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Extreme elevated heart rate with normal exertion - standing, walking
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Extreme elevated heart rate with normal exertion - standing, walking

My daughter-in-law is experiencing unexplainable extreme heart rate elevation with normal exertion such as walking or standing from a seated position.  Emergency room personnel recorded a jump from 98 BPM to 130-150 BPM upon standing from a seated position.  Subject is 20 years old and in good health.  Symptoms started shortly after eating breakfast on a cruise ship. Cruise ship medical personnel diagnosed anxiety as a possible cause, but hospital ultrasound and CBC discovered nothing significant.  Yet the condition persists even when subject is under influence of doctor prescribed Xanax.  What conditions might be causing this problem?
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Going thru the same sitiation right now. More than likely its an adrenogenic response that is unconscious. Second culprit is anxeity and finally innappropriate sinus tachycardia.
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All,

Thanks so much for your comments.  Medical folks have ruled out panic and anxiety since she has the same symptoms while on calming or sedating drugs.  We're looking into adrenal, parasitic, and thyroid as possible causes.  Seeing a cardiologist tomorrow for the isotope stress test.

Pastorphil
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97628_tn?1204465633
Has you daughter-in-law been evaluated for POTs? Postural Tachycardia Syndrome? Contrary to what some may tell you, her blood pressure does not need to drop for this diagnosis.

Satish R Raj, MD MSCI of Vanderbilt University, has authored an article on this topic available on the web.

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Avatar_n_tn
May be anxiety or a panic attack. I am 35, and I was admitted to hospital for a day. Doctor's think I had an anxiety attack with high blood pressure. They put me on 25mg Toprol XL. I had high heart rate in the hospital, laying down on the bed (130 pulse). But I also normally had 100-110 when walking around at home. Sorry If I  wasn't  much help.
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Avatar_f_tn
dehydration in itself could cause similar symptoms, or could aggrivate another possibility you should keep in mind, which would be Innapropriate sinus tachycardia..

i have similar symptoms to this day even though ive been treated successfully for svt.. My heart rate jumps upon standing (almost always above 100, frequently above 120), it would get even higher upon movement, and would go right back down the second i sat... i have a slight IST... Whats helped me is staying very hydrated and exercise.. i hope your daughter in law finds a diagnosis, and you are a superb father in law for caring so much
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Avatar_n_tn
Hi There,

I just wanted to chime in with what kitcurious said...have they checked her for p.o.t.s?  I think they'd do a tilt table test on her to check her heart rate while laying down and then immediately upon standing.  Does she feel faint at all when it happens?

My little brother had issues with his vagal nerve when he was young...whenever he'd stand for too long, his heart would race and he'd feel very faint.  They put him on a high salt and high fluid (water and gatorade) diet which worked for him.  He doesn't have an issue anymore with it.  Just my thoughts, I'm certainly no doctor but I wish your daughter in law the best!  Take care.

momto3girls (:
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Avatar_n_tn
another few ideas to add to the mix, has she had an echocardiogram? Cardiomyopathies cause sinus tachycardia due to cardiac enlargment and floppiness for want of a better term.  It took almost 6 wks for them to dx me with a post partum cardiomyopathy and I had had it for mths, it was missed by my OB office for mths, during an ER visit post partum where I was heart monitored, but was there for another issue and also during the C section and recovery in an Ob unit for nearly a wk.  My HR was in the 120+ while lying down and more when I walked or did similar things.

The Drs focussed on thyroid and pg as being the issues at hand, thyroid probs can cause a tachycardia, and so can adrenal function problems and any anemia esp if its severe or related to iron stores rather than iron levels.  
First two issues are often picked up during an endocrinology work up, second one by some in depth iron panel testing and a work up by a hematologist.

Gl and hope you get some answers soon.

Fiona
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Avatar_n_tn
Kit,

Thanks for the tip on POTS.  I did a web search and found the doctor's paper on the subject.  According to the document, POTS is not typically present in a patient who is dehydrated, or is taking antidepressant drugs.  One of the conditions the doctor on the cruise ship noted was dehydration.  Also, when my daughter-in-law was in the ER a few days ago, the ER docs had her on antidepressants and the condition persisted; even got a little worse.  But I am going to keep POTS in mind when I go with her to the cardiologist.  THanks again for your contribution.

Pastorphil
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97628_tn?1204465633
Yeah, my rate did the same thing for over two years. About 112 standing.

Have no idea if it's still doing it on the low end because I'm so used to that rate  it has to get over 130 before I notice it at all.

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Avatar_n_tn
Hi Pastorphil,
She could have Postural Orthostatic Tachycardia Syndrome

     Tachycardia means an extremely rapid heart rate, usually signified by a pulse rate of over 100 beats per minute (bpm).  Postural Orthostatic Tachycardia Syndrome (POTS) is usually clinically defined as a heart rate increase of 30 bpm or more from the supine (laying down) to the standing position within 10 minutes or less.  Patients with florid POTS develop tachycardia over 120 bpm within 5 minutes or less.  Some doctors use a strict 5 minute standard for defining POTS, while others use a 20 minute standard.  Some patients have heart rates that go all the way up to 150 bpm and beyond.  During tilt table testing, some POTS patients have large drops in blood pressure and pass out (syncope), while other patients have only relatively shallow drops in blood pressure.  A small percentage of POTS patients have no drop in blood pressure at all.uld have Postural orthostatic Tackycardia Syndrome (POTS)

What causes POTS?

1)  Viral and bacterial infections that damage the autonomic nervous system are a common cause.  Patients who develop POTS due to an infection, with no deeper underlying genetic cause, have the best chance for a spontaneous recovery over time.

2)  The development of POTS in women after childbearing is very common and may be due to changes in blood volume during pregnancy.

3)  Exposure to toxic chemicals which damage the autonomic nervous system can cause POTS.  This group includes adverse reactions to prescription drugs.  Some Gulf War veterans have developed POTS like symptoms after being forced by military leaders to take inadequately tested experimental drugs and being exposed to small amounts of nerve gas.

4)  POTS can be caused by genetically inherited neurotransmitter disorders, including disorders of catecholamine production and release, such as Norepinephrine-Transporter Deficiency.

5)  POTS can be caused by peripheral nerve damage due to rapid weight loss, diabetes, and alcoholism.  Doctors at the Mayo Clinic have identified autoantibodies specific for nicotinic acetylcholine receptors in the autonomic ganglia, which are believed to cause of approximately 10% of all POTS cases.  Doctors at Vanderbilt University believe that some POTS cases are caused by a partial sympathetic denervation, especially in the legs.

6)  POTS can be a phase in the gradual onset of Shy-Drager Syndrome.

7)  Damage to the vagus nerve can be a cause and there have been documented cases of patients developing neurally mediated hypotension and POTS after undergoing radiation treatment to the neck.  

8)  There is a mixed bag of less common potential causes, both genetic and acquired.  Ehlers-Danlos syndrome, a connective tissue disorder which permits veins to dilate excessively, is now an accepted cause of POTS.  Essentially anything that can damage the brain stem and important autonomic nervous system structures can cause POTS.

    
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Avatar_n_tn
could be hyperthyroidism, I would definitely have that checked!
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Avatar_n_tn
Hi

Did any of u get a definite diagnosis as to what was causin your symptoms? I have very similar ones. My heart rate is 120 on standing, and it drops to between 80-96, depending on how relaxed i am/what ive been doing) when i am seated. It seems to go up very suddenly.

Sometimes it has gone to the 140s/150 on standing. Admittedly, i have been anxious when this has happened but i dont think the anxiety i have felt has waranted a heart rtae that high! It seems to be getting faster week on week.

This has all started since i had a suspected bout of SVT a few weeks ago, where i got a flutter in my chest and my heart rate went to 173. The symptoms i have had since are not the same  they are not preceeed by flutters, its more of a general fast rate.

i keep checking my pulse and hardly dare move! It is really really scaring me. any advice???? thanks. :(
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471949_tn?1236907626
i have SVT (have had heart rate issues for years) and one of the first tests any of my cardio docs have done is a holter monitor test, both the 24-hr test and the week long test....this is a great indicator of what is really going on for heart rate issues.

i ended up having 2 cardiac ablation procedures for my SVT and will be on meds forever...still have problems with it on and off.

best of luck to all
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Avatar_n_tn
wow Maz 12 I am having the exact same thing and it freaks me out I have been in bed all week due to a breathing issue (chronic hyperventilation syndrome) which made my anxiety sky rocket and I have been having pretty much had constant panic attacks all day long not fun, even wake me up at night . So now i am obcessing over my heart rate :(  I check my pulse constantly and its fine sitting still but when i get up it sky rockets and i can feel it im my chest so i go into panic mode and think the worst of course . If you hear anything please let me know I can't even go to work right now it's miserable i am supposed to be taking .25 xanax but i hate pills . So if you find out anything please let me know I have been to the doctor 3 times in the past week and my heart races more when i go there it's a viscous cycle. 24 female pretty healthy other than panic disorders
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Avatar_n_tn
Poor you, i know what its like! I am not working either at the moment and it is a vicious circle because when not doing normal stuff it become all u can think about which makes it worse! i am going to the dr on wednesday again so i will let u know what he says.

Can i ask what kind of pulse rates u are getting - when resting/standing /walking around house, etc? I too can sometimes feel it in my chest.

Did ur doctor give u any explanation of the symptoms?

Im 28, female and was pretty healthy too till all this!

Hope u feel better soon - thanks for ur reply :)
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Avatar_f_tn
I am a 28 y/o healthy female and I had an ablation about 10 weeks ago.  Since then I have been experiencing POTS like symptoms.  My heart rate swings up 30  beats when I stand up but then it comes down.  Also, when I am doing relatively easy things walking and such my rate seems to hover around 100 or more.  I was extremely fit prior to the ablation but the increased heart rate is giving me some trouble now.  The doctors think that maybe I had some nerve damage during the ablation that will work itself over time.  I hope so because it doesn't feel good to have the heart rate swings...
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Avatar_n_tn
My heart sits at about 90-96 beats a minute and when i get up goes from 120-130 freaks me out doctor say its anxiety but have never had a EKG. but i think about it before i get up and that sets me into a panic which is worse and I feel like I can't breath  I am constantly tense and it makes me gag.  so i lay in bed pretty much all day and have lost 15 pounds in 2 weeks cause I constantly worry about it from the time i wake up till the time i go to bed i even wake in the middle of the night and feel my pulse it's like i obcess over it : ( It's driving me nuts . I have also felt some skipped beats . Hope your doctor appt. goes well
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Avatar_n_tn
Hiya

Sound like ure getting exactly the same heart rates as me. My Dr didnt really shed any light on the situation - he just said that it is being investigated, so unil they knew something it was not helpful to worry about it. I wore a cardiac monitor last week (where u press a button every time u feel ur heart do something odd) and it records for a short period of time. Will find out later this week/early next week what this shows so will keep u posted.(Please note though that they did not give me the recorder just because of my general heart rate, it was given to me because of my suspected SVT)

As you are feeling tense and gagging it sounds like ur pulse rate could well be anxiety related - so although feeling tense etc is not nice, u can in a way be reassured that u are actually anxious and so that could well be causing the heart symptoms. i know what u mean though  - it is hard to tell sometimes whether the symptoms are causing the anxiety or vice versa. It is reassuring too that ur dr is not concerned.

One thing i would make sure though is that u are eating properly, otherwise u could cause yourself more probs. I am the same in that i dont feel like eating when i am stressed, so i eat little and often!

hope u feel better soon, just give urself time to relax and recover and am sure ull feel better!

i know what its like,
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Avatar_n_tn
im so glad to find this website & see that there are other people going through what im going through too .. i too have a heart rate that is going up and down constantly. it all started when i was 6months pregnant and went to get my teeth cleaned  at he dentist , once i got home i could feel my heart racing i went to the doctor & it was going at 200 beats per min , i went to the hospital & it had subsided .ever since ive ended up at the hospital with it going at 160 my highest . also it goes fast if i do the washing and even standing it starts to race and i have to lie down , ive been getting alot of extra beats and fluttering in my chest which makes me faint and hot . my doctor suspects svt and put me on medication . but i dont know whether he really knows what is going on. ive had the holter monitor for 24 hours and it diddnt show anything ,also ecg and echo came out ok . but its not playing up  all the time and usually when im having those tests im laying  down and my pulse is low .. please can someone shed some light on whats going on and what other tests i can get done to see if anything else is doing it .
anxious ..
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Avatar_n_tn
omg1 i have the same problem. start 2 years ago, i was on the atkins diet and i figured the rapid pulse was due to that. the scary thing is that im a nurse so i know about all the diseases. i was at work and i felt my pluse go up to 170bpm and totally freaked out. went to er and was put in the observation unit for 24hours. had an echo and heart monitor and was told everything was normal:( went to cardio dr and was told im ok. what the hell is going on with my body?? i know smoking makes it worse but im under soooo much stress i cant quit right now. im taking paxil 20mg daily but even if im relaxed my hr jumps. help:(
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Avatar_n_tn
I don't know if you have heard of this or not, but I have a heart condition called Neurocardiogenic Syncope. I am 20, this condition started when I was 18 and has continued to get worse. When I am sitting my heart will be around 78 but as soon as I stand it jumps to 120-150. To test this condition they do a tilt table test. They strap you to a table and put you in the standing position and basically wait to see if you pass out or not. They monitor your heart rate and blood pressure to see what happens. There are a few different things that they do to attempt to treat this condition, unfortunately none of them worked for me. Some days are ok and some days are terrible. On the bad days I can barely get out of bed, because if I stand up I will pass out.
To break it down, what happens when I stand is, my blood pressure drops and so my heart rate races to compensate for it, and then they both get tired and I pass out.
I hope that this might be some help to someone out there. I know how frustrating it is to not know what is wrong with you.
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Avatar_n_tn
Oh my god,

I've Been feeling like this for years, all the doctors say is that I have anxiety, but I know it's not true! It was this past Monday when I was standing up for 5 minutes when I suddenly felt my heart besting so fast, I felt tired, so tired that I had to sit, I almost passed out!  I went to the ER and they found nothing!  Going to go see a cardiologist soon, gonna ask them to do the tilt table! I still feel the same, my heart rate raised when I stand up, up to 130 at times, but as soon as I sit down it goes back to my normal 70-80bpm.  I feel do tired, I just want to stay in bed at times. The worst thing is that I am 4 months pregnant!
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Avatar_n_tn
I am glad that I could help. Let me know how it goes. :-)
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Avatar_f_tn
I am 27 years old and am going through the same thing. I've been to the ER and had had rates of up to 180. They did EKG and monitored me the whole time that I was there and said everything was normal, and sent me home with .25 xanax. Which really don't seem to do anything! My doctor even thinks it's anxiety but I've been on the meds for awhile now and nothing seems any different to me. I can feel my heart rate go up and down all day, and I'm not over exerting so it's strange, but I can especially tell first thing in the morning. Shortly after I get up I can tell it's faster than what it should be. I have 3 children and I don't really have alot of time to deal with all of this, but it worries me to know my body is acting so strangely all of a sudden.
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Avatar_n_tn
As convincing as some doctors seem to be, they don't always no it ALL!  I hope all of you with undiagnosed (and even diagnosed)  problems have gotten 2nd and maybe even 3rd opinions.

My daughter went from having SVT, two ablations ---and now has some mysterious condition that looks like POTS

QUESTION--- If you have a negative tilt table test, how else would the Dr's diagnose POTS?

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Avatar_f_tn
i get a high heart rate when i stand up. but i dont get lighthead are passout. could this be pots.
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Avatar_m_tn
i am so glad to read all these posts. i have had symptoms going on for a year now and am going for a tilt table test and an EP. from sitting to standing within about 10 - 30 seconds my heart rate goes from about 90 to 160 and sometimes it is even 190! it started a eweek ot two after a viral infection. my 24 hr holter only showed my fast heart rate. my blood pressure has been a bit high but not low... so that means it cant be POTS doesnt it?
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Avatar_f_tn
I am 21 years old and experiencing the same symptoms. My heart rate when i am sitting is 92-96. It is not always 92-96 but mostly it is 88-92. When I stand up it jumps to 130-140. I don't feel it but only notice if I stand up for too long. How is you daughter-in-law now and did the doctors figure out the cause? I am waiting for my doctor to come back from her vacation so I can go see her.
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i have always been a very active person,but these last 2 yrs have been very hard 4 me i cant do anything anymore shop,take my kids out, pump gas [nothing] my heart races so fast its like ima pass out.the first thing they say panic attack take med 4 it it doesnt work.i was told about 7 years ago i had an enlarge thyroid gland but nothing else has ever been said about it.i was told i had a couple of disc in my neck that wasnt straight but that was all i heard about that 2
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Avatar_f_tn
I have the same problem many of you are experiencing and i was diagnosed with vasovagal syncope. I'm going to the cardiologist again on Friday. Yesterday my heart rate monitor got up to 230 on several occasions and then would immediately drop into the 80's. Granted I had just finished a 20 mile bike ride but that's not abnormal for me. Mine occurs a lot post workout which I find odd. If you haven't read up on vasovagal syncope it's worth looking into. It has to do with the nerve in your brain not firing right so your heart doesn't get the right signal.

It couldn't hurt to check, it's also hereditary, my son has it too. Good luck to all of you on finding your dianosis!
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Avatar_m_tn
yeah all of this is causing you there anxiety attacks or panic attacks i have them all day too and it ***** iam always checking my pulse rate and blood pressure and my blood pressure is perfect but my pulse rate goes up i've been done alot of test and they all come back negative the doctors says nothing is wrong with me i told him that my pulse would  go up to 180 bpm when this happens but he said that for me not to worry that iam not going to die the ambulance used to come like for two weeks straight but they said everything is fine just that my heart rate is high due to panic since then if been better just in the morning when i wake  up i wake with a high pulse rate of 100 - 110 i take xanax .50 two times a day doctor told me to take them 4 times a day but iam good with 2 a day hope this help
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Avatar_f_tn
hi my daughter had the tilt table test as she showing all signs of pots becuase her blood pressure did not drop they said it was negative how do i challenge this result as heart rate was v high
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Avatar_m_tn
Have you checked about POTS?postural orthostatic tachycardia syndrom (syndrome)?
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Avatar_n_tn
I am a diabetic patient. Due to skipping meal, Diamicron and metformin harmed me. At the start blood pressuring falling ans heart rate was increasing. Later only heart was going high on standing and walking.
My blood sugar was high with ups and downs.  When sugar was settled.\, it improved after six months.

After that I started taking Insulin Lantus and Humalog. It was working well for me for a year. After that lantus was not working that well. But it was late in prescribing another one(LEVEMIR) and fixing the dose. IN the mean standing and walking  heart rate started to go high.. It is making lot of stress on eyes

About 2 months blood sugar was high. Now sugar is almost fixed.  In another weak it will be OK. But still I have lot of symptoms.  Can any body help?
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Avatar_n_tn
I am a diabetic patient. Due to skipping meal, Diamicron and metformin harmed me. At the start blood pressuring falling ans heart rate was increasing. Later only heart was going high on standing and walking.
My blood sugar was high with ups and downs.  When sugar was settled.\, it improved after six months.

After that I started taking Insulin Lantus and Humalog. It was working well for me for a year. After that lantus was not working that well. But it was late in prescribing another one(LEVEMIR) and fixing the dose. IN the mean standing and walking  heart rate started to go high.. It is making lot of stress on eyes

About 2 months blood sugar was high. Now sugar is almost fixed.  In another weak it will be OK. But still I have lot of symptoms.  Can any body help?  Resting heart rate is 64, If I wak it goes to 100
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Avatar_m_tn
I've been having these same tachycardia episodes upon standing  I'll go from 55 to 120+ on a good day.  A bad day will push 170+ .  If I lay down it's right back down to resting rate.  I've had every test you can imagine , tilt table , EP,  numerous stress/ echos.  64 slice ct.   I'm on .25 atenolol / x 2 daily & Xanax as needed.  

I'm on my 2nd 30 day cardiopal savi recorder (in 2yrs) and I just recorded a tach event so ill be waiting to find out if I was sinus tach or if I had some afib that started that.  Also: I was diagnosed with moderate sleep apnea 2yrs ago & do not use my cpap.

I usually go months without any of these symptoms, but now i've had several in a week. 3 years and 200k worth of tests.  My Stress level is moderate & life was good untill these episodes started happening.  Please believe me when I say that I feel your pain folks.  I live with the daily anxiety of the next episode.  
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My heart rate read 115bpm when standing, my husband pointed out I had the blood pressure machine on the wrong way, oops!!! When re-corrected, my heart rate was 99bpm!! slightly better.:)
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6391792_tn?1380888227
My heart rate read 115bpm when standing, my husband pointed out I had the blood pressure machine on the wrong way, oops!!! When re-corrected, my heart rate was 99bpm!! slightly better.:)
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Avatar_f_tn
My heart rate goes from 60 sitting to 99 standing ,or 70 sitting to 109 standing  and I feel heavy palpitations in my chest.  My physical therapist said it should only go up about 10 points. I am 63 and have diastolic dysfunction stage 1 but the heart dr didn't say the diastolic dysfunction was causing the high high rate. I do have atrial fibrillation but that only happens once every 4 days. I also get shortness of breath when I stand. I was low on morning cortisone level 2  yrs ago but my afternoon level was ok. I ad shortness of breath then but now it's getting worse. If I walk around it goes up to 132 or higher. Then the nurse practitioner at my heart dr office tells me I have to get down my heart rate but doesn't tell me how to do that. I have been on a low cal diet for 5 months. Could that make my fast hr worse? I work out on an exercise bike 2 hrs a day getting my heart up to 115. If I walk on a treadmill the hr goes  too high which is why I switched to the bike. I am really struggling with this. It is affecting my whole life. I couldn't keep taking the prescription medicine cuz I couldn't tolerate it's affects of making me feel like I had been run over my a truck. It lowered my heart rate to low.
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