Brief Answer:
A cardiac check-up

Detailed Answer:
Hello and thank you for your question. I understand your concern. Welcome to HCM.

Until now, the whole description you gave is that there is nothing to worry about. But, given your age of 76 years old, I would recommend you a full cardiac check-up. The episode that happened on Sunday, may have been due to enhanced exposure to the sun, since heat dilates the arteries in the body, hence lowers the blood pressure, and this can explain the near-fainting episode. However, I would recommend these tests:
- an echo cardiogram - to evaluate the structure of chambers and valves of the heart
- a cardiac stress test - to assess the hwart's electrical system in physical stress state
- a Holter rhythm registration - to see if any episodes such as of Sunday's is depicted throughout 24 hours or not.

I hope I was helpful with my answer. I am glad to help, if you have follow-up questions.

Kind regards,
Dr. Meriton

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Brief Answer:
Stress and anxiety elevate both bp and pulse rate

Detailed Answer:
Hi again and welcome back.

Well, it is a good thing that metoprolol is being taken in larger dosage, because it helps control both the blood pressure and the heart rate. It is very positive that blood pressure is controlled. Stressful situations, such as physical or psychological stress, elevate the heart rate. The main exam that would "clear our minds" to whether this tachycardia is due to stress or not, is a 24-hour Holter rhythm registration, which basically is an EKG spun throughout a day. There we could check the unstressful situations, such as complete resting state or sleep, to divide whether this is a physiological or pathological tachycardia.

I hope my follow-up is helpful. Kindly, if you do not have further questions, close the discussion and rate my answer.

Best regards,
Dr. Meriton

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