Palpitation

29/M C/O. Palpitation, feel missed beat, BP 140/100 sometimes 140/110. Doctor Advice. Ecg, LPT, CBC, BLOOD SUGAR F and random. Ecg Norma, LPT. TG236, Cholesterol 183 HDL 49, LDL 42, VLDL 39. BSF90 BSR 128 Medicine prescribed. Tab. Metoprolol 12.5mg BD Tab. Fexofenadine 120mg OD Tab. Fluconazole 150mg OD only for 2 Tab. Atorvastatin 10mg OD Temperament continue 1month pt normal but now new complaints created that 40-50minuts after meal palpitation start and remain 2-2 1/2 hours continues meanwhile palpitation feel poorly sitting and standing position than sleeping position. Please diagnose and treat

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We don't feel our heart is beating when we feel it is palpitation It may due fast heart rate slow heart or irregular heart or anxiety disorder here you have not mentioned heart rate not known if it is justified to use betablocker in this pt In slow heart rate berablocker will cause further slower rate & further missed beats ecg reported normal reason for fexofenadine + fluconazole not mentioned in raised TG fenesteride is better choice in recurrent palpitation a 24 hrs holter monitering may be done and if found normal a anxietolytic drug may be supplemented for hypertension in young age drug of choice is a ace / arb betablocker is a 4 th choice antihypertensive
At this time palpitation occur only 40-50min. after meal. Always not feeling hr beat (palpitation)
Reason not clear by Dr (fexo+flucon)
HR 92/m

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