240 bpm?

[SoccerDad]

I'ma 46-year old male with Panic Disorder and a moderate case of high blood pressure. I take Clonazepam for the Panic Disorder, and metoprolol and lotrel for my blood pressure. My blood pressure has been very much under control. I weigh about 180 lbs. and run and lift weights about 5 days per week. Two consecutive days I forgot my second dose of metoprolol (beta blocker. The next morning I went for a run, and I didn't feel great (I think I was coming down with a stomach bug) but I pushed it. When I finished my run, my heart rate felt high, so I sat down and took my pulse. I could swear it was 240, but I'm not 100% sure, because I kind of panicked a little and wasn't thinking totally clearly. I had no other symptoms (chest pain, light-headedness, or shortness of breath). I got up, walked into the house and took my metoprolol and a xanax. Within a minute or two, my heart rate had come down to about 120, which I would expect after a run. I have had palpitations for a couple of years (along with the panic disorder), and I have had all the tests, but my doctor has told me my heart is fine. I asked him about this incident, and he said 240 would not have been possible. Any thoughts? I could have mis-counted. Has this ever happened to anyone before? I was thinking that my missing two doses of my beta blocker in two consecutive days could have caused this.

[bb123]

SoccerDad,
Wow!! it is possible to go that high. I totally can understand having anxiety and worried.
Even if 200, that is still high. That would means having SVT SupreVentricular Tachycardia which is what I have since a year and a half. I take 25 MG of Metoprolol twice a day.
I never miss a dose. I can see it happening in your case. Heart is good and normal.
It is just an electricial pathway that shoots fast at times. Meds control it.
You will be alright.
Good day.

[tc1414]

i can see that happening, and i'm pretty sure 240 is possible. i think it's 300 that our nodes actually prevent our heartrate from exceeding. when i was on metoprolol, i weaned off of it....the day i finally stopped taking it, my resting heart rate went up to about 120. it did that for about a week at intervals, so i had to go back on a beta blocker (bystolic this time -- much less side effects). but yeah, i can see how that would happen if you forget a dose and then go on a run. sounds normal!

[fancis]

240 is completely possible. I agree, probably has to be some sort of SVT going on. I take 25 mg Toprol 2x a day and I can feel it if I've missed a dose. My heart rate is high and I get PVC's, or even break into SVT. Not a good feeling. I'd try to get a 30 day monitor and see if they can catch what's going on so you can get diagnosed correctly.

[SoccerDad]

Thanks for your feedback. I take 50 mg of Metoprolol twice daily for my blood pressure (and a 5-20mg Lotrel once daily). My blood pressure is consistently good. I simply forgot to take my second dose of Metoprolol two days in a row (the two days before this happened). I have been taking the Metoprolol for two years now, and I have missed an occasional dose, but never two consecutively. And I have never had a heartbeat this high before. So I have to conclude that this was mainly a result of my negligence in failing to take my med’s. I have Panic Disorder, and I have had palpitations, but I have had EKG’s, blood tests (including thyroid hormones), chest x-rays, a stress test (where they brought my heart rate above 190), a 24-hour holter monitor, and a sonogram. All good. I’m not really satisfied with my GP’s assertion that this incident was not possible, so I’ll be looking for a new GP, and I’ll follow up with him or her. Thanks again.