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What Causes Heart Palpitations While On Lisinopril And Hydrochlorothiazide?
Question: I am a healthy 65 year old in good health. I have mild hypertension and take 10 mg of lisinopril with htz. Some nights when I lay down I have palpitations that I feel in head neck or other. My pulse is normal except at those times. It will beat 3 times with a pause until it passes. My local go says it is nothing serious but it can be scary when it happens. Your opinion?
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would explain that your symptoms could be related to a cardiac arrhythmia.
Anxiety could also trigger this clinical situation.
I would recommend consulting with your attending physician for a physical exam and performing some tests to investigate for the possible cause of these symptoms:
- a cardiac ultrasound to examine your heart structure and function
- an ambulatory 24-48 hours ECG monitoring in order to examine your heart rhythm trends during the day and register possible episodes of cardiac arrhythmia.
- blood electrolytes to exclude possible electrolyte imbalance
- complete blood count for anemia, which could lead to ectopic heart beats
- thyroid hormone levels for possible thyroid dysfunction.
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
I would recommend as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would explain that your symptoms could be related to a cardiac arrhythmia.
Anxiety could also trigger this clinical situation.
I would recommend consulting with your attending physician for a physical exam and performing some tests to investigate for the possible cause of these symptoms:
- a cardiac ultrasound to examine your heart structure and function
- an ambulatory 24-48 hours ECG monitoring in order to examine your heart rhythm trends during the day and register possible episodes of cardiac arrhythmia.
- blood electrolytes to exclude possible electrolyte imbalance
- complete blood count for anemia, which could lead to ectopic heart beats
- thyroid hormone levels for possible thyroid dysfunction.
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
I did consult with him and he indicated it was harmless. This only happens occasionally when I lay down. I typically eat exercise and go to bed. I am bothered by gerd and allergies. I take Prilosec and Claritin for those. Could either of those contribute to problem? Also, the 3 beats and pause. Is that significant?
Brief Answer:
My opinion:
Detailed Answer:
Hello again,
You are right about GERD; it may be a potential trigger for generating ectopic heart beats.
As you experience those palpitations mostly when lying down, acid reflux (it is exacerbated while taking a recumbent position) as a possible cause of arrhythmia is difficult to be excluded at first sight.
Coming to this point, the only preliminary measures for avoiding any potential GERD implications on your ectopic heart beats, besides continuing a regular treatment with gastric anti-secretors drugs (like pantoprazole, omeprazole, etc.), it is necessary to modulate your daily regimen and diet, avoiding fatty and spicy foods, eating late before sleeping, avoiding physical exertion near sleeping and raising a bit your head level when sleeping (elevating the top of your bed, or using a larger pillow).
In addition, I would like to explain you that those palpitations seem to be episodes of trigeminy (an ectopic beat after two normal beats followed by a compensatory pause) and would emphasize the need for further clinical investigations as I mentioned at the beginning of our thread in case those ectopic beats continue to repeat time after time, even after taking those preliminary measures for GERD.
So, only if a recent cardiac ultrasound and the mentioned blood tests (including complete blood count, electrolytes, and thyroid hormones) are performed and concluded normal, we could be sure there is nothing to worry about and thus look after GERD.
Otherwise, if nothing of the above is done, the recommended tests are completely justified and you should find the opportunity to discuss with your doctor and program the scheduled check up.
That’s my opinion.
Kind regards,
Dr. Iliri
My opinion:
Detailed Answer:
Hello again,
You are right about GERD; it may be a potential trigger for generating ectopic heart beats.
As you experience those palpitations mostly when lying down, acid reflux (it is exacerbated while taking a recumbent position) as a possible cause of arrhythmia is difficult to be excluded at first sight.
Coming to this point, the only preliminary measures for avoiding any potential GERD implications on your ectopic heart beats, besides continuing a regular treatment with gastric anti-secretors drugs (like pantoprazole, omeprazole, etc.), it is necessary to modulate your daily regimen and diet, avoiding fatty and spicy foods, eating late before sleeping, avoiding physical exertion near sleeping and raising a bit your head level when sleeping (elevating the top of your bed, or using a larger pillow).
In addition, I would like to explain you that those palpitations seem to be episodes of trigeminy (an ectopic beat after two normal beats followed by a compensatory pause) and would emphasize the need for further clinical investigations as I mentioned at the beginning of our thread in case those ectopic beats continue to repeat time after time, even after taking those preliminary measures for GERD.
So, only if a recent cardiac ultrasound and the mentioned blood tests (including complete blood count, electrolytes, and thyroid hormones) are performed and concluded normal, we could be sure there is nothing to worry about and thus look after GERD.
Otherwise, if nothing of the above is done, the recommended tests are completely justified and you should find the opportunity to discuss with your doctor and program the scheduled check up.
That’s my opinion.
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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