Palpitations

[Ana-16]

I noticed that soon after starting taking steroids I was experiencing palpitations. My dr prescribed beta blockers and they helped. I have been tapering slowly and am at 6 mg and trying to reduce to 5mg. I have recently experienced severe palpitations and I suspect atrial fibrillation. I wonder if this is connected to the steroid reduction and if anyone else has experienced the same. Thanks

[Kendrew]

Hi Ana-16,

Firstly it's important to say that the onset of any heart related symptoms, including palpitations, should always be fully investigated to rule out any significant issues or conditions. We must never assume the symptoms are simply steroid related and therefore dismiss them as unworthy of further investigation.

Having said that, I have suffered from a re-emergence of palpitations since taking prednisolone but as all my extensive tests showed no real cause for concern, it was then concluded that prednisolone had probably been a contributory factor in their return. Beta blockers have successfully remediated the problem.

If you look at related posts you'll see this has prompted quite a lot of conversation as quite a few people have experienced similar.

If you genuinely suspect you are experiencing atrial fibrillation you really should seek medical advice asap, dial 999 or go to A&E.

[Ana-16 in reply to Kendrew]

Many thanks for your prompt reply. I will follow your sdvice

[winfong in reply to Kendrew]

Might not be a bad addition to the FAQs

[PMRpro Ambassador]

I have a/f which was almost certainly caused by the autoimmune part of PMR damaging the electrical cells that govern heart rate. Pred reduces my a/f - it gets worse if I flare. ANd would presumably also get worse if I got to too low a dose to manage the inflammation.

If you think it may be a/f - you need to get an ECG when it is actually happening. An ECG taken when it isn't happening tells you absolutely nothing. By far and away the most likely way of getting that is to call 999 if you get an episode - paramedics carry 12 lead ECG machines and are far more likely to catch it on record. My GP told me to do that, I didn't but when it finally was identified I did wish I had. You need to be on anticoagulant drugs if it is a proper arrythmia to reduce the risk of stroke.

[Ana-16 in reply to PMRpro]

Many thanks for your prompt reply. I had an ECG when I first reported this to my gp but needless to say there were no palpitations. I hope to get an econsult with her next week and I will update her on what’s happening. I will let you know how I get on

[piglette]

Have you had a Holter test or any other tests such as an echocardiogram?

[Ana-16 in reply to piglette]

No not recently. Had two or three when I was having chemo about 5 yrs ago

[piglette in reply to Ana-16]

Was that a Holter test? Palpitations as a side effect of steroids seems to happen quite often. If you think you have AF symptoms you should be referred to a consultant.

[Greytree]

Can someone address the wisdom of using beta blockers, which were mentioned?

[PMRpro Ambassador in reply to Greytree]

Fairly standard treatment for arrythmias of many sorts:

pubmed.ncbi.nlm.nih.gov/211....

texasheart.org/heart-health...

bhf.org.uk/informationsuppo...

Basically they calm down the electrical activity that is causing the arrythmia.

[Greytree in reply to PMRpro]

Thanks so much! Checked out all the links and they were helpful.

[Broseley]

Don't get too worried about palpitations. I have had them on and off since I was a teenager. Eventually aged 55 I had a routine ECG which picked up a blip - which I didn't feel. I was given a Holter monitor for a week and that only picked up one 2 second blip despite my logging virtually constant palpitations. I was told I had "suspected atrial fibrillation" and have been on blood thinners and beta blockers ever since. But the palpitations I was told are nothing to worry about and are related to diet, caffeine, alcohol, stress etc. I seem to get them for a few months, virtually all the time, except when I first wake up. Then they stop for a year or two. I did get them when on a high dose of pred, but not since I got below 20mg. That may be coincidence.

[Ana-16]

Thanks to everyone for the replies. I posted a follow up a couple of days ago but can’t find it. Just to say that that evening the palpitations got so bad that I phoned 111 and after 3 hours at 11.30 when I was in bed and feeling better I had a call from dr who insisted I go a and e. Arrived at midnight and was there until 4am. I had an ecg and bloods taken. All came back normal and consultant advised upping the beta blockers. I will contact my gp for more advice.

[Ana-16 in reply to Ana-16]

From Ana. Confusion worse confounded. Apologies as it appears I’m replying to myself

[PMRpro Ambassador in reply to Ana-16]

That is the wayeveryone is likely to see it.