<s>[INST] I am 49 and about 60 lbs over weight. For the last year and half I keep having episods of Palpitations. They come from no where and can last half a day or a couple of hours. There has never been any pain at all but it makes me feel very lite headed and sometimes I get a a slight headache. I have been in the ER twice with this. The last time was by ambulance as my son is an EMT. They kept me and all the test were fine although each episode my bloodwork shows low potassium. The Cardiologist didn t feel worried and said that it may be something I get from time to time.???????? He put me on a low dose of blood pressure meds but was reluctent because it was fine. I now take Potassium, Maxide for edema, estrigen (Complete historectomy last nov.) low dose of BP meds. Plus asprin. This is wearing me out and frustrated. [/INST] Hi, Maxide (Triamterene) is a potassium-sparing diuretic and you are unlikely to get low potassium as you are taking potassium supplement as well. High carbohydrate meal at times precipitates hypokalemia. Hidden sympathomimetics, such as pseudoephedrine and ephedrine in cough syrup or dieting agents, may also cause unexpected hypokalemia. Finally, marked ingestion (dietary caffeine) may also cause hypokalemia. Hypokalemia is a major risk factor for both ventricular and atrial arrhythmias (palpitations). Blood pressure improves with the establishment of normokalemia. Aspirin is given as an antiplatelet drug in patients with high cardiovascular risk as primary or secondary prevention. Estrogens do not cause hypokalemia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist </s>