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Heart Disorders Message Board

Heart Disorders Board Index

Just a little background - I have had high blood pressure forever - every since I was a skinny 100 lb 21 year old. But about 10 years ago, it started to creep up, so convinced doc to put me on meds. Been on 25mg of Atenolol taken at night for @12 years, with good control.

We recently moved, and new doc said Atenolol was an "old" drug, not used anymore, and since I had lost a lot of weight, may not even need it, and she wanted me to taper off and potentially go on "something new". At the same time she wanted me to start an exercise program - walking.

Long story short, the taper didn't go well, and I ended up back on the 25mg. About a month later, I experience an episode of hypertensive crisis where my bp reach 226/127. It was extremely scary for me, and I ended up in ER. It continued to happen, and so I was given Hydralazine for "resuce" if my BP started to climb, and my Atenolol was increased to 37.5 mg, one 25 mg tablet AM and 1/2 tablet PM.

Things have been going fine, then I lost a lot more weight (I'm on a carb restricted diet due to diabetes) and my heart rate - and bp - started to drop a lot. At a visit to a Nephrologist (to rule out any kidney malfunction that might have cause the bp spike) he told me my bp looked good, but he thought my heart rate was low (sometimes in the mid-high 40s).

I talked to my Cardiologist, and he told me to go to 1/2 tablet Atenolol in AM and 1/2 in PM. Not wanting a repeat of my previous tapering experience, I went to 3/4 first in the AM, and kept the 1/2 in PM for 2 weeks, then did as he said.

All has been well, except that as it grew hot here (we live in SC), I started walking on the treadmill at the gym instead of outside. I noticed that the treadmill HR monitor would during my workouts all of a sudden go crazy, and my HR would jump within seconds from 80s to over 150. My max HR is 163. I use no incline on the treadmill, and was only walking at 2mph for 30 min.

I tried every treadmill - same thing. Had my husband replicate what I was doing - nothing. So I mentioned it to my new doc, and he did a 24 hr holter. He told me that there were 3 SVTs, max HR was 118, longest run 4 beats, PACs and PVCs, and that nothing required treatment.

In getting a copy of the report, I notice that I am listed as having Bradycardia with first degree AV Block (don't know what that means) and that my HR low was 44 - 49 runs, with the longest 22 beats. This worries me a bit, and I see him Mon so will ask.

Fast forward to last Sunday, where I was fast asleep and woke up with a racing heart. I wear a FitBit for tracking my exercise, and noticed my HR was at 54, and within seconds jumped from 54 to the 60s, 70s, 80s, 90s. I was concerned so got out of bed, and my HR kept rising quickly into the 100s.

Frightened I was having another hypertensive crisis, I took my BP, and although "high normal", it was MUCH higher than my normal 90/60 at 137/86.

My HR continued to rise, and so we drove to the ER. By the time we got there 20 min later, my HR - and BP - were normal. They ran thyroid tests, tests to make sure I hadn't had a "silent" heart attack, an EKG, CBC, urinalysis, Chemistry Profile, and magnesium level. All checked out fine.

I was discharged a couple of hours later, and told to follow-up with my Cardiologist. Which I did, as well as my regular doc. My regular doc had the NP call me, and she tried to tell me this was "just me" as I had had SVTs on the Holter, and maybe I should just increase my Atenolol and see what happens.

My Cardiologist office had his nurse talk to me and tell me it was "anxiety" - it's not - I was woken from a dead sleep - but I am certainly anxious about what it is. After several back and forth phone calls, I told her this is NOT normal for me and I wanted some help.

So they put me on a 30-day Event Monitor on Monday. Monday morning - before the monitor was put on, I had another episode, but this time my HR only got up to 108 and I put an ice pack on my face and my HR started to slow down.

The same thing happened Tues and Wed AM.

Yesterday - and today - knock on wood - my HR is normal.

There are things, though, that don't seem right to me. My resting HR is @60. Sitting down right now it is low 50s. There are times I have been riding in the car and it has dropped into the high 40s.

The other day I was just picking up some papers on the dining room table and my HR jumped after about 5 min from 54 to 105. When I sat down, it went back down.

Sometimes standing up it will go from low 50s to 99. Or when walking to the gym, which is (I timed it) 2 min flat walk, it goes from 60s to 110 or so.

I can't figure out why a short walk like that would trigger a HR higher than my normal treadmill 30 min walk (??). Sometimes also on the treadmill 5 min into my workout, my HR will jump for no reason - sometime as high as the 150s.

Something is not right, I know it, but don't know how to find the answers. Hoping the Event Recorder provides some answers.

Does anyone have suggestions on what to ask the docs, or what else could be checked?

For reference, I am female, 57 years old, pre-diabetic, hypertensive (seemingly well-controlled) 5'4" and 107 lbs. I eat very healthy, and workout on the treadmill daily for 30 min and weight train with a trainer 2x/week. Don't drink alcohol or coffee anymore, don't eat read meat, and am on a low-salt diet.

I've had (in Dec) a regular stress test - which was questionable - and then a Nuclear Stress Tests - which showed no Ischemia. It was noted at the time though, that I had "Below Average Functional Capacity" as I could not breathe when the test was finished. Pulmonary workup was normal.

I have an Adrenal Adenoma, but have had all blood tests and 24-hour urine for pheochromacytoma which was negative. My Carotid US showed minimal plaque on my carotid arteries, but my Cardio said not of consequence - no need for a statin. They found thyroid nodules during the US, but the Thyroid tests done in ER show normal thyroid function. Kidney function is normal.

My echo was considered "borderline" I believe due to some "trace regurgitation", mild leaflet thickening, and a small pericardial effusion. That's due to be repeated next month.

I don't know where to go with this, and don't want to just be dismissed. It's hard not knowing what caused this, when it will happen again, and how high it will go. I got a paper from ER that said if HR is over 120 and duration greater than 20 min, to come back, but the ER doc was very dismissive, saying "I've had people in here with HR over 150" and he tried to blame it on anxiety (is that the pat answer for women??). My Cardio even told me not to go to ER unless my HR was over 160!!! And he doesn't want my Atenolol increased as my regular doc suggested. So I feel very caught in the middle with no concrete plan - yet.

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