Inappropriate Sinus Tachycardia (Help)

I was just diagnosed by my Cardiologist with IST. I have had several EKGs, echo, 7 day holter, and stress test before the Dr. came to this conclusion. I am a 26 year old male and the onset of this condition feels like it came out of nowhere over the past month and a half. I only notice the weird feelings with exertion such as stairs or lifting. It causes me much anxiety and I am having a hard time coping. My Dr. prescribed 25mg of Toprol XL but I am hesitant to take a medication for the rest of my life at such a young age. I am now ruling out thyroid issues with my GP but my TSH levels are normal and I am awaiting the results of my thyroid ultrasound.

What else should I be doing? I get overcome with adrenalin rush with minimal exertion and I get extremely panicy. Is this normal with IST? I am tired of people chalking the rest of the symptoms up to stress and anxiety. Any help would be appreciated

[CCFCardio MD2]

Sorry to hear you're having some trouble.  Innappropriate sinus tachycardia is rare and is a diagnosis of exclusion, meaning everything else that causes tachycardia as been ruled out first.  Beta blockers such as metoprolol can be helpful if IST is truly your diagnosis, but many patients don't tolerate them well.  As much as you hate hearing it, anxiety can certainly cause some of the symptoms you're having.  It might be worth trying some anxiety treatment to see how you do.  I would recommend seeing an electrophysiologist--a cardiologist who specializes in rhythm disturbances--before doing anything further.  Best of luck to you.

[updawg86]

I saw an EP and he looked at the ekg, echo, holter, and stress test that the Dr. sent over. He took another ekg said I checked out and to follow up with my cardiologist as he wasn't concerned. Both doctors assured me that its not life threatening which was such a relief to hear. However, I am now at my breaking point in terms of what to do because I get weakness, constant neck aches, blurry vision, and it feels like my head rocks ever so slightly. I understand these symptoms can be chalked up to stress, and I am seeing a school counselor to talk about my stress, but I need additional advice. This all started around October 1st and it has been a constant struggle until today. I have the feeling that the doctors are overlooking something, which is inline with your typical person with anxiety. I just don't feel right and would like to break out of this rhythm.

In regards to testing - don't I need a tilt test to determine IST? Is that something I should ask for? Also how does a doctor determine it is IST and not POTS? Please if anyone could provide me a list of questions to ask my doctor as I feel like everytime I leave the office I forget to ask the right questions. Thank you.

[updawg86]

Anyone care to comment? I am tired of having chest pain at rest which really gets the anxiety going, any ideas on what to pursue next would be greatly appreciated.

[RubyB]

This might not help much, but I am (was) a healthy 23 year old student and I too recently experienced most of the symptoms you described. For a while I felt like I was losing my mind. My heart would start racing or I would have chest pain and this would get my anxiety going. From that point it would become hard to tell what was actually a real medical problem and what was anxiety. I was also suddenly struggling with high blood (usually only diastolic) pressure which for some one of my size  and age is crazy. After tons of tests  I have been diagnosed with IST and I am on 25mg of Toprol XL. The medicine has been working for me with few negative side effects, but it does concern me that I may be stuck taking them for the rest of my life. Ive done a lot of research and other than medication my only other option (according to my EP) is Cardiac ablation. I am opposed to this because It isn't necessarily a cure, and it doesn't always work for people with IST, but if you don't want to take medication this might be a good solution for you.

The other option I have been considering (I have read a TON about this condition) is to do nothing. For many people IST goes away as you age. It technically isn't life threatening, but it is VERY hard to live with. Before I started on the medication I came up with my own "treatment". Wearing a heart monitor for a month revealed that my resting heart rate was always above 100bpm, but it was pretty normal for it to go over 150bpm through out the day. During those times I experienced negative symptoms. The only real danger with IST as far as I can tell is passing out randomly from an elevated heart rate and hurting yourself. This is why whenever my heart rate goes over 120-150 bpm I try and find a place to lay down or sit with my feet propped up (I have told a few close friends and professors at school and at work about my condition so that helps) I dim the lights if I can and I just try to relax and breath. When I'm at home (which typically for me my symptoms are worse in the evening before bed) I take a bath with lavender oil and Epson salt. Although if you have low BP I don't suggest that for you. I also sometimes drink a cup of hot camomile tea, or a coconut water (potassium and staying hydrated sometimes helps). Basically my goal during this time is just to relax and lower my heart rate by doing that. Sometimes it feels impossible, but I have yet to pass out since I started these little rituals. I have tried lots of different techniques. Listening to Binaural beats has helped along with all the other stuff I mentioned above. Find what works for you. Sometimes just having some one sit with me and comfort me is enough to help me relax. I have also joined a support group online for people with IST and reading about others experiences with it has helped me find new ways to cope.

IST *****, and if this is indeed the only thing causing your problems I suggest you try some of the things I have mentioned. For me, my own anxiety about what I was feeling was ultimately worse than the physical symptoms of IST. Talk to your doctors they will explain that there are tons of complications that go along with IST, but every pain, or thump you feel in your chest isnt going to kill you. Trust your gut, if you feel something REALLY isnt right go to the hospital, but eventually you will start to better recognize the symptoms and learn to stop fearing them. Hopefully you will find some of this helpful.