Do occasional episodes of high heart rate (190-220 bmp) that

Patient

Q: Do occasional episodes of high heart rate (190-220 bmp) that last anywhere from 5-15 minutes necessitate taking medication daily (labetalol)?
Other import info and history: I am 30 weeks pregnant. 29 years old and otherwise in good health. No other medications taken currently. I have a long history of these occasional episodes of high heart rates for no apparent reason since highschool. Sometimes I would have 2 or 3 a month and sometimes I would go a full year with no episodes. Sometimes they are associated with a feeling of dread/anxiety, and sometimes I feel fine emotionally during them. My blood pressure has consistently run low, both currently and before pregnancy. I've keep track of it :

95/67 6/2014

111/78 8/25/14

109/75 10/6/14

80/40 11/18/14

90/56 12/2/14

100/58 1/14/15

111/77 2/4/15

108/71 3/14/15

I have a history of anemia- I know this because in the past when I've tried to participate in blood donations ~50% of the time I can give blood and the other 50% of the time they said I was anemic and couldn't donate blood. At my most recent prenatal appointment I was told I was just barely below normal range and technically considered anemic and prescribed 35mg iron per day. I was diagnosed with a mild mitral valve prolapse in 2004 but at my most recent cardiologist visit 3/2015 my cardiologist said he did not see a MVP after he did an EKG and echocardiogram.
I was on Celexa on and off from summer 2012- spring 2013- this was prescribed to me after I expressed symptoms of anxiousness and ocassional episodes of high heart rate- the Dr. At the time told me there is an association between MVP and anxiety and that Celexa would help.

I have a history of low bmi of around 17.5 (not currently while pregnant though).

Thank you so much for looking at all of this information and helping me figure out what's best for me and my baby!

Doctor

A:   Hi.
Thanks for your query and an elucidate history.

To recapitulate important points: 229 / Female - otherwise in good health - episodes of tachycardia since high-school - now 30 weeks pregnant - BP readings noted - **Anemia - low BMI of around 17.5 (not currently while pregnant though) - past history of MPV -
Your query: Do occasional episodes of high heart rate (190-220 / minute) that last anywhere from 5-15 minutes necessitate taking medication daily (Labetalol)?

This is really a debatable, considering your complex history as I have compiled above.
It is now the safety of you (Mother) and child.
It is highly advisable to have a combined approach of management of a Cardiologist and the Gynecologist. And you will have to strictly adhere to their advise.
Now with the advancing pregnancy, the requirements of both are going to change drastically and you should be under continuous monitoring of both the Specialists along with the Radiologist for the welfare of the fetus.
I hope you understand my deep concern for both of you.
Wishing you a very healthy and happy Motherhood.

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