Tachycardia comes and goes for nearly a year now

[andy149n]

Since February of this year I've been getting these random episodes of tachycardia where my heart rate goes up to 180-190's, and this will end up lasting for either several hours or even days. My skin gets really flushed and my hands feel shaky during these. I've been seeing a cardiologist since May of this year, and he's done mri/stress-echo/24hr urine/blood tests/ekg's etc. He hasn't figured out what it is yet and told me most of my tests come back normal. They have me on metoprolol 200mg/day , cardizem 240mg , clonidine 0.3mg, and coreg cr 40mg to try and control it. However whenever it's not happening, i feel HORRIBLE. LIke I've just run 10 marathons in a row and can't even get out of bed (this is after I'm just waking up btw). Can anyone tell me what else I can do? I don't smoke or even drink more than 1 cup of coffee anymore. Everytime I have an episode I get this raging migraine that makes me want to take a hammer to my head. :(

[JaimeMD33]

First of all, that’s a lot of medicines. The clonidine and the metropolol alone if stopped cold turkey (all at once) will cause rebound hypertension and tachycardia, which massively increases the risks of a heart attack. When taking all of these medicines you WILL get massively fatigued, sedated, have the feeling of passing out, nausea, dry mouth, not wanting to get out of bed, headaches, etc. Second, DO NOT STOP any of these medicines cold turkey (arruptly or all at once).  Clonidine and beta-blockers have synergistic pharmacodynamic effects resulting in marked AV block, bradycardia, and hypotension. However, when one or both are stopped arruptly this creates increased blood pressure, hypertensive crisis, hypertensive encephalopathy, strokes, heart attacks and fatalities have been reported after clonidine withdrawal alone let alone withdrawal from all of the other medicines (your heart may not be able to handle it). Third, I would highly advise you to get another cardiologist (second opinion), get yourself a solid family medicine doctor and get referrals to both a neurologist and an endocrinologist. It can be a chemical/hormone imbalance and you need a neurological work-up as well. Have all four work as a team to first diagnose, wean off the medicines appropriately, and then treat. You may need angiograms, further cardiac MRIs, EKGs, echocardiograms, Holter and/or Event monitors, tilt-table tests, stress tests, and electrophysiological test to confirm the diagnosis or to pinpoint the location of problems in your heart's circuitry. Also, blood work such as CBC, CMP, Chem 20, hormone levels, along with neurological exams. Once you have a diagnosis they can treat you either with medications, implantable cardioverter, pacemaker, catheter ablation; and if needed surgery — it all depends on the diagnosis. It’s not normal to have that high of a pulse for that long. I don’t want to scare you, most tachycardia is effectively treated with medications alone. My main point is that you need to get the right physicians, get a full work up and diagnostic imagines and once you have the diagnosis the cardiologist can effectively treat and the family medicine doctor can maintain the treatment long-term if necessary. Best of luck!

[cindy707]

Lisa is so right on this one.......do not stop your meds cold turkey there can be some pretty dire side effects from doing that.  When any of us are finally told we can drop a med we are weaned off of them and the docs tell us to decrease the dose SLOWLY.....but only your doc can tell you the way to do that since we're all so different.
I think personally that Lisa gave you some good advice......Good Luck Andy................

[Mom2four85]

Wow that's alot of meds for not knowing what's wrong with you. I'd would as suggested, ditch the dr and keep looking for dr's until someone figures out what's wrong with you.

Be very careful of quitting the meds cold turkey if you've been on them awhile. I would find another dr and tell him/her what the meds are doing to you and ask about alternatives or cutting them down or out.

Read what others have to say about slowly going off them, each of us react differently and what works for one of us may not work for another.

After I had surgery, I was on meds for about 3 mths, and felt miserable and alot of the same things you mentioned was happening to me.  I got the flu and didn't take meds 1 day, laid in bed all day sick, got up the next morning and was feeling alot better but still flu so I didn't take any meds.  The next day I felt almost back to normal and couldn't believe the difference.

It's a catch 22 though, I have to have meds or suffer through arrythmia's daily and the other side of the coin with no meds so no control over my heart & ANS problems.  For me, at least with no meds except emergency ones that last a few hours, I can manage part of the day to stay functioning.

Please find yourself another cardiologist, get a holter or event monitor and you may even want to go have a full neurological workup.  Also, start a journal of what, when, times, what you were doing etc to keep and see if you can track certain triggers and by all means, ask your current doc if you haven't for a copy of your test results.

[Mike551]

This is to high to assume that its a stigma as a result of indoctrination: get exercise. When I neglect my exercise I tach, but at 110 to 120. Just depends on the type of sugar I intook. I take advantage, and go for a brisk walk, because I have been taught that burning fat calories happens at about 60 to 70 percent max heart rate -- I'm a big guy and thank God for it. Actually the dominate norm in my household is a big person (much more than me), and may want big ppl to surround [her] to feel supported. A general rule of thumb: 220 minus your age is max heart rate.

Now, if you take a stimulate (you have more fat than muscle) and you are worried about being fat - autoimmune issues start in the brain - than you may want to enlist an endocrinologist. Its a matter of chemicals, meaning if you would like to be thin, and learned crystal meth can get you there you may use it. It depends on your obsession [with popular vegan models -- yummy 'they're coming']. But will things like super charged caffeinated drinks do the same? ((Probably not? Its a matter of efficacy, and law that impact that efficacy right? Then there is pop art and religion.))

It was ironic that you mentioned that it feels like you have just ran a marathon. I love that. I would suggest, first get cleared, and look into half marathons: they're about 12 miles long. I've never ran one, but heck, I'd do it with ya. I jog 3 miles sometimes in 36 minutes. Maybe once a week -- when I feel afraid about my heart, I fight with a good brisk walk or jog. To heart health; however I've gotten lazy.  

Also if you have issues with your s-node, it is usually noticeable when you take your pulse. Its a phenomena (it could be chemical, it could be simply fear). Some athletes will experience tach, and palpitations when they are not maintaining. Its a matter of conditioning.

From my experiences, I think you are withdrawing. But if you've done to much, than you ought to get your thyroid checked, or make sure you haven't produced a chemical imbalance -- or whatever.  

Here is to normalcy. After the math, rock on. Peace. I'm just saying.

I'm a politician; therefore I never inhaled, j/k. Good luck man. O' nothing is more addictive than winning a race. Thank you, and God bless.  

[cindy707]

Amen Ireneo.....andy definately shouldn't have to feel like this w. what medical science now offers all of us......and tossing pills at you Andy to me is the cheaters way out....find out what the heck it is and address the situation....don't just throw the spaghetti noodles against the wall and hope that one will stick.....sometmes it does more harm than good......

[ireneo]

Supraventricular and atria mean the same thing. Supra means above and ventricular refers to the lower chambers of the heart. So above the ventricles essentially means the atria.

Also, heart meds are notorious for making people feel tired and you're on several. It might be time for a second opinion as Cindy mentioned. Your present doctor is tossing pills at the problem and it doesn't sound like it's working. You don't have to feel this terrible.

[andy149n]

He's seen it around 4 times now when its going crazy on a monitor. First few times he called it supraventricular, then last week when I went in for it he said it looked like an atrial tachycardia. It's beginning to get rather confusing.

[cindy707]

I agree w. ireneo.......that is wayyyy to high and too long.  I am surprised that he didn't put you on a 24 hour monitor to map it.  No doubt you get the headaches your heart is beating too fast for the blood to go to the brain in the way its intended to.  As for being tired that make sense too.  Think about if you had run marathons and your heart rate was super high during that race.....you would be so physically tired after you'd want to take a nap because your heart is working way too hard.  I don't know it seems to me like you are on an awful lot of drugs for tach. or a fib.  Personally i would shop around for another cardiac doc in your area to get a second opinion.  Sounds like your heart needs to be "fixed" and there are alot of new and simple procedures to do that.  A second opinion never hurts and may just enhance your life so you can live like the rest of the human race..........before i had my ablation my pulse rate was off the charts (in the upper 200's) and now i pretty much stay a steady 70-100 which is within normal limits.  Get pro active and take your life back....get a second opinion.....

[ireneo]

That is too high and lasts too long. Has the cardio seen this on a monitor? Have they given it a name? Some arrhythmias just turn on, last awhile and then go away. So if they check your heart while it's in NSR, your heart will look just fine. But if you're having atrial tach or atrial flutter or fib, they need to see that on a strip. The treatments vary depending on what's happening.