Health Q & A with Dr. Michael Jacobson, D.O.
A member wrote:
I have occasional skips of my heart; last April they happened for several days in a row, making me somewhat nervous. I was under the stress of planning our dream home and preparing our current home for sale.
My doctor performed blood tests that revealed low potassium. I took potassium pills for a week and felt better; when I retested, blood levels were back within normal range. After placing a Holter monitor on me, my doctor said I have inappropriate sinus tachycardia, a condition in which an individual’s resting heart rate is abnormally high—greater than 100 beats per minute or rapidly accelerating to over 100 beats per minute without an identifiable cause. Small amounts of exercise, and emotional or physical stress are triggering factors.
As I tried to lower my stress levels and eat potassium rich foods, my palpitations stopped.
Everything I read says to eliminate caffeine; however, I look forward to my relaxing coffee time. I drink one cup every morning, and it doesn’t seem to cause skipping heart beats at this time.
The doctor also suggested a beta blocker for my tachycardia. I’m wondering if medication is necessary and worth the risk of side effects.
Dr. Jacobson’s response: When I first read your email, it appeared like your diagnosis could be sick sinus syndrome. With this condition, the heart’s sinus node is not pacing the heart properly, causing surges in heart rate. However, the heart rate can also drop to an abnormally low rate—sometimes dangerously so. When treating sick sinus syndrome, beta blockers should be avoided, because they can worsen the problem. However, if the problem is pure sinus tachycardia due to an unknown cause, beta blockers could be considered.
I agree that avoiding physical and emotional stimulants to the heart is the healthiest approach. It sounds like you're doing better with the changes you have made, while still enjoying your morning coffee. However, if the problem persists, you might consider cultivating a taste for non-caffeinated beverages, such as specialty teas. I do not, however, recommend decaffeinated coffee.
Please note: My office requires a one-week turnaround for medical information. If you have an acute or emergency medical incident, please seek immediate medical attention.
If you have a health question for Dr. Jacobson, CHM Medical Director, please email it to email@example.com. This information is not intended to replace the advice of your physician.