I don’t drink coffee but my pulse skyrockets daily – what can I do?

I HAVE had tachycardia on and off for decades. I’m now 73, see a cardiologist and take the right drugs. But still my pulse goes to 116 several times a day, for about 20 minutes. I feel light-headed and suffer chest discomfort, but no pain. I’m active and don’t drink caffeine or alcohol. What else could I be doing wrong?

A TYPICAL heart rate is between 60 and 100 beats per minute when resting — more than 100 is diagnosed as tachycardia. It can be caused by a variety of medical conditions, including thyroid problems, heart disease and anaemia, or it can be benign, implying there are no underlying conditions. Even if benign, it can be distressing, uncomfortable and interfere with life.

As well as palpitations or a pounding in the chest, sufferers can feel dizzy and faint as well as anxious and even panicky.

Certain lifestyle aspects may worsen the problem, so it is wise to avoid alcohol, smoking and caffeine. There may also be overthe-counter medications that worsen things, such as cold and flu remedies.

For treatment, medications are used to slow down the heart rate, but other drugs may be given as well. For example, some people need to also be on blood-thinning drugs.

Learning techniques to slow the heart rate yourself are very important. One of these is called the Valsalva manoeuvre. Pinch your nose while you force exhale with a closed mouth (imagine trying to blow up a really tough balloon).

Another method would involve slow and measured breathing — this can be done by breathing out and holding it for a few seconds before inhaling again.

FOR the past three years I’ve had a problem with chest congestion. I constantly feel the need to cough up mucus. I have been seen by an ENT and no problems were found. My GP seems at a loss. I’m sure I have something like bronchiectasis. I’m only 47 and worried this is what my life will be for ever.

HAVING to constantly clear the throat isn’t pleasant — but it is surprisingly common.

Finding a cause can be tricky, as there are many. Getting the lungs checked is a priority — there could be a lung infection or indeed bronchiectasis. This is a long-term condition where the airways in the lungs become widened, and generally causes a persistent phlegmy cough as well as breathlessness. The best test for this is a high-resolution CT scan which would usually be arranged by a respiratory doctor.

Another common cause of phlegm in the lungs is chronic bronchitis. This can appear in anyone over the age of 35 who has smoked or continues to smoke, and can be treated with certain inhalers and other medications from the GP.

GPs may try a medication such as omeprazole which calms the acid in the stomach, as acid reflux can cause constant irritation and production of mucus. Chronic sinus problems will also cause ongoing phlegm or mucus and would be treated with saline washes into the nose or nasal steroid sprays.

Also consider allergies to dust or cleaning products. This would be easy to test by taking a daily antihistamine from the pharmacy and seeing if the issue settles.

IN DECEMBER I collected my usual prescription for statins but was given a different make. Within days of taking them I began to suffer aching and weakness in my legs, headaches, constipation and bloating. I’ve taken statins since 2018 with no issue, and when I was given my old brand the next time the problems disappeared. What do you think was going on?

OLDER drugs, such as statins, are not covered by a patent any longer, so they’re made by many companies, not just the one that developed it — we call these generic medicines. When we prescribe a generic drug, people may notice that sometimes they are issued different brands.

Generally speaking, we would expect side effects from a medication to be related to the drug itself, rather than the brand.

However if someone has noticed clear symptoms once starting a specific brand, it is reasonable to assume the two are linked. If a new statin is causing an issue it would be reasonable to switch back to the old brand, or try a new type.