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Suggest Treatment For Heart Palpitations, Tachycardia And Hypertension Caused By Stress
Question: I am a 44 years XXXXXXX male working in IT.For past few occasions , at least 3 last years I have been told that my Stress Test , TMT is marginally positive and blood pressure occasionally high.Especially the recovery of heart rate during resting takes long time and considered to be an issue.I do not feel any significant symptoms other than high palpitations sometimes especially after exertion.Typical diagnosis has been "Sinus Arrhythmia" / Tachycardia.2 D echo shows structurally nomal heart with increased heart rate.I have been suffering from IBS for past 20 years and regularly taking "Rekool 20" and "Ridol" to control acidity and motion.For the increased heart rate I have been prescribed "Met Xl" once or twice.My Hb is low ( 11.2) and hence also taking Dexa Orang as well as Dflorate for improvement.What could a good steady long term treatment for this issue?
Brief Answer:
you may have anxiety disorder
Detailed Answer:
Hello Mr XXXXXXX
I am Dr.Rajesh Teli,MD.
I have gone through your qury.Thanks for using HCM.
Basically delayed recovery of heart rate on TMT exercise test may not be related to heart at all.For, abnormal heart rate due to heart disorder, will be picked up by
2D echo and other changes on ECG of stress test.So one thing is clear your high heart rate is related to causes other than heart.
Amongst some of other common causes of High heart rate are
1.Low haemoglobin.
2.Hyperthyroidism
3.Anxiety disorder.
As you have low hemoglobin it may explain tachycardia in your case.You should undergo investigations to find out cause of anaemia.common causes like bleeding piles,Acidity ulcer in stomach leading to blood loss and deficiency of Iron or vot B12 should be ruled out.
2.You should also get your thyroid functions test done,hyperfunctioning of thyroid gland can lead to Tachycardia.
3.You have IBS which is related to anxiety,so you may have anxiety disorder leading to tachycardia.You may be benefited by anxiolytic like aplrazolam o.5 mg at bed time.Met XL too will help you to control it.
If your Hemoglobin is corrected and Thyroid functions are normal ,You must focus on anxiety management
My best wishes
Dr.Rajesh Teli,MD.
you may have anxiety disorder
Detailed Answer:
Hello Mr XXXXXXX
I am Dr.Rajesh Teli,MD.
I have gone through your qury.Thanks for using HCM.
Basically delayed recovery of heart rate on TMT exercise test may not be related to heart at all.For, abnormal heart rate due to heart disorder, will be picked up by
2D echo and other changes on ECG of stress test.So one thing is clear your high heart rate is related to causes other than heart.
Amongst some of other common causes of High heart rate are
1.Low haemoglobin.
2.Hyperthyroidism
3.Anxiety disorder.
As you have low hemoglobin it may explain tachycardia in your case.You should undergo investigations to find out cause of anaemia.common causes like bleeding piles,Acidity ulcer in stomach leading to blood loss and deficiency of Iron or vot B12 should be ruled out.
2.You should also get your thyroid functions test done,hyperfunctioning of thyroid gland can lead to Tachycardia.
3.You have IBS which is related to anxiety,so you may have anxiety disorder leading to tachycardia.You may be benefited by anxiolytic like aplrazolam o.5 mg at bed time.Met XL too will help you to control it.
If your Hemoglobin is corrected and Thyroid functions are normal ,You must focus on anxiety management
My best wishes
Dr.Rajesh Teli,MD.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you doctor for your response.
These are exactly the same possibilities explained by other physicians present during TMT as well.
Just to add precise comments in TMT are "Inappropriate Sinus Tachycardia" and that in 2D echo are "Structurally normal heart. Increased heart rate 140 BPM".
My thyroid tests were normal.
Are you suggesting to continue with iron supplements and Met XL?
Regards
XXXXXXX xxxxxxxxxxxx
These are exactly the same possibilities explained by other physicians present during TMT as well.
Just to add precise comments in TMT are "Inappropriate Sinus Tachycardia" and that in 2D echo are "Structurally normal heart. Increased heart rate 140 BPM".
My thyroid tests were normal.
Are you suggesting to continue with iron supplements and Met XL?
Regards
XXXXXXX xxxxxxxxxxxx
Brief Answer:
please investigate your Anaemia
Detailed Answer:
Hello Mr XXXXXXX
Thanks for your prompt reply. Routinely TMT is done with very intention to raise the heart rate and thereby to challenge the heart to look for any possible blocks in heart arteries. But after exercise is terminated heart rate should settle down quickly. If it takes longer we call it inappropriate.
In your case I feel you should find out cause of low hemoglobin and correct it, so the level should be above 13. Meanwhile continue iron supplements and Met XL,
My best wishes
Dr.Teli.
please investigate your Anaemia
Detailed Answer:
Hello Mr XXXXXXX
Thanks for your prompt reply. Routinely TMT is done with very intention to raise the heart rate and thereby to challenge the heart to look for any possible blocks in heart arteries. But after exercise is terminated heart rate should settle down quickly. If it takes longer we call it inappropriate.
In your case I feel you should find out cause of low hemoglobin and correct it, so the level should be above 13. Meanwhile continue iron supplements and Met XL,
My best wishes
Dr.Teli.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you sir for your prompt reply
I was told by my treating gastroenterologist that the cause of low Hb level is high intestinal motility and hence low absorbation
The UGD scopy and colonoscopy was normal ans since the lebel of HB is between 11 to 12 for many years he didn't advised further investigation
I am monitoring it regularly
Do you advise any further investigation?
This is my final mail and many thanks for your help
Regards
XXXXXXX
I was told by my treating gastroenterologist that the cause of low Hb level is high intestinal motility and hence low absorbation
The UGD scopy and colonoscopy was normal ans since the lebel of HB is between 11 to 12 for many years he didn't advised further investigation
I am monitoring it regularly
Do you advise any further investigation?
This is my final mail and many thanks for your help
Regards
XXXXXXX
Brief Answer:
you may please check your vit B12
Detailed Answer:
Hello
You should check your vit B12 level checked ,if it is not iron deficiency then no point in taking oral iron.
I request you to specifically evaluate anaemia.
You may get
1.complete hemogram
2.peripheral smear
3.vit B12 level
4.HB electrophoresis
Depending upon reports you follow up with your treating physician for correction of anemia.
My best wishes
Dr.Teli.
you may please check your vit B12
Detailed Answer:
Hello
You should check your vit B12 level checked ,if it is not iron deficiency then no point in taking oral iron.
I request you to specifically evaluate anaemia.
You may get
1.complete hemogram
2.peripheral smear
3.vit B12 level
4.HB electrophoresis
Depending upon reports you follow up with your treating physician for correction of anemia.
My best wishes
Dr.Teli.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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