Can you have tachycardia for NO REASON?

01-23-2008, 08:17 AM

Hello. I have been on Toprol XL 25 mg per day for about 2 1/2 years due to unexplained tachycardia. I was orginally placed on the medication by my GP but was a little leary about taking it so I went to a cardiologist to get a second opinion. He did an echo, said he couldn't find anything physically wrong with my heart, although it does beat too fast (about 160 without medicine) and to take the Toprol. So I have been. When I decided to become pregnant, I asked the cardiologist, the GP and the pharmacist about taking it while pregnant because it is I think a Class C or D drug and the effects on pregnancy are not known. The cardiologist and GP assured me that I MUST take it while pregnant and that I would be fine. The pharmacist told me, in his words, "If you were my wife, I wouldn't let you take it while pregnant." I ended up taking the Toprol when I was pregnant with my first daughter who was born in July 2007. She ended up having two holes in her heart. Although I had one when I was born as well, and I guess it could be genetic, I wonder if the Toprol didn't have ill effects or is the cause? Well I just found out that I am pregnant again and should be due at the end of Sept. I went to my GP for a check up on my heart medication and she said she just doesn't understand why they can't find a reason for the tachycardia and wants me to go back to the cardiologist again. I explained that I am very uncomfortable taking this medicine while pregnant but she said that it would be far more dangerous not to take it than it would be to take it. So I feel stuck. First of all, I want to know....is it common for people to have tachycardia for no known reason? I had experienced symptoms for a good two years before ever starting the medicine. While on the medicine, I don't have as many issues as I did before, although from time to time I can still feel my heart race. And now that I am pregnant, I am experiencing frequent palpitations in the morning. I am just confused as my GP is telling me there is a cause and they just need to find it....my cardiologist is telling me he can't find anything and just to take the medicine. I am very worried about my baby and don't want anything to happen from this medicine, and if there is a cause that could be fixed then I would rather do that then have to take this medicine for the rest of my life.

Does anyone know what other causes might be? They have checked all my blood work and everything is fine....my echo came out fine, and my ekg although it showed tachycardia, was a normal heart beat, just a fast rhythm. I am at a loss on what to think and what to do.

01-23-2008, 10:01 AM

I would spend some time finding an electrophsiologist. They have this area of cardiology down to a sub speciality. It may be a challenge, they are few and far between, but well worth the effort.

Our EP is known around here as the "rhythm man". If you have an arrhythmia, he's your man. He can read those EKG strips like no other. He once busted a teenager who was looking for attention by holding his breath and messing around while hooked up to the EKG. The emergency room docs thought the kid was having a heart attack and sent him straight to our guy all in a frenzy. Our guy immediately was able to read the strips and busted the kid cold.
So I would shop around because you have a legitimate situation here. Good luck and hang in there.

01-24-2008, 05:48 PM

Ok Delia let me try to tackle this for ya and tell ya what I know. First of all there is always a reason for tachycardia, they just may not be able to figure it out. A lot of tachycardia is deemed ideopathic, or unknown cause. Sometimes it is just not worth spending millions of dollars trying to find the cause, because typically it will not change how it is treated. You have to remember that your electrical system in your heart is different from the structural components of your heart. So yes you can have a totally normal structured heart and have something like tachycardia, because they are two different systems. So echo's look for structures, like valves, chambers, etc. EKG's look purely at the electrical system. So, as I have found, since I have this too, you can have a perfectly normal EKG and still have or get tachycardia. I, for example, have a totally normal EKG but get random atrial tachycardia. Does that make sense?? They typically just end up treating plain tachycardia with meds because most of the time it isnt worth going in and doing an EP study to try and determine the cause of the tachycardia. They leave that for times when medications do not work. So, with the pregnancy this is what I know. Category C is not a drug that should be taken while pregnant. Toprol XL and regular metoprolol are both cat C. Cat C means: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. I would quote that but i cant figure out how. I am on 3 cat C drugs and my doctors demanded I take birth control. Each drug varies and some drugs they do know the specific defects they cause. I also know this. Often times, plain tachycardia improves with pregnancy due to the extra water you put on. So, it may be worth weaning you off of the medication and seeing if you can handle no drugs while you are pregnant. I have never heard anything about drugs causing holes in hearts, that is most likely genetic, from my experience. Only problem is, most drugs cause defects in the first trimester, and if you are already pregnant, it may be moot point. Sorry this was so long, but hope it gives you some answers.

01-28-2008, 03:04 PM

This has been very helpful. Thank you! I went to the doctor last Friday, just my regular GP, because at this point I am in the process of finding a new cardiologist. My old one is not on my husband's network. Anyway, I went to my GP because for 5 days straight I was having a feeling of my heart beating really hard and then it felt like it would pause. I could feel this in my throat at it was very weird. Don't know what you call that. Anyway, I explained what was going on. He wanted to do an EKG which of course was normal besides an increase in heart rate (95) which honestly for me isn't all that bad, although I still feel like it should be lower considering I take the Toprol. Anyway, he decided he wanted me to wear a 24 hour monitor, which I currently have on as we speak. However, this hasn't happened since Sat. It just stopped out of no where. So the monitor will probably be of no use. He said that it could've been caused by my being pregnant, although palpitations (this is what he called it) were more common further in pregnancy, not at 4 weeks. I asked him if it's common after being on this mediciation after a time period for it to stop working as well? He said that it was and that it might just mean that I need to take more. I am NOT doing that. Especially not right now. I feel as though I could defintely deal with the Tachycardia while I am pregnant, but they INSIST that I need to keep taking it. I am so uncomfortable with it. I feel like I got lucky the first time around that my daughter was born healthy. Maybe I won't be so lucky this time? They have repeatedly told me that the only ill effects that it could have on the baby is possibly a lower birth weight. My daughter was born at 6 pounds 12 ounces, so while not a big baby, she was a decent size. I just feel as though I should print out this drug information (the information you posted before) and take it to him. I don't know what else to do. I am afraid to stop taking it if it's a bad idea. I don't want to cause anything bad to happen, but I also don't want to take the chance of hurting my baby from taking the medicine.

01-28-2008, 08:46 PM

Delia, I definetly understand your worries... Let me emphasize one thing though, DO NOT STOP TAKING your toprol on your own. You have to taper off of it as prescribed or you could have a bad reboud affect and cause many many more problems. Another thing to consider is to ask about doing an event monitor. You wear it for however long, days, weeks, whatever and when you feel your heart doing something weird you push a button that records your EKG. That way if you dont have anything happen in the 24 hours that you have this one on, you can still at least try to capture something. I ended up doing both. At least then you can feel like they are seeing what is going on when you have an episode. What your describing sounds like PVCs which are premature beats. There is often a little pause after it and then the next beat is heavy. Hang in there hun. I know this is stressfull but right now this drug may be the best thing for you, as having arrhythmias off of it may be more detrimental to your baby. Keep looking for a electrophysiologist if you can. Those are the cardiologist that special in rhythms. Take care.

01-30-2008, 10:32 AM

Hello Della,
I just found out i have sinus tachycardia, i have a abonarmaly fast heartbeat also, mine is 100 - 130 , thats without the attacks. my doctor just put me on toprol xl 25 milligrams also. and man i went through alot to find out what it was with my heart, eveyone told me it was panic attacks and finally the doc caught it on the ekg, and found out it was tachycardia. this is all new to me, so wen i read your post i thought i would sign up to learn more about this.of corse i went through alot of testing and it took along time to find a doc that cared enough to find out what was going on.and man its true some doctors dont seem to think that what we are going through is that important. it is soooo scarey wen your heart just starts pumping soooo fast for know reason, how long did your attacks last?, the longest i had was for a hour and 40 minuts. witch they said is way too long , plus i was haveing the attacks alot like every 3 months or so.well thats about it i sure wish you well and good luck to you,
Nichole13

Can you have tachycardia for NO REASON?

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