Ventricular Tachycardia Following Ingestion Of A Commonly Used Antihistamine
Non-sedating antihistamines are available as “over-the-counter” preparations and have been widely promoted in public advertisements. However, two such antihistamines, terfenadine and astemizole, have been withdrawn in Australia and overseas. Their use was associated with ventricular arrhythmias QT-interval prolongation on the surface electrocardiogram and polymorphic ventricular tachycardia .1–3
We report a case of ventricular tachycardia which was probably “torsade de pointes” following ingestion of a single tablet of loratadine.
A 43-year-old woman presented after her identical twin died suddenly, presumably from cardiac arrhythmia. The patient was asymptomatic, had no other risk factors and was not taking any regular medication. Clinical examination showed evidence of mitral valve prolapse, with normal left ventricular function and trivial mitral regurgitation on echocardiography. Several ECGs and her biochemical profile were normal. An electrophysiological study did not show inducible ventricular arrhythmias with standard stimulation testing or adrenaline provocation. Atrial fibrillation was induced during catheter introduction into the right atrium, with ventricular rate less than 130/minute. A prophylactic automatic implantable defibrillator was subsequently inserted. Transient prolongation of the QT interval was noted on ECG monitoring in association with non-sustained VT within 48 hours of the implant.
ECG strip showing sinus bradycardia and a normal QT interval .
So Why Are Decongestants Bad For Your Heart
You reach for a decongestant to help clear a runny, stuffy nose. A decongestant eases congestion by constricting the blood vessels in your nasal passages. This dries up nasal mucus.
But these medications can also abnormally stimulate the heart and blood vessels throughout the body. This can cause an increase in blood pressure and heart rate, or skipped beats. And it can interfere with your heart medications, Dr. Kaminski says.
If you have a heart condition, heart palpitations can last several hours after you take a decongestant. It is a dangerous and worrisome feeling that should be avoided at all costs.
What Causes Heart Palpitations
Heart palpitations can occur for a number of reasons. These include:
- Psychological triggers such as stress, anxiety, or fear
- Excessive exercise exerting too much pressure on the heart
- Certain stimulants such as coffee, tea, and energy drinks. Drugs such as cocaine and amphetamines may also cause heart palpitations
Don’t Miss: Does Acid Reflux Cause Heart Palpitations
Is It Safe To Stop Using Beta
Its dangerous to stop taking beta-blockers suddenly, even if youre experiencing side effects.
When you take beta-blockers, your body gets used to your hearts slower speed. If you stop taking them suddenly, you could increase your risk of a serious heart problem, such as a heart attack.
Contact your doctor if you experience unpleasant side effects with beta-blockers that last for more than a day or two. Your doctor might suggest another type of medication, but youll still need to slowly taper your beta-blocker dose.
A Look At Allergies And Heart Health With Tips To Endure Pollen Season Amid Coronavirus Fears
Spring brings warmer temperatures, blooming flowers and, for millions of Americans, the arrival of allergy season. It also coincides this year with the arrival of COVID-19, which could make allergy sufferers hyperaware of every sneeze and sniffle.
But there are key differences in symptoms. Seasonal allergies can cause sneezing, runny nose, itchy eyes and cough. Yet unlike allergies, coronavirus causes a fever, with other symptoms including cough and shortness of breath.
When seeking relief, people with allergies who are concerned about heart disease or high blood pressure must be especially careful when taking blood pressure-raising, over-the-counter decongestants. They’re also stimulants, which can increase heart rate.
But determining the extent of the direct connection between allergies and heart health is a topic that needs more research. A look at two studies offers examples of differing conclusions.
A 2016 study in the American Journal of Epidemiology examined the relationship between airborne allergen concentrations and emergency room visits for heart attacks in Ontario, Canada, from 2004-2011. The study found the risk of having a heart attack was 5.5% higher on days with the highest pollen levels compared to days with the lowest levels. Heart attack risk was highest in May and June, when tree and grass pollen are most common.
And her advice for patients still hasn’t changed.
Other general tips for allergy sufferers:
Don’t Miss: Tylenol Heart Palpitations
Talking To Your Doctor
The good news is that antihistamines and anti-inflammatory choices are most likely safe even for people with heart conditions. However, if you are actively taking medications for high blood pressure this may not be the case. You may experience heart palpitations while taking allergy medications as well, but in healthy individuals this is usually not cause for concern. While this is general information, it is always recommended that you discuss any medication changes with your doctor even if they are minor or over the counter, because everyones situation is unique.
The good news is that you can ease your allergy symptoms by taking simple steps at home that reduce your exposure to pollen, without putting you at risk if you have high blood pressure. Keeping your car and home windows shut and leaving your shoes outside are just a couple of ways to prevent pollen from lurking in your clothes and home. While allergy medications are usually fairly safe, you never know exactly how your body will react, especially if you suffer from heart disease or a heart condition.
To discuss your cardiovascular healthcare with an experienced physician, visit the Cardiovascular Group. You schedule an appointment online at .
What About People With Heart Problems
Oftentimes, the heart doctor may overlook this topic because there are so many other things that they must bring to the patients attention, Dr. Kaminski says.
His advice? If you have high blood pressure, atrial fibrillation, supraventricular tachycardia or congestive heart failure, you should avoid OTC medicines that contain a ;.
Dr. Kaminski specifically recommends against using pseudoephedrine.
Alternative Methods For Controlling Allergies
If you continue to suffer from allergy symptoms but can’t take allergy medications because of high blood pressure or other heart problems, there are other ways you can help mitigate the sneezing, sniffling, coughing, and watery eyes that allergies can trigger.
Consider these allergy-control methods:
- Run a dehumidifier, because mold loves moisture.
- Use allergen-reducing bedding such as mattress and pillow protectors.
- Try a saline nasal spray or wash to reduce nasal congestion.
Keeping Your Heart Healthy While Taking Medications
The best advice is to carefully scrutinize any drug that you are considering taking by reading ingredient lists and asking questions of professionals. Patients who are taking many different medications at the same time need to take extra precautions, as they are at an increased risk both for drugs reacting with each other negatively as well as kidney problems.
Don’t Miss: Does Tylenol Raise Blood Pressure And Heart Rate
What To Do If Foods Cause You Heart Palpitations
First off, take note if you feel any additional symptoms, because those could signal that youre experiencing more than simple palpitations. Seek emergency medical help if at any point you also have:
- Shortness of breath
- Pain or discomfort in the upper back, arms, neck, or jaw
- Feeling of impending doom
If its the first time youve ever noticed heart palpitations, make a follow-up appointment with your doctor. Its likely nothing is wrong, but its always best to err on the side of caution and make sure that the food-related episode isnt the first sign of a bigger issue.
Next, start a log and record times when the palpitations recur. Note what you ate or drank and what sort of emotional state you were in. If specific foods or beverages tend to cause recurrences, take that as a sign you should reduce or eliminate those foods from your diet. Your body and your heart couldnt be telling you any more clearly that those substances are doing you harm.
Zyrtec & Cardiac Side Effects
Histamine is a substance produced by the body in response to allergic reactions that triggers immune response symptoms such as watery eyes, runny nose, and sneezing. Antihistamines are a class of drugs that block the action of histamine and reduce these symptoms. Older antihistamines had many side effects such as severe drowsiness. Newer antihistamines, called selective H1-receptor antagonists, do not cross into the brain and have fewer side effects. In 2007, the FDA approved Zyrtec, or cetirizine, as an over-the-counter drug to treat allergic rhinitis and chronic urticaria, a skin condition characterized by recurrent hives 2.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Recommended Reading: Can Too Much Vitamin D Cause Heart Palpitations
Managing A Cold With Hypertension
If you cant take a decongestant because of high blood pressure, there are other ways to reduce your cold or allergy symptoms:
Take Coricidin HBP, which is free of decongestants
Drink plenty of fluids including water, juice, tea and soup to prevent dehydration and clear mucus from your lungs;
Take a pain reliever such as Tylenol or Motrin for fever, sore throat, body aches and headache
Flush your sinuses with a saline spray to relieve nasal congestion
Soothe a sore or scratchy throat with lozenges
Use a vaporizer or humidifier if necessary to boost humidity
Get plenty of rest
Return to your doctor after five to seven days to make sure;youre on the road to recovery
When To See A Gp
You do not usually;need to see a GP if;the;palpitations pass quickly and only happen occasionally. They’re unlikely to be caused by a serious problem and probably will not;need treatment.
But it’s a good idea to see a GP if:
- the palpitations last a long time, do not improve or get worse
- you have a history of heart problems
- you’re concerned;about;the palpitations
To help find the cause, a GP;may:
- ask about your symptoms and medical history
- arrange a;blood test
- carry out;an;electrocardiogram to check your heart rate
If you cannot have an ECG at the GP surgery or the GP wants to arrange heart monitoring over a longer time period, you may be referred for tests at a local hospital.
Don’t Miss: How Accurate Is Fitbit Charge 2 Heart Rate
Why High Blood Pressure And Cold Meds Dont Mix
Cold medicines are not off-limits if you have heart disease, but patients with;high blood pressure, or hypertension, should check the label carefully when choosing a cold or allergy medicine.
Thats because decongestants such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline can increase your blood pressure and heart rate. Make sure the cold or allergy medication you plan to take is free of those ingredients.
For allergy sufferers with heart disease, medicines such as Allegra, Zyrtec or Claritin should be safe. However, medicines containing decongestants including Allegra-D, Zyrtec-D and Claritin-D ;could increase your blood pressure and heart rate or interfere with your heart medication.
Allergy Medication And Cardiac Risk
Spring is here! You know what that means: beautiful weather, outdoor games andpollen. Every year, thousands of people across the country suffer from allergies. The signature symptoms of seasonal allergies include a runny nose, itchy eyes and sometimes a throbbing headache. Pollen is everywhere, especially in Georgia. A yellow dust coats your cars, homes and pets bringing with it an uncomfortable spring spent coping as best you can. When seasonal allergies strike, many people scramble to find help over the counter at the drugstore.
Don’t Miss: How Do You Calculate Max Heart Rate
What Allergy Medicines Can I Safely Take If I Have Heart Disease Or High Blood Pressure
Oklahoma Heart Institute Director of Interventional Laboratories, Dr. Wayne Leimbach, shares insights on allergies, heart disease and high blood pressure on our blog today.
Springtime brings not only beautiful weather and beautiful flowers, but it also brings high pollen counts and suffering to people with allergies.; Many people often ask what allergy medicines can I safely take if I have heart disease or high blood pressure.; Many allergy medications include decongestants that can raise blood pressure, create palpitations and interfere with some other heart medications.
Medications that often can be safely used by people with significant allergies include nasal corticosteroids.; In addition, antihistamines are very effective.; The antihistamines include fexofenadine , cetirizine , loratadine and diphenhydramine .
Often manufactures will include a decongestant with the antihistamines in order to provide additional control of the runny nose often seen with allergies.; Manufacturers will often indicate which of the antihistamines also contain a decongestant by adding the letter D to the name of the medicine.; These decongestants can be phenylephrine or pseudoephedrine or oxymetazoline.
Therefore, advertised medicines such as Allegra, Zyrtec, or Claritin should be safe for most patients with heart disease and allergies; however, Allegra-D, Zyrtec-D, Claritin-D could cause problems for patients with allergies and heart disease.;
Can Nasal Spray Cause Heart Palpitations
can cause heart palpitations
. Also know, can nose spray cause heart palpitations?
This dries up nasal mucus. But this vascular constriction also can occur throughout the body. This can cause an increase in blood pressure and heart rate, or skipped beats. If you have a heart condition, heart palpitations can last several hours after you take a decongestant.
Furthermore, what medications cause heart palpitations? Common stimulants include:
- over-the-counter medications such as pseudoephedrine, which is found in cold preparations and some herbal medications, including ma huang; and.
- illicit drugs including: cocaine, amphetamine, PCP, and marijuana, among others, also can cause palpitations.
Also to know is, can Flonase cause heart palpitations?
The FDA SmPC of fluticasone propionate Flovent® for inhalation does not mention palpitations as an adverse drug reaction. The indications might have played a role as well in the palpitations. Psychological or physiological stress caused by COPD or allergic rhinitis might lead to palpitations by themselves.
Can Afrin cause heart palpitations?
Along with its needed effects, oxymetazoline nasal may cause some unwanted effects. Check with your doctor immediately if any of the following side effects occur while taking oxymetazoline nasal: Blurred vision. fast, irregular, or pounding heartbeat.
Recommended Reading: List The Steps Of How To Calculate Your Target Heart Rate Zone
Who Shouldnt Take Decongestants
Dont take decongestants if you have;high blood pressure;that isnt controlled. Taking decongestants can raise your blood pressure even if it is controlled or nearly normal. You may need to look for an alternative to decongestants.
Talk to your https://familydoctor.org/condition/glaucoma/doctor before using a decongestant if you have any of the following health problems:
- prostate problems
- thyroid problems
Dont give decongestants to children younger than 6 years of age. Instead, there are other ways you can treat their symptoms:
- For very young children, use a bulb syringe to remove mucus from their noses.
- Use saline spray or drops to help loosen mucus.
- Use a cool-mist humidifier. Place it in the childs bedroom. The moisture created by the humidifier will help your childs nose and throat not feel so dry.
- Use ibuprofen or acetaminophen to lower a fever. However, always talk to your doctor before giving your child any medicine.
Why Foods Cause Heart Palpitations
Feeling palpitations after eating is a relatively common experience, which tends to occur when a substance in your food or drinkor your bodys natural biochemical response to that substancejolts the hearts electrical system and causes fluttering sensations, skipped beats, or a feeling that your heart is beating too hard or too fast.
Coffee drinkers, think about the last time you drank one cup too many. You know what I mean!
If your heart is healthy and you have no history of arrhythmia or heart diseaseand youre not experiencing any other symptomstheres little need to worry about an occasional episode of these irregular beats. For people who do have arrhythmias;or cardiac issues, however, its a different story. Palpitations caused by food can cause an existing disruption in your hearts rhythm to escalate, and potentially lead to a major event.
Read Also: Does Acid Reflux Cause Heart Palpitations
Dangers Of Allergy Meds For Your Heart
Have high blood pressure, heart rhythm problems, or another heart condition? Heres what you need to know about allergy drugs.
Allergy medications might seem harmless enough they’re sold over the counter , so that makes them safe, right?
Though allergy drugs can stop the misery of seasonal bouts with pollen, hay fever, and grasses, some can aggravate a heart condition, or be downright dangerous when mixed with blood pressure drugs and;certain heart medicines.
“If a patient has allergies or a cold and is considering OTC medications, it is always recommended to talk with the pharmacist on site, or to ask your physician for recommendations in the context of the other medications that are prescribed,” says L. Kristin Newby, MD, MHS, a cardiology professor at Duke Medicine in Durham, North Carolina.; ;
“Some OTC medications for example, those containing pseudoephedrine or similar components may cause increases in heart rate or blood pressure that could exacerbate some cardiac conditions,” explains Dr. Newby.
Does Benadryl Cause Heart Palpitations
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
HealthTap doctors are based in the U.S., board certified, and available by text or video.
Recommended Reading: How Does Anemia Cause Heart Failure