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  • Can Toprol XL mask a more serious heart problem?

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    Old 11-13-2003, 09:40 AM   #1
    KATIE25
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    Question Can Toprol XL mask a more serious heart problem?

    Hi! I am a 25 year old newbie to this site. My cardiologist has me on 100mg of Toprol XL (50mg am and pm) because I have a fast resting heart rate (140 bpm). I have had several test to look for structural problems and all have returned normal. I am now wearing a 30 day event moniter to try and determine what my episodes are. My cardio suspects runs of SVT, but none have been caught on the EKG. My hubby has caught my pulse in the 160-190 range on several occasions, but by the time the EKG is hooked up, it has fixed itself. ( Big Surprise! ) My PCP thinks they are only panic attacks and I should with my cardio's approval gradually stop the Toprol. My PCP put me on Lexapro daily and Xanax for these episodes. My PCP says that a resting heart rate of 140 isn't that fast, but I must disagree. I live with it, he doesn't . Long story short, can the Toprol be masking (slowing down) these runs of SVT, such that the event moniter is futile? My resting heart rate is now down to around 70, and I have only had to trigger the moniter about 5 times in 28 days and those were at best minimal episodes, and most likely panic attacks. I haven't had the racing heart/fainting/chest pain deals since my Cardio upped the Toprol to 100 from 50, 2 weeks before I got the event moniter. I am also on Lotensin HCT 20/25 for high bp, if it matters. Also, is 100mg a day, a high dosage of Toprol? My PCP seemed to think so. Thanks in advance for your help!
    Katie

     
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    Old 11-25-2003, 10:42 PM   #2
    PeacedogUK
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    Re: Can Toprol XL mask a more serious heart problem?

    Hi Katie,

    To some extent I think you have answered your own question. Toporol is as you know a cardio-selective beta blocker its specific aim to suppress the catecholamine receptors of the heart slowing down the pacing of the heart and suppressing potential runs of SVT and other Tachycardias induced by catecholamine. (This is from memory so please check this out ) So to answer your question I could say that the Toprol seems to be workng for you and keeping your heart in steady rythm SUPPRESSING but not masking the SVT. But just to answer it another way, the only way you will see the runs of SVT you were having would be (BY YOUR DOCTORS CONSENT ONLY) to stop using the successfull suppressent (TOPOROL). I guess what I'm saying is what do we mean by 'masking'. I hope the above makes sense if not just let me know and I'll try and reword it lol

    The even monitor is not futile though its real good insurance

    Sounds to me though that you have lucked out with the TOPOROL and found somethng to suppress the rythm problem (GOOD FOR YOU )

    Just a final point Xanax in a few people can cause Tachycardia/skipped beats and hypertension, just do a quick search on the net I'm guessing here that your Doctor is thinking that the Toprol will counteract this though. Best thing to do is ask your Doctor why he has you on this and also if he would find it agreeable for you to limit the Toporol for a while and do another holter this way. I know this depends on how approachable your doctor is but well worth a shot


    Long may your funny rythm never return

    Take care Richard.

    PS don't know about the dosage 100mg seems reasonable to me as its time relased over the 24hr but maybe someone on here that uses Toporol could answer you that one.


    Quote:
    Originally Posted by KATIE25
    Hi! I am a 25 year old newbie to this site. My cardiologist has me on 100mg of Toprol XL (50mg am and pm) because I have a fast resting heart rate (140 bpm). I have had several test to look for structural problems and all have returned normal. I am now wearing a 30 day event moniter to try and determine what my episodes are. My cardio suspects runs of SVT, but none have been caught on the EKG. My hubby has caught my pulse in the 160-190 range on several occasions, but by the time the EKG is hooked up, it has fixed itself. ( Big Surprise! ) My PCP thinks they are only panic attacks and I should with my cardio's approval gradually stop the Toprol. My PCP put me on Lexapro daily and Xanax for these episodes. My PCP says that a resting heart rate of 140 isn't that fast, but I must disagree. I live with it, he doesn't . Long story short, can the Toprol be masking (slowing down) these runs of SVT, such that the event moniter is futile? My resting heart rate is now down to around 70, and I have only had to trigger the moniter about 5 times in 28 days and those were at best minimal episodes, and most likely panic attacks. I haven't had the racing heart/fainting/chest pain deals since my Cardio upped the Toprol to 100 from 50, 2 weeks before I got the event moniter. I am also on Lotensin HCT 20/25 for high bp, if it matters. Also, is 100mg a day, a high dosage of Toprol? My PCP seemed to think so. Thanks in advance for your help!
    Katie

     
    Old 11-26-2003, 10:18 AM   #3
    KATIE25
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    Cool Re: Can Toprol XL mask a more serious heart problem?

    Thanks for replying Richard!
    My PCP gave me the Xanax and told me to take one when I felt one of these episodes start and it would mellow me out, so I wouldn't freak out. I tried to explain to him that there is no panic involved in the deal, just chest pain, sob, and a racing heart which may or may not cause me to pass out. Fortunately my cardio took the hint. I haven't actually taken the Xanax because I am not going to drive while taking it, (and that's not possible) and because the Toprol, luckily seems to control the problem for the most part. I can tell no benefit with the Lexapro other than I don't eat as much after lunch, but that is a good thing . I am glad the Toprol is working and luckily I haven't had the horrid reactions that I have read about on this board and others. I was only trying to confirm that the possible SVT wasn't something worse (it's bad enough!) and the Toprol would stop it (mask it, slow it down, etc...) such that any major rythem issue would be missed. My cardio told me there was a slightly increased risk of SVT turning to VF in some rare cases, but by suppressing the SVT this risk was averted. I guess I would know that I needed help quick if I had another severe episode while taking my Toprol. I am interested in your suggestion re: reducing/stopping the Toprol, and then doing another holter, but I am getting very happy with life without a racing heart. I will talk to my cardio and get his take. He is more cautious, so he probablly won't be interested in confirmation, he already has strong suspicions, based on hubby's account (he's a medic).
    Thanks again for responding and sharing your knowledge!
    Katie

     
    Old 11-26-2003, 03:09 PM   #4
    PeacedogUK
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    Re: Can Toprol XL mask a more serious heart problem?

    Hey Katie,

    Glad that the Toprol is really given you some peace of mind and reduced/stopped the SVT. With hubby being a Medic (sure its not Hubby that sets your heart racing lol , nurses tend to have that effect as well as the wife on me ) I'm sure between the the 3 of you cardio/hubby/you that you have nailed the rythm and by the look of things dealt with it

    I had to check with my wife but when I had my monitor(s) my Dr had me stop taking my Beta Blocker before I got the Holter. This was when my PACS/PVCS and "Narrow Complex Tachycardia" were picked up. This was picked up on a day that I thought I had minimal skips/flutters.

    So far I haven't yet found a Beta Blocker that helps me with the bumps/jumps and flutters to the extent now that my Dr has just prescibed me FLECAINIDE an anti arryhthmic, I'm trying to pluck up courage to swallow the dam thing lol (I just dont fancy it as it appears not to have such a good record lol)

    I was jusr wondering do they know or have a good idea where/what is causing your SVT or are you in the Idiopathic club like I am lol

    Take care, wishing you a skip/bump + flutter free day. Richard.


    Quote:
    Originally Posted by KATIE25
    Thanks for replying Richard!
    My PCP gave me the Xanax and told me to take one when I felt one of these episodes start and it would mellow me out, so I wouldn't freak out. I tried to explain to him that there is no panic involved in the deal, just chest pain, sob, and a racing heart which may or may not cause me to pass out. Fortunately my cardio took the hint. I haven't actually taken the Xanax because I am not going to drive while taking it, (and that's not possible) and because the Toprol, luckily seems to control the problem for the most part. I can tell no benefit with the Lexapro other than I don't eat as much after lunch, but that is a good thing . I am glad the Toprol is working and luckily I haven't had the horrid reactions that I have read about on this board and others. I was only trying to confirm that the possible SVT wasn't something worse (it's bad enough!) and the Toprol would stop it (mask it, slow it down, etc...) such that any major rythem issue would be missed. My cardio told me there was a slightly increased risk of SVT turning to VF in some rare cases, but by suppressing the SVT this risk was averted. I guess I would know that I needed help quick if I had another severe episode while taking my Toprol. I am interested in your suggestion re: reducing/stopping the Toprol, and then doing another holter, but I am getting very happy with life without a racing heart. I will talk to my cardio and get his take. He is more cautious, so he probablly won't be interested in confirmation, he already has strong suspicions, based on hubby's account (he's a medic).
    Thanks again for responding and sharing your knowledge!
    Katie

     
    Old 11-26-2003, 03:52 PM   #5
    khudsonwv
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    Re: Can Toprol XL mask a more serious heart problem?

    may i suggest that you have your cardiologist refer you to an electrophysiologist (specializing in rythem/svt etc) - he can do an EP study and possibly ablate the problem area allowing you to, in some cases, safely go off of the toprol all together.. best of luck to you

     
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