Heart issue or anxiety?

[daniel8719]

Hello, I am 26 years old and well over a month ago now I went to the hospital with a rapid heart beat.
I had experienced some occasional discomfort in the heart region prior to this event but thought it would
eventually pass. Then one night I found that my heart was beating very rapidly. I couldn't sleep because of it, and
i found that it put me in a cold sweat followed by frequent urination. It eventually subsided very early in the
morning and went back to normal. Later maybe a few weeks after this event, it happened again, my heart would beat rapidly, i'd get the cold sweats and would have to urinate about every 15 minutes. This continued until 7am, not being able to sleep all night, i finally took a blood pressure monitor to test my heart rate which read over 120 bpm. At this point I decided to go to the ER. I was there for several hours where they did a number of different tests which included a EKG as well as a Chest PA/Lat test. They also did various lab tests including CBC w/diff, CMPL, D.Dimer, and tsh. After looking at the results the doctor there told me everything came in as normal and that she saw no abnormalities except that my potassium levels were a bit lower that they should be. So for that I was given 2 potassium pills while I was there and then prescribed the same pills for 10 days. I asked what the frequent urination meant (which I was even experiencing while in the ER), and they told me it could be due to being dehydrated. I didn't fully understand why that would be because I normally drink liquids throughout the day, but I decided from then on I would drink a lot more. So after being hooked up to an IV for several hours my heart rate eventually came down to 80-90. The doctor recommended me to a cardiologist and told me I was free to go. For the next few days I kept getting spikes in heart rate of 90-100 while resting. I then went to see the cardiologist a few days later which at that day my heart was at 120 bpm again.

[daniel8719]

Thank you as well for your response,

I am also speculating whether it may be an anxiety related issue, especially when my cardiologist cannot find anything out of the ordinary after all the tests they've done.
I would in fact be much more relieved if that were the case instead of it being something more serious. I'll make note of the medications you mentioned as well.

[daniel8719]

Thank you for the response,

The main reason I would refer to 90 or more as a "spike" is because there would be times that I would be at a restful state, and not particularly thinking of anything that would stress me out, and yet my heart rate would just seem to go up without any reason.

During the last week that I was on my heart monitor, and the following two weeks after i sent it back, awaiting my next appointment with my cardio, it got to the point where I felt almost nothing out of the ordinary and my heart would usually stay between 60-70 or slightly more, then the day I need to see my cardio arrives and I am once again over 100 bpm. The next few days following that visit my heart would randomly go up to 90 or more (at rest) and then go down again. Occasionally I will also feel a slight burning sensation that will extend to the left side of my back. Though today, so far I have not felt anything out of the ordinary.

But it is due to the way it occurs that I'm starting to think that maybe it is somehow anxiety related, and that after the first event that occurred over a month ago, I have become much more attuned to "feeling" my heart beat and almost obsessing over how fast it is beating and checking it more frequently.

Also regarding the nicotine, when I started using the electronic cigarette I was using between 18-25 mg of nicotine, so if it could have been the cause, then maybe this amount was way too high for me at the time. But from the time of the first event last month up until my last visit with the cardio, I did not use the e-cig nor did I consume any coffee or tea for that whole time. But as for my results from the stress test and heart monitor, my cardiologist could not find any heart arrhythmia's, tachycardia or heart disease. He said that he of course cannot guarantee 100% that there would be no heart disease, but said that due to how well I did with the stress test, that he simply saw no signs that would suggest it. Also when asking him about caffeine use, he said it was fine, but not to over do it, and with the e-cig, to just keep decreasing my nicotine use until I don't need any at all.

Because of my results and what he told me, I am wondering whether I should bother with the heart monitor again for a second round or just go to my family doctor and look for whether anxiety is part of the issue.

[CCFHeartMD27]

I'm sorry to hear of your problems.  First, please know that a heart rate of 90 beats per minute at rest is not a "spike" and is certainly within the realm of normal.  The fact that your heartrate came down after appropriate hydration suggets that your tachycardia was indeed associated with volume depletion/dehydration.  I wonder what role your electronic cigarette plays in this.  The nicotine solutions are unregulated, so who knows how much nicotine you're actually getting when you smoke that thing.  Tachycardia is a well-known effect of nicotine consumption.  

First, the questions is what is actually bothering you?  Do you have palpitation or is it that you're measuring your heartrate and are alarmed when you determine that it's high?  You should discuss your concerns with your family doctor.  

[heartfluttersflyawayplz]

I think get meds for anxiety, I to have that problem and it's anxiety, won't hurt to try them, I would ask for a fast acting med and only take when your heart rate is up, like Ativan, I take it now and than

For a long term med klonopin is a good one, they told me to take 3 times a day I took it twice a day morning and nite and they told me to take 1 mg each time I cut in half and took .5 , I don't need much

Keep in touch and let us know how your doing,

Enjoy that your heart is in good shape and prayers you can get heart rate under control

Also they put me on a very low b- blocker, I take timilol twice a day 5 mg it holds the heart best down

[daniel8719]

He checked everything and while didn't hear anything abnormal, he ordered a stress test with 2DEcho with Doppler and to wear a Cardionet live event monitor for 14 days. The stress test came in as normal, and results from the Cardionet monitor also came in as normal. The day I went to my cardiologist to get this info, my heart rate was again close to 120 bpm, yet for the past few weeks prior to the visit it was consistently between 60-80, with no spikes at all. Yet on the day of the visit all of a sudden it was way up there again. I was told it was probably because I was anxious. But anyway he told me he saw nothing abnormal, he did not see that I had any tachycardia or heart disease, and said it was ok to exercise, and drink normal amounts of tea or cofee, and basically said to just live my life as normal. I also used to smoke now and then when I was in college, but quit last year and just use an electronic cigarette from time to time, and he told me that was ok to use as well as long as I kept the nicotine low and worked on quitting completely in the future.

So after I left the cardiologists office my heart began to go down again, and then I had my first cup of cofee in a month and my heart rate was normal around 70 bpm. Then that night I woke up with a heart rate of over 90, but went back to sleep. the next day I also had random spikes ranging from 90-100 and then going back down. It is now day 2 or 3 since visiting the cardiologist and I'm again getting spikes ranging 90 or more while resting. The day I visited him he told me even though he saw nothing If I had any more incidents I could get back on the monitor and try it again in case they missed it the first time. So the question is, should I go back, get a second opinion elsewhere? Or should I go to my family doctor and get medication for anxiety issues. I know things aren't totally normal yet, even though prior to my last visit with the cardio everything seemed great until that day.