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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Reoccurring Sinus Tachycardia. On Coralan. Suggested Tambocor. Migraines, Raising BP. Problem?

Hi, I am taking coralan 5 mg twice a day for a diagnosis of inappropriate sinus tachycardia. I have started to get episodes of tachycardia once again on this medication. My cardiologist suggested taking tambocor as needed to slow my heart. Alternatively, he stated that I may take inderal daily to see if this helps the tachycardia. I also suffer migraines and my blood pressure rises during these occurrences. Thank you
Thu, 2 May 2013
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Cardiologist,  's  Response
Dear Sir / Madam
Thanks for writing to us.
1. Inappropriate sinus tachycardia (IST) is something which is not very well understood by cardiology fraternity. Generally we look for the secondary causes of sinus acceleration like anxiety, coffee , tea, alcohol, tobacco, cocaine, hyperthyroid state, anemia, pain or any stress.
2. Drug therapy is indicated only in symptomatic patients. Drug therapy is not very effective in all the patients. Ivabradine (coralan) has been found to be most effective. Thereafter beta-blockers (inderal or propanolol) are indicated. It will be better than tambocor for you because you have migraine also and you find your BP on higher side too. Discuss with your Cardiologist before you start a new drug.
3. If your diagnosis has been made carefully and you surely do not have POTS (a syndrome where heart rate increases when you stand) & you have debilitating symptoms because if IST, ablation of abnormal focus is another option (but only after discussing with your cardiologist.)
Feel free to discuss more.
Sincerely
Sukhvinder Singh
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Reoccurring Sinus Tachycardia. On Coralan. Suggested Tambocor. Migraines, Raising BP. Problem?

Dear Sir / Madam Thanks for writing to us. 1. Inappropriate sinus tachycardia (IST) is something which is not very well understood by cardiology fraternity. Generally we look for the secondary causes of sinus acceleration like anxiety, coffee , tea, alcohol, tobacco, cocaine, hyperthyroid state, anemia, pain or any stress. 2. Drug therapy is indicated only in symptomatic patients. Drug therapy is not very effective in all the patients. Ivabradine (coralan) has been found to be most effective. Thereafter beta-blockers (inderal or propanolol) are indicated. It will be better than tambocor for you because you have migraine also and you find your BP on higher side too. Discuss with your Cardiologist before you start a new drug. 3. If your diagnosis has been made carefully and you surely do not have POTS (a syndrome where heart rate increases when you stand) & you have debilitating symptoms because if IST, ablation of abnormal focus is another option (but only after discussing with your cardiologist.) Feel free to discuss more. Sincerely Sukhvinder Singh