Sertraline and Nortriptyline both can increase seratonin levels–one symptom of excess seratonin is elevated heart rate.
Diltiazem with nortriptyline also increases the level of nortriptyline–symptoms which can include elevated heart rate.
Just make sure drug/drug interactions are being explored. Never abruptly stop any of these medications without discussing with your PCP.
Good luck!
Could the meds you’re on or the related stress be messing with your adrenal system and triggering random adrenaline releases?
Agree with seeing an EP. As my cardiologist said, “I’m the plumber and she (the EP) is the electrician.”
Seratonin syndrome? http://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/basics/causes/con-20028946
Is there a pharmacist who can look at your meds and cross-reference for side effects and combinations? My SIL has done that for me with all my meds.
Ok I’m totally missing it but what is an EP? (I can’t find the original suggestion for one.)
I don’t know if this makes any difference but I started most of my meds in and before December of last year. The prednisone, plaquenil, and orencia all started in February. The lyrica started around March. I didn’t get any symptoms until May. Toporol was started in response to the heart issues and lowered my heart rate from 140s to 110s. I was switched to Diltiazem to see if that worked better sometime in July. Would it take that long for meds to start showing interaction signs?
Every time I get a new script, I ask the pharmacist if they will interact with my current meds but my guess is that they only look for serious interactions. I’m due to get another few renewed next week so I will have a consult with them then.
ETA:
Yes. This is something my ER doctors were SUPER confused about since I have low-ish BP as it is. I remember my cardio saying that it was supposed to “reset” my heart rate at night so that it hopefully stays lower through the day.
I believe you’ve posted before that you suffer from anxiety. (Hope I’m remembering this correctly). Have you discussed that with the doctors in connection with this episode? Could you have been having a panic attack?
An EP is an electrophysiologist - which is a subspecialty of cardiology. Those are the docs that trace the flow of electrical rhythm signals through the heart nerves and muscle and try to correct any jumpy nerves or nodes that are causing problems.
Their bread and butter procedure is in treating A-fib by catheter ablation after drugs have failed. I doubt you have A-fib because you said your heart was in sinus rhythm, which by definition means no A-fib. But the EP may be able to find some other problem. It’s worth a shot. I’m surprised your regular cardiologist hasn’t already referred you to one.
Lots of autoimmune stuff in my family. My brother had symptoms very similar to yours. He had tons of testing, monitoring, etc. over months. Maybe he just had bad luck with docs, but it took a scary long time until he was finally diagnosed with Wolff-Parkinson-White syndrome. According to Mayo, that should be detectable via electrocardiogram, which my brother had several times, but it took the right doc to figure it out.
Based on the symptoms I would suggest Torsades de pointes, although like the A-fib they should have been able to see that on the EKG.
Sorry, Romani, I just wish the best to you. I have no medical expertise to add.
I’m sorry I added my woes to your thread. Anxiety causes out of character behavior. To Busdriver and others, I’m home after 7 hours in hospital for 10 minute surgery. The coolest thing: my good friend the physician, who arranged for the surgery ASAP, 6 years ago, when visiting Boston, invited my son and the surgeons daughter to dinner. The girl was at Harvard, and now in medical school. Isn’t it a small world?
Glad that is behind you and you are home, @bookworm. Hope all is well!
@nottelling yes, I’ve had anxiety and depression for a long time. A panic attack was my first thought too (and I’ve had many) but it felt very different. They did have the emergency psychologist (psychiatrist? I can never remember the difference) come talk to me and he didn’t seem concerned.
@bookworm I’m glad your home. Best wishes for a speedy recovery!
I’ve had either 3 or 4 EKGs and all normal.
a psychiatrist is a doctor of medicine…I assume you saw a psychiatrist. a psychologist would be unable to help you in this situation.
@bookworm, glad things are okay now. MRSA was literally the nail in my mom’s coffin - so glad they caught it & could take care of it for you.
Ack- I made a nails on a chalkboard typo. you’re***
@kelsmom my condolences for you and your mom.
Read through the thread
Just wondering if you still have fevers weakness malaise and any heart failure symptoms such as shortness of breath or swelling in the ankles along with the tachycardia then lupus patients can have myocarditis.
I don’t think you do but if you have all the above it is a thought to bring up with your physicians.
“I’m sorry I added my woes to your thread. Anxiety causes out of character behavior. To Busdriver and others, I’m home after 7 hours in hospital for 10 minute surgery. The coolest thing: my good friend the physician, who arranged for the surgery ASAP, 6 years ago, when visiting Boston, invited my son and the surgeons daughter to dinner. The girl was at Harvard, and now in medical school. Isn’t it a small world?”
You are an interesting person, bookworm. You seem relatively unconcerned about yourself, and more interested in others, though many of us would be freaking out with having a surgery like that!
Hmm, son and the surgeons daughter. Sounds like a set up?
romani, I don’t know if this has been addressed in the thread, maybe I missed it. But has something changed before you started having the heart issues? Have you recently started on a new medication? Is there something that is just recently different now?
Busdriver, it was a set up. My son had already started dating his still g/f, so didn’t give this new gal a chance. Had it worked out, the kids would have been flying to SE Fl for holidays, so I’d see him a lot more often. Plus, the surgeon is just so,personable. I’m far less upset now that the poison is out of my body. Now, I’m concerned about the hurricane; it’s all the TV focus. American already cancelled flights.
Romani, you most likely saw a psychiatrist. As a psychologist, I’m called in to consult AFTER patient has been seen by a psychiatrist or neurologist.
Some times medication has side effects that don’t show up right away. I just had that problem with a steroid inhaler I had been taking for asthma. Everything was fine for a few months and then I started having problems. It took a while to figure out that was what was causing the problems since I didn’t have them right after starting the inhaler. So maybe it is one of your medications.
Also DH had the rapid heart beat and it took a while for them to figure out it was his thyroid. I would make sure they really tested you for that.
BD, I answered it in bits and spurts but here’s a summary:
Meds I started in December '15 and before: Allegra, nexplanon, pamelor, prilosec, vit b12 & d3, zoloft
Meds I started in February: Orencia, Plaquenil, Prednisone (finished in July)
I started lyrica some time between February and when my heart problems started but I haven’t been on it in over a month.
The rest are either in response to the heart issues or ones I’ve gotten on very recently.
Random thing I just remembered: the first time I went to urgent care because of the heart palpitations, I was diagnosed with a sinus infection. I just looked at my prescription history and I went to the urgent care in late April and my PCP prescribed the toprol the first week of May so that was when my symptoms started.
That would’ve been after the end of my semester so my stress levels would’ve been way down. I can’t think of any other changes that were occurring around that time.