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Subject: Re: Fast racing heart Hello, I am a 40 year old female, weight is 320 pounds, have lost about 110 pounds in the last year using a 1500 calorie program similiar to Weight Watcher, ex smoker since 1992,chronic asthmatic . I also suffer from Panic Disorder since the age of 25. I take Luvox for my Panic Disorder, and also Take 2 puffs of Serevent 2x a day. I take my abluterol inhaler as needed as a rescue drug. I also take 2 puffs of Flovent 2x a day. Yesterday morning upon waking, I became distressed to find my heart beating very fast. This was very diquieting so say the least. I decided to call 911 cause it just scare the heck out of me. I knew it wasn't a panic attack cause it was lasting too long and I could seem to talk myself down. My symtoms were so weird. I felt like someone ran warm water through my veins, and a rush that was so weird. My heart was racing and I felt lightheading and a bit confused. I was scared for sure. I waited for the ambulence to arrive, and by the time they got to me, I was feeling a lot better. I almost felt silly for having called them. They hooked my up to the Oxygen sensor and the heart montior. My oxygen was good, I think, at 93 or 94. My heartrate was up at 120 or so. The paramedics said that they were going to take me in anyway. Just to be on the safe side. Suddenly as quick as it started before, my heart started to race this time going up to about 180 to 190 beats per min. I felt sooo scared. I thought this is it. They decided that I had exceeded what they called the magic number. They gave me two doses of Addenosine. First a 6 the didn't take, then a 12. This stabilised me to about 110 and by the time I got to the ER, was coming slowly but surely down. Upon doing an EKG, they found nothing wrong with my heart. I spoke with my Asthma Doctors partner via the telephone last nite. Told him what happened. Told him that I was afraid to take my asthma medications. Especially the Serervent. He said to just take 1 puff 2 x a day instead. He also said that if I needed to take something for my asthma as a rescue med, that I should take my albuterol solution. Last night, when I took my asthma machine, I had that racing problem again. This time it only lasted about maybe 10 minutes, maybe not even. And I did vomit. I think the vomiting was from fear though. I think I wanted to get rid of the medication cause I was feeling it is what cause the racing heart problem. I had this happen one year ago. And needed 3 IV pushes then to correct this situation. I am doing all that I can to reduce my weight. I am going to make an appt. with and Intern and Cardiologist this week. I should say the the first time this happened a year ago, I had taken my Serervent about 10 minutes after taking my machine treament. I have never done this since. I always wait at least 1 hour before taking either drug together. I am usually controlled for the most part with just the Serevent and the Flovent. I have been sick with a cold, and this is when it seems that I need to take the albuterol as well. Or if I am very stressed. I should also mention that the day before this terrible incident, I had went to my Asthma Doctor. All was well. My Oxygen level was 98 and my pulse was 66. My blood pressure is always very good. 115/75. I requested them to give me a sample of serervent as I was out, and wouldn't be able to get to the Pharmacy before the end of the day. Had to work. So they did. I went to take a puff of what should have been a metored dose, and it came out non stop like hairspray. I don't know how much of the serervent I got. But it was a heck of a lot more than 2 puffs. I told them about it, and they gave me a new one. This dose I took was about 10 am. I took my normal 2 puffs at about 12 midnight. I am wondering if this caused my problem the following day. The fast heart rate problem that is. I also know that last nite when I took the Albuterol, it gave me the same symtoms. I am so scared to take the drugs now. I know that I have to take something cause my asthma is to bad to go with no meds. I could do without the serevent, it just makes my life normally easier cause I am not a reliant on the rescue drugs. I would appreciate any feedback on this. I am so scared about what is going on. This of course is not helping the Panic Attack Syndrome that I suffer. But if I had to choose which I would rather suffer from, it would be the Panic Disorder. Thank you for your time. Linda
Dear Linda, thank you for your question. I suspect that you had an episode of supraventricular tachycardia (originating from the atria or "top" of the heart) that may have been induced by your albuterol inhalers or machine. Albuterol (serevent is similar) is a beta agonist that relaxes constricted bronchioles to open up the airways and relieve wheezing in asthmatics. However, beta agonists can also speed up the heart rate and may have caused your episode of tachycardia. One alternative would be to talk to your pulmonologist regarding switching to a steroid inhaler and a leukotriene antagonist (a new asthma medication). However, most people who use albuterol don't develop supraventricular tachycardia so this may have brought an underlying condition to your attention. Thus, I think it's also important for you to see a cardiologist regarding the tachycardia. Once these issues are settled, your panic disorder should also improve. Finally, congratulations on the remarkable weight loss and keep working hard to continue that process. I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions. Good luck! If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart
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