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Heart Disease (Expert Forum)
Could Toprol XL interfere with pheochromocytoma diagnosis?
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Could Toprol XL interfere with pheochromocytoma diagnosis?
by fearfactor, Jun 26, 2006 12:00AM
I was tested in October 2004 for pheochromocytoma using a 24 hour urine test. The symptoms that led to this test were tachycardia, extreme anxiety, waking in the night with tachycardia, trembling and sweating that began in August 2004. The urine catecholamine test was negative and I was finally diagnosed with anxiety disorder. Now, I am 30 weeks pregnant and am concerned because I periodically have spells of sweating and my heart speeds up. I do not now nor have I ever had high blood pressure - in fact, my blood pressure is very low, often reading in the 80/50 range (90/60 is normal for me). I have also had trouble gaining weight with this pregnancy. The anxiety is still present. I take 12.5 mg of Toprol XL per day (any more and my BP drops very low). When I'm on Toprol, I don't have the waking in the night spells but when I'm off it I do (I've tried to get off once last summer and had to start taking it again). When I had the urine test back in October 2004, I had just started Toprol XL and was taking 12.5 mg per day for about a week before the test. I am wondering if the Toprol could have somehow skewed the results of the test and I may need to be checked for pheo again without the Toprol in my system. I realize pregnancy causes tachycardia, and I realize that anxiety disorders are very real. What I have never been able to figure out is why, when I am off Toprol, I have spells of waking in the night extremely afraid with my heart beating very fast, sweating and trembling. I realize this sounds like a panic attack but I just want to be sure. Thank you.
Doctor's Answer
by CCF-M.D.-MJM, Jun 26, 2006 12:00AM
It really sounds like you are describing panic attacks. With blood pressures that low, a pheo is very high on my list (it isn't really on my list unless you really spike your blood pressure).
a beta blocker would not interfere with the diagnosis. The urine test is for a very specific chemical that is not masked by beta blockers.
I think you should focus more the treatment of your panic attacks. Recognizing a panic attack when you have one and being able to talk yourself down because you believe you are not going to die is the first and most important step!!! It sounds like you are almost there.
Congratulations on your pregnancy!!! and thanks for posting.
a beta blocker would not interfere with the diagnosis. The urine test is for a very specific chemical that is not masked by beta blockers.
I think you should focus more the treatment of your panic attacks. Recognizing a panic attack when you have one and being able to talk yourself down because you believe you are not going to die is the first and most important step!!! It sounds like you are almost there.
Congratulations on your pregnancy!!! and thanks for posting.
First of all congratulations! I already have 3 girls and my husband is hinting around about trying for a boy (: We'll see.
Well, after reading your post I felt like I was reading my own. I too have lots of night-time tachy that wakes me up and night sweats. The night sweats actually don't happen every night though. I had a CT scan of my adrenal glands/abdomen a year ago because I too had the same symptoms and basically told my Internal doctor to test me for a pheo. I even had flank pain in my right back. All negative. Still though, nobody has explained the night-time tachy or sweats to me.
Let me ask you something, do you wake up with tachy (even after a nap) with a jittery feeling or pounding heartbeat? I do and was curious if you've experienced it.
Did they check your thyroid at all? After I had my 3rd baby my body went haywire and the first thing I noticed was I dropped 15 pounds in days, lots of sweating, tachycardia and a lot of bowel movements (: I went hyperthyroid and it was a post-partum issue apparently. Just a thought since maybe the pregnancy is affecting your thyroid a bit.
I too have low/normal bp. Mine runs 110/60 but since I'm on the Atenolol (12.5mg two times a day) it's more like 90/50's. I was on a higher dose of 25mg 2 times a day and my bp went down to 85/48 and my pulse was in the 40's! I was like a zombie and told my cardio doctor I wanted to decrease it. She actually wanted to increase it because I was still having runs of tachy at times. Ya, ok, let's increase it and then I'll just be comatose all day with 3 little ones running around (:
Well, I'm very curious what the doctor will say...we're kind of in a similar boat (: Good luck with this pregnancy! I personally loved being pregnant and loved having a newborn baby to hold and love (: Best wishes to you!!
Sorry, this is your post and I'm complaining (: Like I said before, best wishes to you on your pregnancy. I really would like to have another baby soon but all this heart stuff kind of scares me at times. I truly understand about the anxiety issue. It really can cause so much, what's the word...ANXIETY! Try to enjoy the fact that soon before you know it you'll have another bundle of joy (: It's such a wonderful experience and the end result makes all the discomforts of being pregnant worth it! Good luck with everything (:
At this point they are thinking it is neurochemical related. Somehow I shoot out adrenaline inappropriately. Sometimes the beta is great at keeping my rate down, but other times it happens anyway.
Feel good with this pregnancy and I hope it calms down afterwards.
Congratulations!
Weird. The same thing happens to me...if I'm taking a quick afternoon nap and the phone rings or my girls wake me, I feel very startled immediately and my heart feels pounding and jittery. Hmmm, maybe it is adrenaline associated. It's just so strange and it happens at night while I'm trying to sleep as well. It does calm down within a minute or 2 at the most but boy it feels disturbing when it happens. Interesting comment though about the sensitive CNS.
So, are you feeling better I hope? Did they determine what caused that strange brain episode? I just feel so awful for you dealing with so much still. Hopefully they can nail down some issues and put the pieces together for you (: Hang in there.
Hi Mom4cem,
I too have 3 little ones and the smallest is 3. It's just too funny to hear other people who have the same symptoms (: So often I feel like some kind of nut case who has the strangest things happening to me physically. My mom teases me that I'm the healthiest sick person she knows. Comforting isn't it? My heart rate too used to just shoot up, within a couple of beats from 90's to 180. The first cardiologist I saw said to just ignore it. I didn't return to his office for another appointment (: Well, it's just so comforting to hear fellow sufferers of weird things! I mean that nicely of course! I'm going to look into the adrenaline issue then, like you mentioned about yourself. Best wishes to you and enjoy your little ones! Mine seem like they grow overnight (: