Tenormin and Asthma

  Hi! I posted Panic Attacks and Tachycardia a few days ago. I was wondering about the effects that Tenormin has on asthma.Although I have never had
  an acute asthma attack I was wondering if Tenormin can cause my asthma to get worse. If I use my inhaler will it not work well?
  I was also wondering if my 24 hour halter monitor results are negative should I get an echocardiogram? I had one two years ago. I'am a 21 year old female that
  has tachycardia (EKG ruled out everything abnormal except heart rate) and some chest pain when I stand up from sitting down, I feel the pressure from my chest to my head.
  My doctor thinks it is reflux. I was wondering though if anymore tests should be done. All blood tests were normal(no anemia, thyroid problems etc..)
  Thanks A lot, sorry to bother you again,I'm just nervous!!!!
  JAMIE

[CCF CARDIO MD APS]

Dear Jamie,
I just read your other posted note and re-read this one regarding tenormin and asthma.  Firstly nervousness and fast heart rates are side effects of certain inhalers used in asthma (especially ones with albuterol which are "beta stimulants"). Conversely, "beta blockers" used in cardiology for fast heart rates can and often do exacerbate asthma.  It is fair to say that your tenormin and your inhaler are counteracting one another, that is to say they are cancelling one another out. In general most physicians will try a beta blocker in asthmatics but stop it at the first sign of trouble (increasing asthma symptoms).
The pattern of your tachycardia is important in answering your questions, for instance if the tachycardia is always present an echocardiogram and further testing is required since persistant tachycardia can lead to heart failure that is totally reversible when the persistent tachycardia is relieved (usually by a cardiologist that specializes in fast rhythms-called an electrophysiologist.)  If on the other hand your tachycardia occurs only in relation to use of the inhaler and or episodic anxiety, then these underlying processes need be addresses first and foremost.  Of course there are many other reasons to get an echocardiogram other than a negative holter, for instance if the cardiac exam reveals a murmur or if there are other symptoms not explained by findings on the holter monitor.
If after all forms of investigation are undertaken and all symptoms are evaluated  and you are diagnosed with panic disorder alone (plus your underlying asthma disorder of course) it might be best to recieve treatment from a mental health professional who deals with panic disorder.  Tenormin is not the drug of choice and you sound as if your asthma worsens while taking it.  From my limited understanding of painc disorder, the attacks are incredible and very much lifestyle altering but often fade in time and usually are controllable with relaxant type drugs like valium.  It is also not uncommon for a person to feel as if they will die during a panic attack, but it is good that you are having your heart checked and not just assuming it is panic attacks alone.  
Information provided in the heart forum is intended for general medical purposes only, any diagnosis and treatment can only be made by your physician(s).