146 Pulse Rate in 90-year-old woman

[Bev170]

My mother has hypertrophic obstruction cardiomyopathy.  She is 90-years-old.  Also, she has been hospitalized in recent months with heart failure.

This morning she was short of breath (it's now mid-afternoon).  She was having a "tightness in her chest."  Her BP was 120/77 with a pulse rate of 146.  About 30 minutes later I checked her again.  BP 113/66 and pulse rate was 77.  She had rested and was feeling MUCH better but weak and "drained of energy."  She continued to improve and because she was feeling stronger we went to lunch with friends.  

Do I have reason to be concerned?  Should I have taken her to the hospital?  Should I leave this alone or do I need to contact her cardiologist?  Since we are in the weekend, I hate to do that.  But if this is serious, I wouldn't hate to do anything for my mom.  

Originally, I was going to call 911, but she stopped me saying that she would REALLY be upset.  I would do it anyway if this is something that is life-threatening.  Her cardiologist told me last August that my mother is "approaching end of life."  She is in good spirits today.

[Bev170]

My mom is on Amiodarone.  Also, she is on other medications, specifically for Alzheimer's.  

Thank you for your response.  Since she is doing well this morning, I'll call her cardiologist tomorrow.  Again, thanks!

[Michael J. McWilliams, M.D.]

I cannot really assess whether she needs to go the hospital.  The best approach to answer that question is to call her cardiologist on call.

Regarding the fast heart rate, the most likely explanation is atrial fibrillation or atrial flutter with a rapid response.  There are medications that can be used to help control this.  There are other heart rhythms that are possible but hey are much less likely.  If she is feeling better it is probably not an issue.  If you do have questions though, call your cardiologist in the morning (sooner if needed).