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1124887 tn?1313754891

Beta blockers and heart contractility

I'm taking 25 mg metoprolol and occationally 10-20 mg of propranolol because of anxiety, sinus tachycardia and PACs.

I've got a stress test done, lots of EKG's (one of them uploaded on my profile), Holter, echo x 2, troponine after having a rapid heart rate, and a lot of other blood tests. Everything is completely normal except for the rare PACs and some sinus tachycardia.

Anyway, since I started taking the beta blockers, my heart rate is slower, which is nice, but it also feels more forceful with stress. During my first echo, I was really scared and my heart rate was 120. Everything normal, with EF 60%.

An echo done last winter (with beta blockers) was also completely normal, my heart rate was 80 (still nervous) but EF had increased to 80%. The cardiologist told me that "this heart would everyone envy you".

Since I started taking the beta blockers (and after that starting to exercise), my pulse pressure is increased too. Earlier, my BP was in the 115/75 to 120/80 range, now it's more like 115/60 or 110/57. This is bothering me a bit, because I'm afraid my aorta is getting inflexible already at my age. Is this the explaination, or is it simply that my heart is pumping more blood?

I occationally feel some diffuse chest pain (not with exercise), but occationally I get some discomfort if I'm suddenly scared or jumping up from my chair. Can I rule out beginning angina at age 30 if my cholesterol is 4,6, HDL 1,2, BP fine, stress test got me up to HR 210 with no ST-depression or arrhythmia. I don't smoke or drink, no illegal drugs, exercising or walking 5 miles 3 times a week. Some family history (my dad got angina at age 60 but at that time his lifestyle was extremely bad. He's doing fine now after weight loss and quit smoking).

Thank you very much in advance.
2 Responses
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1687176 tn?1321398009
MEDICAL PROFESSIONAL
It is impossible to rule out angina as a cause of chest discomfort -- especially over the internet. However, in the setting of minimal risk factors and a recent negative stress test. Your blood pressure ranges are within normal limits for someone your age and actually does not qualify as hypertension --- i.e. a BP of 120/80 is normal for you. Your echocardiograms also report that your ejection fraction is normal (> 50-55%).  

Again, while it is impossible to make a definitive diagnosis over the internet, it is possible that your chest discomfort is related to your underlying anxiety (especially if you carry a previous diagnosis).

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1124887 tn?1313754891
Giving my post a little bump, I hope this is OK.
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