night tachycardia and pounding heart

Mainly at night, but also sometimes during the day my heart pounds and races.  I feel my pulse throughout my entire body.  I'm a 28 year old otherwise healthy female.  I've cut out caffeine and drinking, I exercise regularly and eat a well balanced diet.  I don't feel other anxiety symptoms, but have in the past.  I've had an echo, ekg, holter 24hr and all results have been normal.  I do have a heart murmur and PVC's and I am waiting to see the cardiologist in early Jan.  Taking ativan does not decrease the speed or force of my heart, and so i do not take it often.  

Yesterday I was prescribed beta blockers (propranolol) and took one 10mg tab split in two pieces.  I took the first at 11:30am and the second at 2:30pm (very close together).  My heart rate dropped to 55, but my BP also dropped to 90/43.  I have very low BP to begin with... I felt okay, a little light headed, but no more pounding.  Thought i would finally sleep through the night, but an hour in I awoke to my heart racing and pounding.  This carried on for the entire night; drifting, waking, drifting, waking and so on.  

Here are my questions.

1.   Can my heart be affected by anxiety when there are no other symptoms present?
2.   Can anxiety wake me from a sound sleep?  (not short of breath or scared)
3.   Is propranolol fast acting?  
4.   Would it likely have left my system by the time i was sleeping?
5.   I have very vivid dreams; is it possible they are affecting my heart?

Please add any advice or thoughts on what might be causing this condition.

Thank you

[Brooke_38]

Hello...

Anxiety can be experienced in many different ways. You don't neccessarily have to be consciously aware of its presence. I think that we all, to a certain extent, whether we admit to it or not, have periods of anxiety...some that we may not even be aware of. So yes, it can have an affect on how your heart responds...usually an increase in rate.

When our bodies are under stress it may be difficult to completely relax. Further, it will impact how we sleep. There are five recognized levels of sleep, the two deepest being Slow Wave Sleep (SWS) and  the shallowest is Rapid Eye Movement (REM) Sleep. Typically, in the first part of sleep, the deepest level is reached rapidly. Then the level of sleep alternates in a pattern of shallower and deeper levels with the average level becoming shallower as sleep progresses. It is during these 2 levels of sleep that we dream. Vivid dreams as well as nightmares will cause a release of adrenaline into our bloodstream....this will certainly have an affect on your heart rate and could very well wake you from a sound sleep.

Propanolol takes about 30 minutes to start working. Peaked levels are reached about 60-90 minutes after taking and it's duration is typically 6-12 hours. You mentioned that you split the dose and took it 3 hours apart. Was this how your Dr told you to take it?

[lulu002]

Hi Brook. Thanks so much for responding.  

The doc told me to take the propanolol .5 to 1 tab two times a day.  She didn't say at what time to take it... I spoke to a pharmacist today and they said try taking it 12 hours apart. I took it at 7:30am and i'll take it again at around 9 tonight and see what happens.  I'm avoiding the full 10mg dose due to low BP.  Do you think 10mg can take my BP down to dangerous levels?

Again, I appreciate your input so so much, and the bit about anxiety has eased my tension a bit.

[Brooke_38]

Hello...

If you are already prone to a lower than normal BP than 10mg may drop it even lower. It is hard to predict how low yours would drop. You will probably have a much better result taking the 10mg in a divided dose 2X day (12 hrs apart, as the Pharmacist mentioned)

I'm glad that you are feeling less anxious:) Keep us posted with how this works out for you:)))

[lulu002]

One more thing.

Do you mean that I should take 20mg a day total by dividing the two 10mg doses?

[Brooke_38]

No, you should do what the Pharmacist recommended 10mg in divided doses means
,5 in the am/.5 in the pm = 10mg total in one day

[Brooke_38]

I didn't mean to confuse you:)  I meant to say 5mg in the morning and 5mg at night. This means that the 1 pill that is 10mg is cut in half...

[lulu002]

Thanks again.   I'll let you know how it works out.