Tachycardia, palpitations, anxiety and hormones

[scareddee]

Hello,

Thank you for taking my questions and for providing this very valuable service.

I am a woman who turned 49 years old yesterday.  I have a ten year history of panic and GAD that waxes and wanes.  Cardiac symptoms, such as tachycardia and "skipped" beats occur when it's high.  I have had two echocardiograms, the first showed MVP(mild, but medicate for dental work), the second didn't.  These were both performed several years ago.  I had a normal holter monitor test last April.  I did have some symptoms, but was told holter was "normal."  I did not ask any specifics.

I have been having increasing bouts of tachycardia and palpitations again.  I am also struggling again with my anxiety and I'm in the middle of an awful perimenopause.  I am sometimes anemic and have had problems in the past with low potassium.  Lab values for each of these was normal last month when I had them retested.

My questions for you are: 1.  How much do changing hormones and anxiety-produced adrenaline factor in to periodic tachycardia and palpitations?  2.  Is there any way I can tell if anxiety is precipitating the palps or if the palps are precipitating the anxiety?  3.  Would more testing be in order and if so, which tests would be helpful?  4.  Is it better to medicate for the anxiety or the cardiac symptoms?  (I have had success in the past with klonopin and had no problems coming off.  I have had terrible side effects with SSRI's and also with beta blockers.  I am willing to give the beta blockers another chance if that is the best route to go.)

Thank you very much.

[Cleveland Clinic]

scareddee,

thanks for the post. cute name.

1. How much do changing hormones and anxiety-produced adrenaline factor in to periodic tachycardia and palpitations?

For some women, hormonal fluctuations can have significant effect on their palpitations. Anxiety can also play a big role.

2. Is there any way I can tell if anxiety is precipitating the palps or if the palps are precipitating the anxiety?

If the anxiety is getting worse I would imagine that it is probably the main component here.

3. Would more testing be in order and if so, which tests would be helpful?

I probably wouldn't pursue too much more testing if your previous test were normal.

4. Is it better to medicate for the anxiety or the cardiac symptoms? (I have had success in the past with klonopin and had no problems coming off. I have had terrible side effects with SSRI's and also with beta blockers. I am willing to give the beta blockers another chance if that is the best route to go.)

Again I proably would focus mor on the anxiety component. It would be important for your cardiologist and whoever you see for your anxiety communicate their findings.

good luck

[NurseKagome]

The birth control pill (low does oral route) is pretty darn safe. The only big warnings are if you are a smoker, it can really increase your chances of bloodclot or stroke. But otherwise it has been around for quite sometime and posses little threat, otherwise I would think it wouldn't be so popular and you really only hear about bad side effects with smokers. I guess it could be an option for you. Don't read up on any drug and consider ALL of the side effects, I mean if you look up a simple drug like Advil or Tylenol they have some very bad sounding side effects, also VERY rare. :) Hope this helps.

Nurse Kagome

[Rachel's mom]

Yes, my cardiologist has me taking 25 mg of atenenol just during my period.  i go on for 5 days then off till my next cycle...has worked for me as i said but last month horrible pvc...so we will see.  Low dose pill sounds safe according to the comments here i think it could really help with the perimenapause im about to go into...can you stay on it thru menapause??  Say hi to your rachel...mine is 3 years old.  Geez no wonder im flipping and skipping im chasing a 3 year old around all day...haha.

[Rachel's mom]

I feel for you as I am experiencing very similar hormonal reactions.  I started having tachycardia during my period last january and continued every month until i started a beta blocker during my period.  That has completely stopped the tachy but i had a very bad bout of pvcs/pacs last month...worse than i have ever had in my life while on the beta..i was surprised.  If it happens again this month i will look into swithcing beta blockers as i am suspicous it had something to do with the meds.

You read on here about alot of women having symtoms of more severity during their cycle and menopause...makes menapause even more scary.  I am almost tempted to do a low dose birthcontrol pill to even out my hormones.  Anyone try that?  Good luck and i hope you feel better soon.  Judianne

[anacyde]

Hormones have been playing 90% of the role in my palpitations since the birth of my son 11 months ago.  It can be extremely frustrating.  

I have frequent exercise-induced PACs and my cardiologist seems to think it's adrenaline.  Like you, I have a history of anxiety.  It seems many people here do, which makes me think it's very likely adrenaline plays a very big role in our ectopic frequency.

[CollegeGirl143]

since you know that your tachycardia and palps are caused by your enxiety, i think the best way to go would be seeking counseling and some kind of anti anxiety medication (not a benzo)... klonopin and drugs like it are only temporary masks. Also maybe seek treatment for premenopausal symptoms. Treating your cardiac symtpoms rather than your anxiety disorder thats causing the symptom wont make u any better, just offer a temporary cover up