Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Irregular Heartbeats And Feeling Of Breathlessness While Treating High BP?
Question: I'm on 10mg of cipralex, also taking Ramipril &Hydrochlorathiazide for high blood pressure. Been having episodes of irreg. heartbeat 40 beats/ min. 3-4 x per day and feeling of breathlessness during episodes. Been taking meds for 2 yrs. but these episodes only began a few months ago. Getting more frequent. How likely is it that this is related to meds and what do you recommend?
Brief Answer:
A rare side effect of escitalopram
Detailed Answer:
Hello. Thank you for your question and welcome to HCM. I understand your concern.
It is really hard to differentiate whether this is a side effect of escitalopram (Cipralex) or it is a primary problem of the heart conduction system.
Only a few cases with bradycardia (low heart rate) are reported with use of escitalopram, even in large studies. There are suggested mechanisms for this, but non established so far. Ramipril and hydrochlorthiazide do not cause bradycardia. My opinion is that you should consult with your curing psychiatrist about the possibility to be switched to another drug from the anti-depressant family.
With this being said, at the point we stand, we also cannot rule out the possibility that this can be caused from a primary problem in the heart conduction system. Therefore, I would recommend you to be put on a 24-hour Holter rhythm monitor, so we can depict to how low the heart rate goes and whether there are blocks in the conduction system, throughout a day. The breathlesness you experience, I think that it comes from the anxiety accompanying this clearly concerning feeling you get from these episodes.
I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.
Best regards,
Dr. Meriton
A rare side effect of escitalopram
Detailed Answer:
Hello. Thank you for your question and welcome to HCM. I understand your concern.
It is really hard to differentiate whether this is a side effect of escitalopram (Cipralex) or it is a primary problem of the heart conduction system.
Only a few cases with bradycardia (low heart rate) are reported with use of escitalopram, even in large studies. There are suggested mechanisms for this, but non established so far. Ramipril and hydrochlorthiazide do not cause bradycardia. My opinion is that you should consult with your curing psychiatrist about the possibility to be switched to another drug from the anti-depressant family.
With this being said, at the point we stand, we also cannot rule out the possibility that this can be caused from a primary problem in the heart conduction system. Therefore, I would recommend you to be put on a 24-hour Holter rhythm monitor, so we can depict to how low the heart rate goes and whether there are blocks in the conduction system, throughout a day. The breathlesness you experience, I think that it comes from the anxiety accompanying this clearly concerning feeling you get from these episodes.
I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Thank you very much for your reply. I am attaching an image of my heart rhythm during these episodes, taken by my fitness tracker device. This is a consistent example that the device is recording during these episodes. I realize it is not necessarily a reliable method, but does it offer any further insight? Thank you in advance.
Brief Answer:
Hello again
Detailed Answer:
Welcome back
Yes, it was helpful. I understand you have low heart rate registration. The 24-hour registration would be more helpful, as it records your heart electrical and conduction systems' "behaviour" throughout a day. It is basically an EKG spun into 24 hours. Based on the recordings acquired from this test, we can further decide about the treatment.
I hope this is helpful. If you do not have further questions, please close the discussion and rate the answer. Feel free to ask follow-up questions, as I am glad to help.
Best regards,
Dr. Meriton
Hello again
Detailed Answer:
Welcome back
Yes, it was helpful. I understand you have low heart rate registration. The 24-hour registration would be more helpful, as it records your heart electrical and conduction systems' "behaviour" throughout a day. It is basically an EKG spun into 24 hours. Based on the recordings acquired from this test, we can further decide about the treatment.
I hope this is helpful. If you do not have further questions, please close the discussion and rate the answer. Feel free to ask follow-up questions, as I am glad to help.
Best regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
