The patient's cardiologist changed her prescription from Profex to Tambocor on the slight chance that she could be allergic to Profex, and that is was the allergic reaction that caused her fainting.
I learned today that she had another episode of tachycardia a couple of days ago and she avoided taking the Profex, thinking that she would also avoid the fainting... and after about an hour her heart rate returned to normal spontaneously. I warned her that her tachycardia could progress to arrythmia, and that could be lethal if she were alone and untreated.
This morning, she had another episode of tachycardia, and not yet having obtained the Tambocor, she took Profex. I was able to get to her about 90 minutes later and found her blood pressure 145/85, pulse 76, but she had a lingering headache and weakness. I'm a medical engineer and not an MD, but seem to fill in some of the blanks that her cardiologist misses (e.g. that increased pulse induces lowered blood pressure).
The cardiologist's report stated that if tachycardial episodes continue, he would recommend either taking amiodarone or performing ablation.
Any further comments on your part would be appreciated. Was my warning of tachycardia progressing into arrythmia correct? What might be behind her post-episode headaches and dizziness, despite normal blood pressure - could it be that my reading indicates at least temporary hypertension? Many thanks, Yehuda
Dear Dr. Jyoti: I believe your advice was very sound. As a professional, I'd like to inform you of how the patient progressed. You may remember that initially she took Profex after not having trachycardia for a long time. The day of your last response, she had a further episode and was briefly hospitalized but tests did not indicate anything special. Then the episodes repeated on a daily basis, and after the fourth episode including continuing headaches and weakened strength, her cardiologist implanted a Medtronic ADDR01 Adapta DR Implantable Pulse Generator (IPG). A day later she was sent home to rest for a week, and she is now feeling quite well. The cardiologist apologized for not having picked up on the needed for pacing earlier.