Bradycardia / Alcohol

[pdoran01]

Hello, I would appreciate any help that can be offered.

I am a 29 year old male at 6'1" 185lbs.  I exercise a few times a week.  I smoke cigarettes occasionally and consume alcohol in somewhat large quantities on the weekends.

Approximately 3 months ago, the day after a relatively hard night out drinking, I experienced severe tightness and some pain in my chest, arm, neck, and jaw.  I had a high level of anxiety and a feeling of a need to move around / walk.  I also experienced shortness of breath and lightheadedness / dizziness.

My systolic blood pressure was elevated at approximately 150-160 but my diastolic was low at approximately 45-60.  My resting heart rate (which I remember being between between 65-70) dropped to between 42 - 45bpm.

Ever since this day, the chest tightness / dizziness / anxiety symtpoms return the following day after drinking even a small amount of alcohol.  However, my heartrate has consistently remained at around 45 bpm at all times and has not returned to more normalized levels (is never above 50 bpm).

I have been to two cardiologists who so far have not been able to provide the answers Im looking for.  Tests performed included bloodwork, EKG, ECG, and stress ECG.  In regards to the blood work, CPK came back elevated at almost 400.  My doc said this was likely related to exercise instead of an MI (I had not exercised that day but had gone on a long walk).  Can anyone tell me what CPK levels are associated with MI?  

I am concerned about the rate of my heart, what could cause it to be low, whether it can be causing these other symptoms, and is it treatable.  Can high blood pressure cause chest pain / tightness?

Any help would be appreciated.

[770shelia]

I read somewhere that you can have something called "holiday heart" after a night of partying. My best friend is an ECHO tech and her and her husband party alot and she says that they both get skipped beats after drinking which is common.
I took my blood pressure once after a few glassses of wine and it was much higher than usual.
I am experiecing the exact oppoiste of you though, I have tachycardia but worse when I drink. I do not drink much but I do enjoy that wine and the occsional martini. Good luck to you...hope you get some answers.

[bgrimes86]

Alcohol can screw up your nervous system, especially when used in excess. Lay off the booze for awhile and your body will bounce back.

Also, the reason behind the tightness in your chest is probably because of the huge difference between you systolic and diastolic pressure. This is known as "pulse pressure." You calculate your pulse pressure by subtracting the diastolic from the systolic--for example 120/80...120 - 80 = 40. 40 is a healthy pulse pressure and is the norm. With your blood pressure at 160/60, your experiencing a pulse pressure of 100, which is very high. I don't want to freak you out, but a high pulse pressure coupled with bradycardia can be dangerous, especially if your old and unhealthy, but you're not (which is a good thing!). You need to get your systolic pressure down as soon as possible. Again, don't drink anymore until you get your medical situation figured out.

Good luck,

Ben

***I am not a doctor, so do not take this as solid medical advice.***

[dolfnlvr]

Hi there.  

CPK stands for creatine phosphokinase.  It is an enzyme found in the heart, the brain and skeletal muscles.  When the total CPK level is very high (normal is between 0-200), it usually means there has been injury or stress to the heart, the brain, or muscle tissue. For example, when a muscle is damaged, CPK leaks into the bloodstream. Determining which specific form of CPK is high helps doctor's determine which exact tissue has been damaged.  

Your doctor is right.  Regular exercise that increases intensity can cause a release of CPK into the blood stream.  Weight lifting and running are two types of exercise that can increase blood levels of CPK because there is mild damage caused to muscle tissue involved in the building of new muscle tissue.  However, your doctor can perform (well he could have anyway) that indicates WHICH CPK levels are high; whether it is skeletal, brain or cardiac.  This should have been done once the original levels were found to be high to rule out cardiac damage.  By the way, high cardiac CPK levels don't always indicate a heart attack either....they do indicate heart muscle strain, and given your high systolic pressure and very low diastolic pressure.  This causes strain on the heart muscle.

You should check to see that your regular blood pressure (without alcohol involvement) is stable and within "normal" ranges.  If it is, then your "cure" is fairly straightforward.  Relax on the alcohol and your cardiac symptoms should also abate.  However, if you notice that your BP is irratic or generally high, you should follow-up with further testing to investigate and treat the cause.  

You should also avoid binge drinking.  I am unable to determine from your email whether you had "crossed a line" with the drinking prior to your symptoms, but alcohol is a diuretic.  If you take in too much alcohol and not enough water, you will drastically dehydrate your body.  If, on top of this, you are sick due to the alcohol consumption, you will experience even greater dehydration.  Dehydration can raise your blood pressure by putting stress on your kidneys (which play a key role in BP regulation).  As Ben said, the tightness in your chest could be a symptom of your high pulse pressure.  Your other symptoms could (I repeat COULD) be a symptom of severe dehydration.  The following signs are suggestive of dehydration; increasing thirst, dry mouth, weakness or lightheadedness (particularly if worsening on standing), darkening of the urine, or a decrease in urination. Severe dehydration can lead to changes in the body's chemistry, kidney failure, and can even become life-threatening.  

If you are prone to binge drinking (and I'm not saying that you are) you should realize the stress and the danger you put yourself in each time you overindulge.  For every alcoholic drink that you take in you should drink 8 ounces of plain water to decrease the liklihood of dehydration (however, there are other risks involved with binge drinking that have nothing to do with dehydration).  

Alcohol is considered benign by most people, but it is a drug and it can be dangerous.  If you are experiencing cardiac symptoms as a result of alcohol intake, your body is asking you to stop.  You should try to listen.

Like Ben....I am not a doctor, and none of my advice should be taken as a substitute for medical care and supervision.

Take care,
April

[bijuvpillai]

I am 36 year male experiencing low heart rate 49~53 that was in the normal level (63~67) a month ago. Also, my CPK has been tested at 1024 IU/L. Although I don't feel much discomfort, I am worried about the values. I should state that the above readings were obtained 36 h after I had physical exercise for 2 h. My doctor didn't suggest anything. Should I consult a cardiologist? Give me your valuable suggestions.
Sincerely,
Basudev