Varying Heart Rate

[Capleton]

I have already posted this in support forum.  I am 25 yr old Male with no symptoms except what I describe below. Three things in particular - exercise, heavy food and alcohol can cause my heart to beat rapidly for a couple of hours before returning to "normal". Two years ago I had the full works - Blood tests, 2 EKGs, Echo, 24hr Holter Monitor and Exercise Stress Test. Two Cardiologists looked at the results and neither were concerned. My GP (who referred me to the Cardiologist after taking my pulse at about 110 a couple of hours after exercise) says I have a structurally normal heart but agrees that I have a fast HR. He is convinced that there is a reason for it but does not know how to establish it.

I guess I have a few questions:

1. My resting heart rate varies considerably during the day. It is almost always between 60 and 100 but the changes seem strange.  Just after waking up it is usually between 64 and 72.  In the afternoons after lunch it is usually in 80's or low 90's. In the evenings it goes back down to 60's or 70's.

2. Is it just the case that some people are over sensitive to stimulants like alcohol or even exercise? I had two glasses of champagne yesterday and my HR stayed over 100 for 2 hours.  Exercise will also do this.  I cycle to and from work each day - 30 mins each way.  My HR will stay around the 100 mark or 90's for an hour or even more after exercise.

3. Do I need to just forget about this. Should I get a second opinion? I would be really grateful to hear your thoughts.

[Forum-M.D.-MJM]

Hi Capleton,

This is situations are very tricky.  Once metabolic causes of high normal to high resting heart rates are ruled out, it is difficult to pin down a cause other than calling it inappropriate sinus tachycardia.  This means exactly how it sounds -- a heart rate that is inappropriately high for the level of metabolic demand.  One of the truly interesting things about this condition is that about 70-80% of people with this are in health care related fields.

1. My resting heart rate varies considerably during the day. It is almost always between 60 and 100 but the changes seem strange. Just after waking up it is usually between 64 and 72. In the afternoons after lunch it is usually in 80's or low 90's. In the evenings it goes back down to 60's or 70's.

This could be consistent with inappropriate sinus tachy.  The name is more of a description than an explanation of the physiology.


2. Is it just the case that some people are over sensitive to stimulants like alcohol or even exercise? I had two glasses of champagne yesterday and my HR stayed over 100 for 2 hours. Exercise will also do this. I cycle to and from work each day - 30 mins each way. My HR will stay around the 100 mark or 90's for an hour or even more after exercise.

There are definitely people that are more sensitive to things like stress chocaloate, caffeine, etc.

3. Do I need to just forget about this. Should I get a second opinion? I would be really grateful to hear your thoughts.

If your TSH is normal and a history and physical fail to turn anything else up, it is possible this inappropriate sinus tachycardia.  If this is the case, it is only a mild case.  I would not even recommend medications unless you are very symptomatic. It would also help to not check your pulse too often -- sometimes this feeds into the problem and you start to obcess about your heart rate.

Thanks for posting.

[TeachK2007]

I, too, am having what seems to be a fast heart rate.  It is much higher than yours, and does not occur only after exertion.  I can be perfectly at rest and will notice a pounding sensation.  My pulse seems to stay around 96-97 bpm.  Cause for concern??

[ricco87]

I have just come on to ask exactly the same thing!

Measuring my pulse for an hour yesterday and It was averaging about 80-90 after no exercise or anything. It went up and over 100 onece or twice and below 70 once or twice.

I'm a bit worried because I'm 19 and not unfit. Is there any advantages/diasadvantages of a fast HR?

[kitcurious]

Tachycardia is a heart rate in excess of 100 beats per  minute. It is appropriate for it to be over this during exercise and inappropriate at rest.

[Forum-M.D.-MJM]

There is a lot of variabity between average, minimum and peak heart rate in the population.  If you graphed it, it would look like a bell shaped curve with most people around 70.  There are perfectly healthy people walking around with heart rates in the 40's and high 90's to low 100's.  It is a continuum and where one chooses to call it abnormal or inappropriate is very arbitrary. I would not consider heart rates in the 90-100 range abnormal, I would consider them high normal.  If it suddenly changed from 60 to 100 and then would suddenly drop back to 60, that would suggest a mechanism to the tachycardia rather than just normal physiology for an individual.

If I saw you in clinic based on what you told me above, I would not give you a diagnosis of inapproriate sinus tachycardia.  I would tell you that you sound fine and to take your pulse less.  It is easy to fall into the trap of thinking that something is wrong with yourself when you are perfectly fine.  That is what I am afraid you are doing.

I hope this clarify the questions.

[Celeste07]

I was recently diagnosed with IST, as was my mother at my age. The difference is mine comes and goes in phases, hers was chronic and stayed at 120 bpm most of the time.
My HR will jump by 40-60 beats per minute and stay there for hours, often going as high as 130-145 bpm.
As Forum-M.D.-MJM stated, taking your pulse often can then attribute to it becoming worse (anxiety induced). I also notice several triggers like you, ie,
heavy meals, workouts, alcohol, being sick (colds, etc.), dehydration, stress, being overly tired, etc. Adrenaline is a huge factor, and as my cardiologist told me, some people are simply more sensitive to excess amounts of it. I began drinking more water, taking extra mag. and cal. and NOT taking my pulse. I've seen an dramatic improvement without having to start the Sectral (a beta-blocker) my cardiologist prescribed. (I have wicked PVC's also)
I take comfort in knowing that IST can be successfully treated if it becomes significant with beta-blockers or at last resort, ablation.

Good luck to you!

[prjose56]

Hey everyone.  I also experience a varying heart rate.  What concerns me is how dynamic it is.  There's really no steady beat...it just speeds up and slows down all the time unless I sit perfectly still.  Even then sometimes I feel some beats quicker than others.  I've been told it's anxiety and have had some tests run (all negative), but I still don't believe my heart is normal.  It's gotten to the point where I don't want to engage in rigorous exercise anymore in fear of having a panic attack and my heart rate shooting up to 160+.  I've started taking a fish oil supplement which helps with the PVCs/PACs...still something just isn't the same anymore.  

Does anyone else experience this high variability?  Please respond or email me with any suggestions.  I wish everyone the best.

Jose
lilrican_56***@****

[KentC]

I am a 51 year old white male, in fantastic health.  Yesterday, I went to the Red Cross to give blood, as my wife do every 60 to 90 days.  They would not allow me to give blood because they said my blood pressure was 150 over 110.  I just got back from a nurse's station where they messured my blood pressure to be 138 over 76.

What is going on?  I don't exercise like I use to, but I weigh 200 lbs and have no physical problems and am very active.

Thanks in advance for you help.

[KarenSA]

My heart rate also used to run at about 130-140 quite often during the day for no apparent reason.  I had lived like this for so many years and did not pay much attention to it as I was used to it and did not consider it abnormal.  Then I went to have atypical avnrt ablated.  After they got that ablated and out of the way, atrial tach presented itself whilst still in theatre, so they ablated that too.  That was in Oct 2005 and since then my heart very seldom beats over 90 beats/ minute if ever.  I cannot remember having a rate of 130-140 again since the procedure (other than in the early weeks as is considered normal due to heart irritation and recovery) and it is really nice not to have that pounding heart anymore.  I don't even know its there anymore!