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Does situational tachycardia need to be medicated

I have recently experienced episodes (lasting hours over several days) of rapid heatbeat which I can feel and which are disquieting, but which are out of proprotion to any anxiety (if any) that I am emotionally feeling.  

I am a 60 yo female, 115 lbs, 5'3" in good health, taking Actonel for osteoporosis.  No other meds. I am physically active, swim half mile twice a week, walk 2-3 miles 3 times a week and work out with weights 3 days a week.
I have an unremarkable medical history except for periods of treatment with Prozac and Lexapro in the past of depression/anxiety.  I stopped taking 5mg dose of Lexapro 3 months ago (had been taking for 5 years) and have been feeling no different than when on the Lexapro, i.e, fine, happy, not anxious or depressed.  Then the episodes of rapid heartbeat start.  I do not consciously feel emotionally anxious or depressed.

Recently started with a new internist (my old doc closed her practice) and he noted my rapid pulse (90 and 96 on repeat later) on my first office visit.  Thyroid and other labs are normal.  My total Chol is 220 with HDL of 82. It has been this way my whole life. He sent me for a CardioLite stress test. It was normal.  Now he wants to put me on medication to control my heart rate.  I don't want to take any more meds and have to deal with the side effects.  When I am at home and doing my normal things, my pulse is 60-70.  Do you feel I need to be medicated ?  Is CBt an option ?  What is the risk to my heart without medication ?
1 Responses
469720 tn?1388149949
Hi Carla
It sounds very unsettling. You didnt mention what your associate blood pressure is durin these events or at baseline.  What is your LDL? Have you kept a journal to determine the frequency of this process. All of these would be quite helpful. Lastly have you had an echo to assess the structure of your heart and any evidence of valvular disease. Your heart is doing a bit of additional work during these periods and I would seek to determine the reason so that you can move on comfortably
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