Persistent sinus tachycardia with intermittent palpitations

a 51yr old female, obese with no dyslipidemia, normal thyroid profile, and cbc . having persistent tachycardia and intermittent palpitations since a year..serial ecg done shows sinus tachycardia (H.R ~110-115 bpm) woman is hypertensive on azilsartan 40mg od. can we start metoprolol succinate 25mg od in this case or ivabradine 5mg od could be considered?

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Need to find cause of tachycardia Consider checking FREE T3, T4 Anxiety causing tachycardia Drugs like amitryptaline, amlodipine Mitral Valve Prolapse , ECHO needed. Hyper dynamic circulation due to anemia ,infection . Sick Sinus Syndrome . Metaprolol can be added to / Substituted for ARB. 24 hour Holter monitor may give extra information about tachycardia.

Thank you doctor
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Adv. Potassium

Within normal range
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