I'ma 46-year old male with Panic Disorder and a moderate case of high blood pressure. I take Clonazepam for the Panic Disorder, and metoprolol and lotrel for my blood pressure. My blood pressure has been very much under control. I weigh about 180 lbs. and run and lift weights about 5 days per week. Two consecutive days I forgot my second dose of metoprolol (beta blocker. The next morning I went for a run, and I didn't feel great (I think I was coming down with a stomach bug) but I pushed it. When I finished my run, my heart rate felt high, so I sat down and took my pulse. I could swear it was 240, but I'm not 100% sure, because I kind of panicked a little and wasn't thinking totally clearly. I had no other symptoms (chest pain, light-headedness, or shortness of breath). I got up, walked into the house and took my metoprolol and a xanax. Within a minute or two, my heart rate had come down to about 120, which I would expect after a run. I have had palpitations for a couple of years (along with the panic disorder), and I have had all the tests, but my doctor has told me my heart is fine. I asked him about this incident, and he said 240 would not have been possible. Any thoughts? I could have mis-counted. Has this ever happened to anyone before? I was thinking that my missing two doses of my beta blocker in two consecutive days could have caused this.

Thanks for your feedback. I take 50 mg of Metoprolol twice daily for my blood pressure (and a 5-20mg Lotrel once daily). My blood pressure is consistently good. I simply forgot to take my second dose of Metoprolol two days in a row (the two days before this happened). I have been taking the Metoprolol for two years now, and I have missed an occasional dose, but never two consecutively. And I have never had a heartbeat this high before. So I have to conclude that this was mainly a result of my negligence in failing to take my med’s. I have Panic Disorder, and I have had palpitations, but I have had EKG’s, blood tests (including thyroid hormones), chest x-rays, a stress test (where they brought my heart rate above 190), a 24-hour holter monitor, and a sonogram. All good. I’m not really satisfied with my GP’s assertion that this incident was not possible, so I’ll be looking for a new GP, and I’ll follow up with him or her. Thanks again.