat or pulse. I think that will help me get my anxiety down. The more I focus on it the worse my anxiety becomes. When the palpitations started in the summer it was very scary for me. I became even more hypervigilant than I normally am. Even though my cardiologist and family doctor have told me my heart is healthy and that anxiety is my biggest problem, I think I carry around a fear that something will happen to my heart. I think that is why I began to panic when my heart rate exceeded 100. I appreciate your opinion and advice. It helped to calm my nerves. Thank you!
 
 
Answered by Dr. Sagar Makode 1 hour later
Brief Answer:
You are welcome

Detailed Answer:
That's great. So just remember, even normal person can feel his/ her heart beat and rate above 100 doesn't mean abnormality. So all the best.
Above answer was peer-reviewed by
 
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