HI, thanks for using healthcare magic

In the normal heart beat, a signal is sent from a specific aspect of the heart. It travels along a specific pathway to stimulate the rest of the heart to beat.

An increase in heart rate can occur if : (1) there is increased stimulation at that starting point (2) if there is another part of the heart , other than the normal area,that is stimulating the heart beat (3) if the stimulus travels along another pathway than normal or there is a blockage along the normal pathway (4) if there is a structural problem with the heart

The conditions that cause some of these are: anemia, hyperthyroidism (high level of thyroid hormone), side effect of medications, heart disease, caffeine, smoking, alcohol, fever, electrolyte abnormalities. Sometimes the exact cause cannot be found.

If you are experiencing episodes of increased heart rate, then it should be investigated to determine the cause. Normally the tests would include an ECG, blood tests to check electrolytes, blood count and thyroid hormone levels.
The ECG checks the rhythm of the heart,the heart rate and can also identify if there are areas of reduced blood supply to the heart and areas of increased size.
These are minimum tests that should be done, other investigations would be done based on these results.

I hope this helps, feel free to ask any other questions

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HI

Propanolol is one of the medications most commonly prescribed for tachycardia (increased heart rate). As one of the beta blockers it slows the heart rate and can also reduce blood pressure.Normally if a persons has undergone all the necessary investigations like you have and they are all normal but the palpitations are still present, medication is simply started to control the rate.
In cases where the exact cause is not found the person is said to have idiopathic tachycardia.

Revelol is also a beta blocker (metoprolol), it is unusual to be taking two beta blockers at the same time.
Telmisartan is an ARB medication and is used for high blood pressure. It is also helpful in heart failure, heart attacks and to protect the kidneys from damage in diabetes. It is a good drug for hypertension.

Telmisartan dose can be increased to improve blood pressure control. Normally for blood pressure control, the current medications are optimised, if the blood pressure is still high then other medication is added.

Since you are on an ARB and a beta blocker then a calcium channel antagonist can be added for example.
These medications relax the blood vessels to cause a decrease in blood pressure.
Some of these are also used to control the heart rate.An example would be verapamil

You may want to discuss this option with your doctor.

Please feel free to ask any other questions

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HI

The fact that your investigations are all normal is good and indicate reduced risk. Your future risk would further be reduced by controlling any conditions that could potentially affect the heart.
This would mean ensuring good blood pressure control, control of cholesterol, screening for diabetes regularly, reducing alcohol intake and if smoking is an issue, you would need to consider stopping smoking.

Verapamil is marketed under different names such as XXXXXXX covera, isoptin,verelan.

You would need to speak to your doctor to determine if he or she believes that it is appropriate for you.

IF it is considered an option for you after discussion, the lower dose of 40 mg would be best, taken 3 times a day.
The dose can be increased if necessary.

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