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Suggest Treatment For Severe Anxiety Attacks Despite Taking Valsartan

Posted on Wed, 19 Apr 2017

Question: experienced what I think was an anxiety attack, similar to one that landed me at the ER last week. I am taking 20mg of Valsartan HCT daily, starting in December, 2016. I have NEVER experienced any anxiety before in my life prior to last week. I have also experienced pounding heartbeats since taking this medicine. Is this a reaction tomfhe Valsartan?

Answered by Dr. Ilir Sharka (23 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that your symptoms do not seem to be related to valsartan, as anxiety is not a known adverse effect of this drug based on the medical literature.

Coming to this point, I would recommend performing some tests to exclude other possible causes of your symptoms:

- a chest X ray study
- a resting ECG
- complete blood count for anemia
- blood electrolytes for possible imbalance
- thyroid hormone levels for thyroid dysfunction
- fasting glucose.

An ambulatory 24-48 hours ECG monitoring (Holter) would be necessary to examine your heart rhythm trends for a longer period of time and exclude possible cardiac arrhythmia.

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Feel free to ask me again whenever you need!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (41 minutes later)

The EKG run at the ER was negative as was the chest xray. What was interesting was the my thyroid levels were elevated. Total Thyroxine (T4) was normal at 7.7 as was the T4 free at 0.87 but my TSH was 0.209 L.

Answered by Dr. Ilir Sharka (15 hours later)

Brief Answer:
I recommend consulting with an endocrinologist.

Detailed Answer:
Hello again!

Thank you for the additional information!

Your TSH levels are low, which means that you have a thyroid hormone imbalance (indicative of hyperthyroidism).

This hormonal imbalance can explain your symptoms, because thyroid dysfunction can mimic all this clinical scenario (including palpitations, arrhythmia and anxiety).

For this reason, I recommend consulting with an endocrinologist to help you normalize your thyroid hormones.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri

p.s.: I am sorry for the delay on answering, but it has been a busy day at the Hospital! Hope you can understand!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (21 hours later)

thank you so much for your reply.

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (6 hours later)

One other question. Would the hyperthyroidism cause a rapid heartbeat every time I eat?

Answered by Dr. Ilir Sharka (37 minutes later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

These symptoms (rapid heart beat after eating) is not typical of thyroid dysfunction.

It could be related to postprandial hypotension. Stomach distension with an elevation of the diaphragm could also play role in this scenario.

Anyway, I would recommend avoiding large meals and try to eat more frequently in small portions during the day. This will help improve your symptoms.

Hope to have clarified some of your uncertainties!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (1 hour later)

Thank you. I think, unfortunately, that this is all stress related re: Stomach.

I took your advice to see an endocrinologist re TSH level.

Once again, many thanks.

Answered by Dr. Ilir Sharka (3 minutes later)

Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you have any other uncertainties in the future, please feel free to ask me directly at any time.

I would be happy to answer to all your questions!

Wishing good health,

Dr.Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar