Metoprolol + very strong heartbeat

[DefectorQC]

I'm 39 yo guy who is not active physically basically because I have plenty of other health problems (fibro, chronic fatigue, severe anxiety). I'm in a deconditioning physical state and have a very fast heart rate so my cardiologist put me on a beta blocker years ago to reduce my heart rate (was around 130-140 sit before the beta blocker), now my resting heart rate is around 65-90 depending of my level of anxiety or if I'm in a standing position (POTS possibly but didn't had the tilt table test to prove that)... If I try to exercise my heart rate will increase to 140-160 even on 75 mg day of metoprolol and just after 20 seconds.

Is it's normal to have a normal heart rate but with a very strong and forceful heart beat, I mean when I'm sit, my heart rate will be normal but it's very strong and pounding so I can feel each heartbeat and even my body is moving from the very strong heartbeat. At night it's impossible to sleep cause my bed move because of the very strong heartbeat...

I went to my doc yesterday and he told me that when he took my blood pressure with his stethoscope and the manual blood pressure monitor, he almost became deaf because my heart beat is very strong ! My blood pressure is normal, usually 115/70 and can go up to 130/95 if I'm very anxious and need to get out of the house (have agoraphobia)...but usually when I'm sit and watch tv it's 110/65...

What I want to know is if it's normal that the metoprolol lower my heart but don't decrease the force of the contraction of my heart? Beta blocker usually slow down the heart rate and also reduce the pounding sensation in the chest no?

Any input on this? Thanks -:)

[DefectorQC]

Hi, what you explain is what I also think. The pounding heart in my chest start after I was switch to the Metoprolol... I never had this before on the other beta blockers I tried before.... but the metoprolol is the only one who reduce my heart rate...

But what I don't understand is why my heart is pounding in my chest even if my heart rate is very fast like when i'm standing (average of 100-120 without moving)... Same thing at night, my heart rate is faster than at daytime (80-90 range in my bed) and all I feel and hear is my heart beating really lound and strong in my chest... my bed move... that's what I don't understand...

Right now i'm sit and my heart rate is about 65 and can see my shirt moving with each heart beat... That's make me feel really anxious...

[DefectorQC]

Hey thanks for your explanations... If I understand well, it's not dangerous?

My last echo from the summer 2014 show nothing wrong and my EF was 60... At the end of 2012 I had a nuclear stress test call Persantin mibi and nothing wrong with my heart was found, nothing to explain the chest pain like reduce blood flow...BUT my EF was about 47...

I never was very active physically, I mean I did a lot of solo sports like riding my bike at summer and had a physical work for 10 years working really hard physically... and also had morbid obesity until I had a gastric by-pass surgery to loose weight at 25 yo... Im now 39 yo...

Since 2010 i'm not active at all, I can't even do physical work or exercise cause I feel very weak, have chest pain, left arm pain, jaw pain, i'm too much Dizzy, heart rate can increase from 60 to 160-180 in a matter of seconds and have a very fast heart rate  just standing... that's why I take 75 mg day of metoprolol...

I had some major surgeries for my intestines back at the end of 2011, both surgery left me in a kind of deconditionning physical state...

Anyway, thanks again... My anxiety is so bad that it may be the main culprit afterall...

[kcolly32]

Beta blockers are actually used a lot in people with heart failure and help the heart pump better and more blood. So the fact that you feeling a hard thumping isn't surprising as you are pumping out more blood and increasing you EF. Here's some info on them, might make more sense.

Beta-blockers help treat diastolic heart failure, because they slow the heart rate and allow more time for your heart to fill with blood. This allows the left ventricle to fill more completely and increases the volume of blood that the heart pumps with each heartbeat (ejection fraction). Then, your heart can pump more blood with each heartbeat.

[itdood]

Hyperdynamic heart can mean a few different things.   My heart is hyperdynamic because my ejection fraction is 74%, which is on the high side.  in my situation it's because the muscle is squeezing more than average and emptying the left ventricle more.  This can create that distinctive thump you are talking about.  In my case it was something to consider, but it turned out to be benign so we just left it alone.  Even with that hyperdynamic feature with my heart, my BP is low.   It's very unusual for my age.  

So what I'm saying is that your heart might be behaving the same way.  It would be found on an echo.  Mine was found on echo and confirmed on an MRI.  While it can cause for concern at first, it probably points to a very healthy muscle.  I was also very athletic in my 20s and early 30s, and my heart muscle might be showing some signs of that wear and tear.

[DefectorQC]

Humm I have POTS but my cardiologist also said that I'm in a deconditioning physical state...

I don't know what is a Hyperdynamic heart? Can you explain it?

I had so many heart tests but everything seem to be fine... They just don't seem to know why all of this happen with my heart...

[itdood]

Mine does this sometimes.    Sometimes it happens where my rate will slow down to the high 40s but it will be pumping so hard that it shakes things around me.  bizarre stuff.

I think there are two reasons why it might.  Either Hyperdynamic heart, or dysautonomia, or a combination of both.  Have you ever heard of either of these?