Accelerated Heart Rate

Posted By  CCF CARDIO MD - MTR on September 18, 1998 at 15:15:43:

In Reply to: Accelerated Heart Rate posted by David on September 16, 1998 at 17:43:34:
  I have decided against taking the Nopramine until more questions are answered.
  My question is whether or not I should ask my doctor to refer me to a cardiologist at this point or if I should wait until after the stress test.  Will the stress test be able to indicate whether or not there is a problem with one of the arteries supplying blood to the brain?  I am concerned about whether or not the proper steps are being taken or if a General Practitioner would have enough expertise to make this call.
  Any input would be greatly appreciated.  Thank you.

[CCF Cardio MD - MTR]

Dear David, thank you for your question.  I agree with stopping the nopramine for the time being until everything can be sorted out.  I can't determine exactly why your heart rate was so elevated, but it may be related to stopping the nopramine.  The dizziness, extreme sweating, fatigue, and insomnia are non-specific symptoms that can be related to many different disorders: stress, a viral syndrome (i.e.- the flu), or side effects from medications.  There is nothing in what you describe that makes me concerned that you have blockages in your carotid arteries that supply blood to the brain.  Carotid arterial disease rarely causes headaches and since you had normal CT and MRI scans, I doubt that you have a structural brain disorder.  As for your general practitioner, he sounds like he's doing an excellent job treating your various conditions.   A stress test just looks at the blood supply to the heart and how it changes with stress; it does not look at blood supply to the brain.  The carotid arteries are most commonly imaged with ultrasound.  A stress test sounds like an appropriate test for you now and I wouldn't suggest anything else at this point.  If your stress test is interpreted as abnormal, then you may need to see a cardiologist.  For now, however, I suggest that you continue to see your general practitioner and that you keep a log of your blood pressure and heart rate (on a daily basis).  When you next see your doctor, bring that log in with you.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Please feel free to write back with additional questions.