Bradycardia in the morning Tachycardia at night.

MRG

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Any great ideas?

A year and a half ago my new PCP said my BP was too high, it was, and put me back on BP meds. I'd been off them for over a year with my prior PCP'S ok.

She started with the last one I had taken, diltiazem, a calcium channel blocker. Unfortunately it wasn't up to the challenge and she pulled out the metoprolol, a beta blocker. I told her I'd had an issue with beta blockers causing bradycardia(heartrate too slow)in the past. I've also had non-specific tachycardia(heartrate too fast) when I wasn't on beta blockers. I was not experiencing tachycardia when she chose this medication.

So I've taken this crap for over a year and was dizzy the entire time. Complained several times with no resolution.

Recently I have started doing more cardio and have had to cut the dosage in half, with my PCP'S ok. She finally agreed maybe I was taking too much. Now my body is used to a beta blocker so my heartrate is like a hummingbird's. It's been a couple months and it doesn't seem to be correcting.

So now I have tachycardia at night(100+) and in the morning my heartrate is too slow(50 and dizzy). When I complained again, her nurse suggested tracking my numbers for a while.

At this point I'm losing faith in my PCP. Seriously does anyone else have this issue? I'm in an area without a lot of health care choices. There is a cardiologist not far away, perhaps I should see them?
 
You should probably go see a proper cardiologist. Takes me forever to get my BP under control. I get Bigeminal PVCs when it is to high. Seems OK now but I take meds in the morning and in the evening.
 
You should probably go see a proper cardiologist.
+1 Go see the cardiologist. It might be nothing, but seeing a cardiologist can't do any harm. Even if he doesn't change your medications, at least you will get some peace of mind because you will know he agrees. Or, maybe he will change your medications. And BTW, good for you to be taking care of your heart.
 
Agree, go see the cardiologist.

We woke up May 30th, starting our day like any other. My wife had just finished brushing her teeth when she suddenly fell backward, crashing against the door and landing on our tile bathroom floor. I rushed in to find her laying there lifeless. She wasn't breathing, her heart wasn't beating, and her eye's were wide open with no sign of life in them. It was very scary, and I sat there in shock calling her name for over 20 seconds. I thought I had lost her, and never even got to say goodbye or tell her I love her. I was so scared and confused I didn't even think to call 911.

Thankfully after 20 seconds or more she slowly started coming back to life. She has fainted in the past, but this time was a little more extreme. We rushed to the doctor office and she passed out again in the car on the way. She passed out again in the doctor office so they called an ambulance. On the way to the hospital her heart stopped again and she stopped breathing for 20 seconds. Once she was in the emergency room she probably lost consciousness five or six more times. They diagnosed her with Bradycardia and she had a pacemaker implanted on June 1st.

She's only 49, in good health, and we had no prior warning. They say her heart is in excellent condition, but the timing mechanisms just aren't working right. It was a really scary experience and gave us a new outlook on the future. Enjoy life now while we still can, because we don't know how long we'll have.

If you're having heart issues, get it checked. Life can change in an instant!
 
Not sure if this helps, but I was having PVC's (premature ventricular contractions) over a year ago now. First couple docs I saw were no help, but I finally found one who suggested I try metaprolol at 25 mg daily. I did that, and the PVC's immediately stopped. Heart rate did slow a bit, but nothing that was really a problem. I eventually cut the metaprolol dosage in half (cut the 25 mg pill in half and just took one half daily - just before bedtime), and all is good - still no PVC's, and heart rate is fine.



I came to find out much later that my PVC's were most likely being caused by too much iron in my system (iron overload). It is not that uncommon in guys over 50, and can be serious. You can find out if you have iron overload by having a ferritin test done (simple blood test, not expensive). Donating blood is a simple way to reduce your iron level. I started doing that more frequently also, so that probably also helped eliminate the PVC issue.
 
Are you taking a daily multi vitamin? I traced my PVCs to vitamin E.
 
Going through a rebalancing with my cardio right now. Metaprolol 12.5 2x a day brought my HBP down. Now after 5 years, I have developed AFIB. So switching out metaprolol and amlodine for eliquis (2x), verapamil and hydrochlorothiazide (also some foot swelling).

We have a new PCP so getting the updated referral was no problem. He will deal with my COPD.
 
Any great ideas?

A year and a half ago my new PCP said my BP was too high, it was, and put me back on BP meds. I'd been off them for over a year with my prior PCP'S ok.

She started with the last one I had taken, diltiazem, a calcium channel blocker. Unfortunately it wasn't up to the challenge and she pulled out the metoprolol, a beta blocker. I told her I'd had an issue with beta blockers causing bradycardia(heartrate too slow)in the past. I've also had non-specific tachycardia(heartrate too fast) when I wasn't on beta blockers. I was not experiencing tachycardia when she chose this medication.

So I've taken this crap for over a year and was dizzy the entire time. Complained several times with no resolution.

Recently I have started doing more cardio and have had to cut the dosage in half, with my PCP'S ok. She finally agreed maybe I was taking too much. Now my body is used to a beta blocker so my heartrate is like a hummingbird's. It's been a couple months and it doesn't seem to be correcting.

So now I have tachycardia at night(100+) and in the morning my heartrate is too slow(50 and dizzy). When I complained again, her nurse suggested tracking my numbers for a while.

At this point I'm losing faith in my PCP. Seriously does anyone else have this issue? I'm in an area without a lot of health care choices. There is a cardiologist not far away, perhaps I should see them?

PLEASE NOTE i am NOT a medical professional , however i may be on the way to becoming a professional patient .

also note i am not accustomed to the US health-care system

and have not been prescribed the same medications as you

HOWEVER i would ask you doctor if an ECG ( or EKG ) is appropriate

Blood Pressure : Electrocardiogram (ECG) and high blood pressure

this may ( or may not ) lead to an Echo-cardiogram

https://www.webmd.com/heart-disease/guide/diagnosing-echocardiogram#1


please also note my philosophy on heart problems

whatever you do DON'T panic ( there will be enough medical staff in disarray if it is serious , already )

your issues are ( hopefully ) different to mine , but indeed considering you are on medications already , i can see why you have concerns .

in Australia the GP ( or the hospital ) refers you to the Cardiologist

however a second opinion if you are still worried , maybe wise

given my current health ( and medications ) if my heart rate drops below 60 bpm .. my GP is WORRIED ( so far 64 is the new normal for me .. even during an Angiogram )

i hope your health improves

( PS have they given you a wearable heart monitor yet , normally you wear for 24 hours while you are at home )
 
I think the OP needs to see a cardiologist. I saw one in Texas when I had an irregular heart rhythm and underwent some tests including a 24hr heart monitor. Since returning to the UK I have been referred to a cardiac electrophysiologist and my immediate problem is AFib, for which I expect to have cryo AF Ablation in the near future.

The point is that the electrical system of the heart is pretty complex and I think that conditions such as bradycardia, tachycardia etc. should really be investigated thoroughly. However, I’m an engineer not a doctor, and just another anonymous voice on the internet, so my opinion is not worth much.
 
Agree with Alan. Your symptoms warrant evaluation by a cardiologist. Ask your PCP for a referral to a cardiologist. A simple 12-lead EKG is not good enough. A cardiologist can order and evaluate a 24-hour Holter monitor, which is a device you wear for 24 hours, going about your normal activities. You note the exact times you experience symptoms (short of breath, dizziness, chest pressure, a fluttering feeling in your chest, arm numbness, anything that seems unusual), and a technician can correlate the symptoms to any cardiac rhythm changes. The cardiologist can then evaluate and recommend treatment or further diagnostic tests. You'll get a much more satisfying evaluation compared to what your PCP's office is doing. My 2 cents.
 
I would suggest seeing a cardiologist that also has clinical cardiac electrophysiology training, not all do.
 
This is very handy. It allows you to take an EKG with your phone whenever you feel it's too fast or too slow. You can show the results to your PCP, cardiologist or EP so that they know instantly what you're talking about.

https://www.alivecor.com/

Will also show if you have any arrythmias.
 
This is very handy. It allows you to take an EKG with your phone whenever you feel it's too fast or too slow. You can show the results to your PCP, cardiologist or EP so that they know instantly what you're talking about.

https://www.alivecor.com/

Will also show if you have any arrythmias.

I've been using it since January and the cardiology unit I attend are fully aware of it and approve. It was nice to be able to go to my last appointment with 6 months of data summarized in a spreadsheet plus a printout of some of the Afib traces. Year to date I have had 48 irregular heart beats as recorded on my BP monitor and 31 of those were shown to be Afib using the alivecor device. I have really learned to recognize the symptoms of Afib from this feedback. Many folks never realize that they are in Afib so I am fortunate to know from a slight dizziness when I go into Afib.
 
I've been using it since January and the cardiology unit I attend are fully aware of it and approve. It was nice to be able to go to my last appointment with 6 months of data summarized in a spreadsheet plus a printout of some of the Afib traces. Year to date I have had 48 irregular heart beats as recorded on my BP monitor and 31 of those were shown to be Afib using the alivecor device. I have really learned to recognize the symptoms of Afib from this feedback. Many folks never realize that they are in Afib so I am fortunate to know from a slight dizziness when I go into Afib.
Good luck with the Ablation. Try to get the most experienced EP that you can find, with hundreds or more under his be!t, and don't let him use you as a teaching aid [emoji4]
 
Good luck with the Ablation. Try to get the most experienced EP that you can find, with hundreds or more under his be!t, and don't let him use you as a teaching aid [emoji4]

Thanks.

He is an EP with hundreds of ablations on his record. He deals exclusively with heart arrhythmias.
 
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