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On Metoperol for sinus tachycardia. Elevated levels of SGOT, SGPT. Rapid heart rate while standing. Reason?

I am 42, and I have been on Metoperol 100mg BID for the past 5 yrs for sinus tachycardia . I was diagnosed in November 2012 with Ankylosing spondylitis . I began Humira 40mg every other week. It has been helping with my pain, however I have had increassing dyscomfort, fatigue , SOB when walking. Even short distances. I am obese, but have been gaining weight and have not changed my diet. My heart rate has also been out of whack. Rising sometimes 40 BPM when I stand or walk short distance. 1 Week ago I came down with URI, and bronchitis and was put on Levaquin . I was coughing up pink/yellow sputum . The other day at work( I work in a medical clinic) I walked to the back of the office and felt aweful, I checked my Heart rate with the pulse ox it was 167, and 02 had dropped to 88 One hr later at rest it was 127. The nurse in the clinic told me to go the ER which ended up being a joke. They said from labs I was dehradted and I had a fever of 101.5, and that i needed to drink electrolightes. I have been doing that, and rested over the weekend. While I was resting heart rate went down ranging from 92-110. When I would stand up or walk, it would rise to 130-150. I had a echo last year which was normal, I have one scheduled again tommorow. My dad has Congestive heart failure and has had it for the past 20 yrs. On my complete metobolic panel done at ER, My ALT(SGPT)WAS 68(normal value 0-50) and AST(SGOT) was 69 normal value 15-41. My heart rate today at work was 137, and temp was 99.9, have felt misserable. I feel frustrated, and I don t want cardiologist just to say, here take these meds youll be fine. I want to figure out was is causing these elevations when I stand up or walk, while on metoperol. I don t think a Echo will do it, as my heart rate is normal when laying down. What do you think, what testing should be done. What does it mean with my elevated labs?
Asked On : Sat, 19 Jan 2013
Answers:  1 Views:  77
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Cardiologist 's  Response
I believe your elevated labs might be part of the metabolic syndrome associated with obesity, with fatty liver infiltration. An abdominal ultrasound should be able to determine if you have fatty liver. In terms for the irregular episodes of tachycardia, the best initial test would be a Holter monitor for 24-72 hours depending on the frequency of the episodes; it seems however that you have had several reasons recently for APPROPRIATE sinus tachycardia, such as fever, infection and dehydration.

Hope this helps,

Dr Brenes-Salazar
Mayo Clinic Rochester
Answered: Tue, 23 Apr 2013
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