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I was previously on 12.5mg Atenolol a day, but my heart rate

Customer Question
was staying too low in...
I was previously on 12.5mg Atenolol a day, but my heart rate was staying too low in the 40s and 50s, making me very cold and want to pass out. My doctor changed me to Metoprolol 25mg, 1/2 pill twice daily and now I'm having tachycardia again. Is it safe to go back to the Atenolol?
JA: Do you know if your family has a history of heart disease? In general, how would you describe your health lately?
Customer: My mother was born with Tetralogy of Fallow and has 4 heart surgeries, she developed Afib and had her pulmonic valve replaced on her last surgery. My father died of a heart attack in his sleep, he had sleep apnea and had the attack and just didn't wake up. I myself have never had heart problems until my thyroid issues started becoming very apparent. My TSH was 5 and went down to 1.6, but now my antibodies are elevated. I have symptoms that suggest Hashimoto's disease.
JA: Anything else in your medical history you think the doctor should know?
Customer: I have had 4 EKG, blood work several time, Echocardio gram, and all come back as normal. The 24 hour Holter monitor showed arrhythmias, but the Echo didn't find anything. My blood work came back normal each time and when they check my thyroid, the thyroglobulin antibodies were elevated. Also I do have a heart murmur, but the doctor said there was nothing to worry about it.
Submitted: 6 months ago.Category: Medical
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Answered in 55 minutes by:
5/10/2017
Doctor: Dr. Muneeb Ali, Doctor replied 6 months ago
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 7,775
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi, welcome to Ja and thanks for this question. I'm sorry to hear about your symptoms. Now I think rather than jumping back to atenolol I would first prefer to i crease the dose of metoprolol to 50 mg twice a day which should help control the heart rate. And if that does not work then we can even go to 100 mg twice daily. This should help to control the heart rate effectively . if that does not work either then we can consider other beta blockers like carved lol which can help here as well. In some situations esmolol can also be used. Then if that is not an option either rather we can consider using atenolol and that too at a lower dose of 6.25 mg. But rather than go back to atenolol I would consider switching to calcium channel blockers like versatile or diktiazem if beta blockers fail to control the heart rate. Do you have anymore questions? Do remember to leave a positive rating as that is how we are compensated for helping you today.
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Customer reply replied 6 months ago
I just took my second dose of 12.5 of Metoprolol at 11pm, should I take the additional the additional pill and a half now? My heart rate is now fluctuating from the high 50s to the 80's and my skin is tingling. I don't feel good at all, very jittery from my heart racing so fast. Also if I need to increase my dosage to 50mg twice daily, who will write the prescription? My PCP told me to go to the ER the last time this happened. I thought it happened because my body was trying to adjust from going from the atenolol to metoprolol.
Customer reply replied 6 months ago
Did you see my last response?
Doctor: Dr. Muneeb Ali, Doctor replied 6 months ago
I'm writing down a response just now
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Doctor: Dr. Muneeb Ali, Doctor replied 6 months ago
Actually if you do have a fluctuating heart rate between 50 to 80.then you should not be using anymore beta blockers. Do not add anymore metoprolol right now. And if the tingling increases or if you develop any shortness of breath, chest pain, palpitations, sweating, dizziness or lugtheadedness or the heart rate drops below 50 then you should immediately proceed to the er. And secondly your pcp would increase the dose or you would need to visit a cardiologist. But for now do not increase the dose on your own and if the symptoms worsen then go to the er. Do you have anymore questions? Do remember to leave a positive rating as that is how we are compensated for helping you today.
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Customer reply replied 6 months ago
Ok thanks
Doctor: Dr.Saleem, Consultant Cardiologist replied 6 months ago
Dr.Saleem
Dr.Saleem, Consultant Cardiologist
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Satisfied Customers: 729
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