Dysautonomia (Autonomic Dysfunction) Community
fast heartrate
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This patient support community is for discussions relating to Dysautonomia (Autonomic Dysfunction) including: Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, mitral valve prolapse dysautonomia, pure autonomic failure, autonomic instability and others.

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fast heartrate

My heart rate has been extremely fast for a while now. Especially upon any kind of exercsise or just standing up. I got out of the shower today and decided to check my blood pressure and heartrate because I nearly passed out in the shower. I could feel my heart pounding and started feeling lightheaded and weak. My heartrate was 143 when I checked. I get short of breath and hot flashes, my muscles feel tired and weak especially in my neck, shoulders and upper arms. I get headaches alot and occasionally high blood pressure, I also get heart palps frequently! I have been to the doctor and they have referred me to a cardiologist. They also have me on 20 mg of propanolol once a day, it helps with the fast heartrate, but usually all of my other symptoms are still there and it makes me extremely tired! Is there anyone here that is going through something similar and does anyone have any suggestions as to what might be going on with me? I am really nervous that this is something really bad because most days I feel like I am dieing. I have a 17 month old and that makes it even harder, as I just don't have the energy to keep up with his needs! Any suggestions are greatly appreciated!!! Thanks!
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875426_tn?1325532016
First, having a 17 month old active child can be contributing to muscle tiredness if you are picking them up a lot, I'm sure, and I don't it's amazing how you mothers do it!

But that said, you may want to find out if you are having iron deficiency if you haven't had your ferritin (my dr. says best indicator of what iron is doing in the body) checked lately.  I had worse symptoms with my postural orthostatic tachycardia syndrome (diagnosed by a type of cardiologist called a electrophysiologist who did a tilt table test), when my iron was low, even though I had a normal complete blood count.  Iron deficiency can cause rapid heart rate, shortness of breath, extreme fatigue and headaches.

I recommend a shower chair, a great medical invention and so useful for those of us with orthostatic intolerance.  I can gray out or mostly white out with my vision, but if I sit awhile after and don't raise my arms up too much, it helps.  Many on here have given up hot water altogether.

You may want to not only get your ferritin and iron checked, but your thyroid function, potassium and sodium levels as well.  And are you staying well- hydrated is another thing to think about.  And you might check with your gyn dr. to see if your female hormonal levels are messed up.  

Hopefully, the cardiologist will run all the appropriate tests to find out what kind(s) of tachycardia you are having, whether it is all sinus tachycardia, whether you are having another kind, like supraventricular tachycardia, whether it is happening only when standing or if you are having episodes at rest.  Hopefully, they will take orthostatic blood pressures, to see if the fluctuations of blood pressure from laying to sitting to standing are normal or not.  

If you are having your pulse go up by 30 plus beats per minute after standing & a even a spike in your blood pressure with standing, you should ask the cardiologist about a tilt table test.

If your tachycardia, high blood pressures, sweating and headaches are coming at random times and not just with standing, you might ask your primary doctor if they would order a plasma free metanephrines test to rule out a rare tumor called pheochromocytoma, which can emit high levels of catecholamines and cause these symptoms (usually very high spikes in blood pressure)
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1490386_tn?1301382186
Usually all of these symptoms are after I am standing. I wake up in the morning and make my son breakfast and then eat a bowl of cereal, check my e-mail. Usually by the time that is all over with I am starting to feel really bad. About an hour or so after I wake up! I get shakey (shaky), headaches, short of breath, dizziness and it only gets better if I sit or lie down. I still feel slight dizziness after sitting, but most of the other symptoms have calmed down. If I stand up anymore in the day my heartrate will immediately start racing again and then all of the other symptoms. I have been checking my heartrate and blood pressure for the past 4 or 5 days in the laying down position and standing position. My heartrate went up 45 beats when standing on day1, 29 beats on day2, 29 beats on day3, 24 beats on day4, and 41 beats today. I have occassional good days where my heartrate is good and I feel normal, but not very many maybe 2 or 3 a month. I have an appt with a cardiologist this Thursday, is there anything in particular I should bring up to him. Also, do you think that from my symptoms that this could be pots?
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875426_tn?1325532016
Recommendations with the doctor- give them your heart rate and blood pressures that you've been measuring, explaining your symptoms as you have here.  You may want to jot them down so you don't leave out any important details.  And you might want to bring someone with you- that extra set of ears might help in case you miss hearing something important the doctor says & see if they might even take notes for you.  

I think there's a possibility you might have P.O.T.S., but you need to get proper diagnostic testing to determine what is causing your symptoms.  You might ask your cardiologist if he/she feels a tilt table might help with a diagnosis or in ruling out P.O.T.S..  They may want to start out with a holtor monitor you would wear for at least 24 hours to see how high your heart rate is going and how often.  Since it isn't going as high when you stand EVERY day, hopefully, they might order it for more than one day.

I do think maybe you should get some of the other tests I mentioned in my previous post above, but those might be ordered by your primary care physician rather than a cardiologist.
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1490386_tn?1301382186
I went to the ER in September 2010 with the same problems I am having now. They did a tilt table test and thyroid test. They said something about disautonomia in there notes that was faxed to my doctor at the free clinic. Also at the time my thyroid levels were on the hypo side, but just barely. When I went to the clinic in Feb 2011 they retested my thyroid and it was normal. They were concerned about my heartrate being so fast and they referred me to the cardiologist. I don't have insurance and really can't afford for them to do alot of tests at the moment.
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1490386_tn?1301382186
I went to the cardiologist today! They gave me a 24 hr holter monitor and they have me scheduled for an echo on the 18th. He doesn't think that there is anything bad wrong with my heart because my age, but wants to rule out some things. I did mention the disautonomia, he didn't really say anything about it. I really hope they can give me some answers, I am going crazy with all of these things going on!
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875426_tn?1325532016
Well, w/out insurance, I'm sure you would want to limit your tests....sounds like you aren't a hyper-thyroid sufferer.

And you would want to limit your iron deficiency checking, since you have no insurance, to the one test my dr. says is the best indicator of how your iron is doing in your body, that being your ferritin (iron stores).  Because even if you do suffer from dysautonomia, many disturbing symptoms (experience talking) can be heightened by an iron deficiency.   In the past, I had a dr. who said iron deficiency is a very common problem in the menstruating female.

I'm very glad he ordered the holtor monitor and echocardiogram, but I wonder w/his non-response re:dysautonomia if he is familiar w/the term, doesn't really believe in the problem, or doesn't know how to treat it.
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1490386_tn?1301382186
When I went to the free clinic they tested me for anemia but they said that came out normal. I don't think it said anything about ferritin on the lab report. It says RBC 4.41 Range (4.00-5.20). Seems normal, but there is nothing about ferritin on my labs!! The only thing that was flagged was SEGS- 76H range (36-66) and LYMPHOCYTE- 17L range (24-44) and I have no idea what that means, but I guess it is ok because they never said anything to me about it! I am in the process of trying to get insurance because the cardiologist is definately not cheap. I know they are going to charge an arm and a leg for the Echo they are doing on me, but it has to be done!!
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1490386_tn?1301382186
Today has not been good so far. Heart raceing to 140 just walking around the house and ofcourse don't have the holter monitor today when it actually would of picked up quite a bit. Palpitations and raceing!!! Oh well, he said that if it didn't pick anything up, he would do the 30 day holter on me. Just ready for some answers!!
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875426_tn?1325532016
Glad he's willing to do a longer holter monitor time, if needed.  

Iron can be low and dysautonomia sypmtoms can feel worse before it gets to the point your red blood cells drop below normal range- my experience with feeling worse and low iron, normal CBC result in the past.  Last year, it did get so bad my RBCs went low.

    Re: your other results, I have an old lab book by Frances Fischbach, called "A Manual of Laboratory Diagostic Tests" second edition.  It says about segmented neutrophils- "segs" (is this what you are speaking of?):

"In pernicious anemia and chronic morphine addiction, only adult or mature hypersegemented neutrophils are associated with increased neutrophils."  It also says:

'An increase in mature cells (known as a "shift to the right," as in liver disease and megaloblastic anemia due to vitamin B 12 or folic -acid deficiency) can occur
  (a) In hemolysis
  (b) With drugs such as digitalis, mercury, ACTH, sulfonamides, arsenicals, potassium chlorate, benzene, venoms
  (c) With tissue breakdowns as in burns, myocardial infarction, tumors, gangrene, or pus formation; hemolytic transfusion reactions, after surgery, after cancer of liver, GI tract, and bone marrow
  (d) With allergies"

I have more info, so let me know if that's what you are talking about.  
Also, re: low lymphocytes, my book says that "Occurs
(a) In Hodgkin's disease
(b) In lupus erhythematosus
(c) After administration of ACTH and cortisone
(d) After burns or trauma
(e) In chronic uremia
(f) In Cushing's syndrome
(g) In early acute radiaton syndrome"

I think that's a shame the doctor said nothing about those abnormal results.  

Of course, I recently had an experience with band neutrophils being high where a hematologist dr. who ordered the test said everything was normal in my f/up appt..  I later called his office, the nurse asked him what this high percent of band neutrophils meant.  And she said the dr. said it meant I had infection.  So, here it was weeks later I had called about this number, and I asked that nurse, so should I see my doctor about this and she said yes.

So, I saw my primary care dr. the next day.  By then, evidently from new blood testing, band neutrophils were normal, but my dr. ran a bunch of tests that same day he's waiting on results of to make sure no infection.

I think you should get another differential done, with those abnormal results to see if they are back to normal or not & pursue following up those outside the normal range results you had & I think you might ask for a ferritin check at the same time.
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1490386_tn?1301382186
Yes, "segs" is what I was speaking of! Thank You for taking the time to look that up! I think I am going to ask the cardiologist about it. I really don't trust the doctors at the free clinic anymore. They don't really listen to me anyways! Thank you, again for taking the time to look that stuff up. I will ask them to check my ferritin and for another CBC.
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875426_tn?1325532016
Needs to be CBC with differential in order to get the segs and the lymphocytes done.

You're welcome.  Fischbach's book (referenced above) has more info, but think I'll reserve it for if you get neutrophils re-tested and number comes back high again, if you'll let me know (private message me, please).  God willing, I would give you that info then.  

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1490386_tn?1301382186
Ok, I will! Thank you
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875426_tn?1325532016
Looking at my iron numbers today, think measurement of iron saturation percentage might be needed (though my current primary care dr. has not been ordering it)...

Back in 2006,  I was iron deficient, according to the lab back then: both iron and iron saturation were low & out of their reference range, with ferritin in normal range (thought possibly elevated more than it would normally have been due to recent surgery).  

However, with the labs here (different laboratories, in a different state now), the reference range for blood iron starts a lot lower, and they would have passed me as normal here with just blood iron and ferritin testing (as my PCP here does).   But, my iron saturation percent was 11 percent, which still would be below normal, even by reference range standards with the laboratories they use here & that would have tipped them off about the iron deficiency, despite falling in their normal range on ferritin and iron.
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