can short term use of pergolide cause permanent tachycardia?

Hi my name is Carlie I am 22 yo female with a VERY long medical history. currently I have many undiagnosed problems, along with various manifestiations of Autonomic dysfunction....working on that with my endo...but for now I just have one issue that I have been wondering about.

I have an 8mm pituitary adenoma that is non secreting. When it was first diagnosed however, they thought it was a prolactinoma b/c I had elevated prolactin but I was also on 2.5mg bid of risperidone (for tourette syndrome, I am not skitso) which can also cause a rise in prolactin. I was at some point able to reduce the risperidone to 0.25mg bid and my prolactin went back to normal. That is when they determined it was the risp and not the adenoma.

Back when they first thought it was a prolactinoma however, my endo put me on pergolide (dont know the dose unfortunatley). I was only on it for less than a month when I felt very short of breath upon standing. My mom is a nurse and has an oximeter so she took my pulse while standing still it was 170. I sat down and within less than a minute it dropped to 65 or 70. She didnt know what the heck was wrong so she took me to the ER. They told me it was the pergolide and to stop it. So they gave me some IV fluids and I went home with orders to stop the pergolide and and a perscription for gatorade and salty foods to keep my sodium up. :) So I did that but weeks after stopping the pergolide, the orthostatic tachycardia remained. I sought a cardioligist and he drew me a diagram of something do do with the anatomy of my heart and why this was happening (although he didn't know the cause) which I didn't really understand and gave me a diagnosis of POTS (postural orthostatic tachycardia syndrome) and put me on 10-30 mg of propranolol. Turns out I only need 10 to make me comfortable enough not to feel the symptoms. 10 mg a day brings my resting HR to the mid 80's (which is fine because I am heavy). The thing is since I was put on it probably 4ish years ago, I have tried stopping it at least 3 times. I have weened off of it, but after it gets out of my system (about a week), my HR always goes up again to where I am uncomfortable, have dyspnea, trouble standing for long period of time, and am easily fatigued and I have to go back on it. I also forgot to mention when I reacted to the pergolide they put me on cabergaline which I also reacted to with extrapyramidal symptoms, so I stopped that too.

My question is I know both of these drugs can cause damage to the heart, but I asked my endo if this could be why the effects of the pergolide remained even years after stopping it and she completely denied that it could be the cause because I wasn't on it nearly long enough or even near a high enough dose to do this.

My question to you is as a cardio doctor and not an endo, is, is this true? and if the pergolide did not cause this then why did it begin after I began pergolide and has not gone away?

if you could give your thoughts on this question that I have been wondering about for years now, I would really appreciate it. I have enough other issues going on.

thanks in advance,
Carlie

P.S. I know this should be posted in the "heart rhythm" forum, but the post button there is gone. I think it may have reached it's daily limit.

[cduval04]

whoops I apologize, I thought I was posting this in the "ask a doctor" forum...chime in if you like, but I am going to repost it in the experts forum...    :)