Fast Pulse After Sleeping On Left Side

[johnnyky]

So I'd been getting this random rapid heartbeats off and on and when I'd exercise or do activity. I drank coffee more than I should but have quit caffeine for now. Basically I've always had skipped beats and faster pulse, but in the last couple weeks I've been getting an even faster pulse even when at rest. A couple of nights it was very fast. I've had EKGs, an echocardiogram last year, CT scan last yr, all were normal. They say I have a structurally normal heart. So it must be electrical? Heres my question. I saw a cardiologist a few days ago. I had been taking a baby dose of Propranolol as needed for anxiety 10mg, he put me on Metroprolol 25mg twice a day. I am now taking the Metroprolol. I definitely notice that my heart is far more settled and slower during the day and I can tolerate activities that before would make my heart race. I'm not overweight at all either, I'm 5'11 165lbs and have always been slim. I've always had a fast pulse but in the last couple weeks things like bending over or getting up would make my heart race. I had been on Lithium for bipolar for 4 days, but I stopped it due to side effects. Could the brief period I was on Lithium have triggered this bout of racing pulses? I told the docs about it but they never seemed to be concerned about it and just said my heart was normal.

So I started taking the Metroprolol 25mg and I do notice my heart is calmer although I still get skips I don't get the racing. At first I wanted to see if I could manage on just 25mg a day once in the morning. But last night I woke up from sleeping on my left side and felt like my heart was going to race and I sat up in bed and it was beating too fast though not as fast as it had before. I had taken 25mg Metroprolol yesterday morning and 12.5mg at night. But this morning I woke up feeling my heart beating fast. So should I take the full dose of two 25mg tablets a day? Maybe this will help?

What is causing this and why would my heart suddenly beat fast after being asleep on my left side? I've only been on metroprolol for 3 days so hoping it will help. It's helping already but I'm still scared of these weird night time episodes. Also does metroprolol have any sexual side effects for a guy? I'm just taking it with a low dose Xanax as needed for anxiety. Thanks so much.

Oh btw the cardiologist put me on it because he said it's more selective and thinks I'll do well on it. Time will tell I guess.

[tom_h]

At this risk of repeating myself, I'll just paste the link in from when you asked this recently:
http://www.medhelp.org/posts/Heart-Rhythm/Does-Metroprolol-Help/show/2347387#post_11360341

As I mentioned there, Metoprolol Tartrate has a serum half life of approximately 5 hours.  let me add this though: Let's say that you take your 25mg dose at 6am.  BY 11am it has halved in strength, by 4pm it has halved again, by 9pm halved again.  By 1am, you have the equivalent of 1.5 milligrams remaining in your blood, a miniscule amount.  

Your physician had a reason to prescribe the twice daily dose.  I wouldn't self medicate as you are now doing.  Take the prescribed dose. If you need to change it, it's not a problem as the effects of it are not long lasting.

[Bromley]

Ok first of all, the problem.

One, you dont know what is causing the racing.
Two, there are some symptoms that are "mysterious". eg it occurs when asleep and is associated with being on your left side.
Three. You are using a few medications, changing doses at the moment and are unclear on what the right strategy is.

1. You have a structurally normal heart.  But I see no indication that you were checked for heart disease.  This might be because you are young or do not have the personal profile associated heart disease.  Instead of that, the racing could be caused by SVT, a heart arrhythmia that is usually curable. They check you for that using a portable heart monitor that you take home with you. Arryhtmias occur sporadically and have way of not happening when the ecg  machine is hooked up. A heart monitor can be worn all the time. You could ask for a heart monitor.

2. Mysterious symptoms. OK I've had the left side thing happen to me myself and I am stumped. However, I generally feel better when I am off of caffeine for a full month. While I am getting off of caffeine I have a nightmare of symptoms. Headaches, heart palpitation, breathlessness, sweating, light headed or dizzy, you name it. Weird stuff. I take no drugs of any type, but still get the symptoms.  Some of these symptoms also improve if I do some very light exercise. Ask you doctor if that would be ok. I definitely feel better after several weeks of no caffeine though.

3. I would expect some symptoms to be jerking you around until you guys get your dosing figured out. Just  keep working with  your doctor on this and be patient.

Best of luck.