Elevated heart rate upon waking.

Hi. I found this forum in hopes that someone out there could help me out here. I'm a 40 year old female. I started having lot's of anxeity and panic back in june of this year after I quit drinking. My first panic attack lead me to the ER. I felt like I was going to pass out. My heart was racing.. felt like I was going to die. At the ER..I checked out just fine. So.. way back in June I followed up with my rpimary doc.. who ran a routine CBC and then was ready to just throw on some lexapro and be done with me. I was NOT willing to accept this.

I have had issues with alchohol and I am a light smoker.So, He gave me some xanax that I have been taking now since  3 times per day low does of .,025 mg. I have had all sorts of tests. CT's of My belly, MRI's and an MRA of my brain.. blood work and EKG.. all up the ying yang. All 100% normal. My cardio doc had put me thorugh 2 stress tests, an echo cardiogram, a 24 hour holter monitor.. and a month long event monitor and ran a bunch of blood work..  ll normal. So conclusion has been that I have sinus tach. When I have my EKG and I'm having the tach im still within a normal rrythm. My heart rate is in the 80-90's during the day and evening hours.. sometimes in the 70's  at night this is normal for me. But.. in the morning and more so around my menses.. my heart rate stepping out of bed is like 107. Then just doing a few things like a shower and such it can like 127.. but then by mid morining or so. it's back to 90's. I can't help but still be worried.. even though my cardio doc who is suppose to be one of the best.. told me that I'm ok. Can anyone relate? I do plan to start the lexapro and get off the xanax. I have been putting that off for to long. My cardio doc does not feel the need for a beta blocker at this point.
Do I sound ok?

[ladyjake]

Hi.  I think there are two factors that you are already aware of, good job in finding some of the triggers for the fast rate.  One being anxiety/panic situations and the second being the hormone fluctuations.  Both of these can contribute to the fast heart rate.

I have the same fluctuating heart rates along with PVC's.  I also have the honor of having a Generalized Anxiety Disorder.  There are times that my heart will run around 125-128 when I'm at work and that's for a full day.  Sometimes just getting up from sitting for a long time or out of bed in the morning will rev it up.  It's frustrating to not be able to slow it down, but like you, it eventually falls back into the 90's.  I talked to my cardiologist about this and when wearing a Holter Monitor we were able to capture the fast rate......his verdict was "fast, but nothing to worry about".

Your heart will beat faster at times due to stress, hormones, a big meal, dragging yourself out of bed, being over-tired and various other situations.  Your numbers sound ok to me, especially since your doctor has given you a clean bill of health.  Please keep in mind that you have been going through some major changes and anxiety can cause what you are experiencing.  The number of beats per minute varies from person to person, but the general concensus is that the 'normal' range, at rest, is between 50 and 100, so you do fall within this category.  As you explained, the fast rate comes on when you are moving around.   I know it is worrisome when it's up the 120's, but if the doc says it's ok, the best we can do is find ways to relax, get a good nights sleep, exercise, de-stress, eat healthy and control the anxiety/panic issues (I keep Alprazolam handy and only take it as needed because I hate meds and don't want to be on the forever, once a day thing).  Try not to worry as this only increases the problem.

Beta Blockers will lower your rate, I tried it and it worked (didn't stop the PVC's), but I was so tired all the time, we decided they weren't for me as my heart was healthy, just fast and skippy. Besides, what I heard about the long term effects didn't impress me.  The BB's are great for those with heart problems, but I'm not there.   The doctors Rx was what I mentioned above.

Hope this helps a bit.  You are not alone, there are lots of us with these same symptoms, and lots of people with even faster rates.  Good luck with the anxiety issue (I know how horrid that is- and you are taking steps to treat it) and congratulations on  tapering off of the alchohol, you are taking back control of your health and life.   Take care.
I

[blondemiss]

Thanks lady lake for your post. It's just so odd that it's a morming issue. I tend to wake up all excited and full of energy.. this might boost my heart rate. Morings are crazy getting 3 kids out the door. It tends to stay high in the am.. then goes into the normal range. I even more a event moniotr for 6 weeks and that caputured the fast rate.. even with that fast rate.. EKG all normal same rythm. Perhpas this is just my chemical make up. As long as it's safe and not worry some then I can accept that. But.. my problem is I  worry. I don't get flutters of flip flops much at all just everynoiw and then when I have my period and I heard that is very normal.

[Wisconsin2007]

If you've had all those tests and the doctors, who pay loads and loads of malpractice insurance and would usually rather OVERmedicate than undermedicate, all told you you're fine, then you probably are.

I'm a father to two kids, and during the night I think my heart rate is in the mid-50's.  Resting in bed just before I go to sleep, my event monitor will often clock in between 55-65, so I have to assume it drops a bit lower when I'm sleeping.  

Around 6:30 every morning my kids wake up - the baby monitor in the hallway picks up the sound of her door opening, shortly after my daughter comes into our room and climbs into our bed, our son isn't old enough to sleep outside his crib, but he usually wakes up shortly after our daughter and starts making noise, wanting to come out and see us, too.

I've had mornings where just sitting in bed, within a minute or two of that noise on the baby monitor (ushering in the start of the morning craziness), my HR will quickly climb to 90bpm.  Up from the 50's.  My presumption is this is my mind and body's way of preparing for the morning (sympathetic or parasympathetic nervous system - I don't recall which one) - getting kids on potties, changing diapers, changing clothes, brushing teeth, making breakfast, cleaning dishes, etc.  Oh, and the whining.  And the mess making.  Sometimes in my head it feels like I'm getting ready for a 30 minute bull ride.

So if you're jumping out of bed to prep three children for the day, I would expect your internal mechanisms know this already and your heart rate jumps up pretty quickly.  

I also notice that my heart rate, in anticipation of time on the treadmill, will be higher before I start but actually slow down once I've been on it for a few minutes.  I mention this because it seems clear to me (and online research bears this out) that anticipation of an activity can increase your heart rate, and then when the anticipation is coupled with activity, the rate can go even higher.  But like me, in your case once the "bull ride" is over and your heart and brain know that, your heart rate slows down.

Sounds to me like you should trust your doctors - you are most likely fit as a fiddle.

[blondemiss]

Nice to hear from someone who can relate to the craziness of having kids. :) Yes the morings are nutty.. and I do tend to get excited easy. I often wonder if my heart rate has always been sort of high in the am and I just never new becuase I was not checking. Now today for example. I was about 114.. when I can down stairs. I took my xanax before getting out of bed. I checked it on and off from about 7 30-10 am. Around 9:30 it was down to 100 normal range.. and then in the 90's. This seems to be my pattern.. resting so for the most part my resting heart rate is normal for most of the day. At night it's 80 and 90s and I never feel it race when I sleep. So, I assume this how my body must be wired.. and also perhaps my hormones are playing a role here. For the most part, I have always had a heart rate in the 90's.. so really when I think about it it;s not that much higher. Only if I have a real bad panic attack then my legs are shaking..i feel strange and my heart rate can go as high as 130... but has never gone higher than that. It also comes down on it's own. I guess I need to learn to relax! lol

[jkfrench]

You are fine.  The first thing you need to do is stop checking your pulse.  I used to do that and belive me just the anticipation of checking for people like us will raise it slightly.  Everything you describe sounds anxiety related.  Put a rubber band around your pulse and every time you go to check it...snap it!  Get out of that habit and you will feel so much better.  I run a daycare and have 8 kids here today.  Just getting up and helping them clean will raise your pulse up 10 or 20 beats.  These are normal everyday variations in our body and you have been checked out completely so there is nothing to worry about!  Wisconsin has been wearing an event monitor for a few weeks now.  He is living proof that hearts are up and down all day.  They don't stay steady.  I actually heard that wasn't a good sign if your heart just beat at a steady 75 all day.  I remember watching mine when I was hooked up before my stress test.  Turning around, coughing, swinging my legs etc...changed my heart rate.  
Don't worry!!  ps...my heart has been up to 220 during a PAT attack and I'm still told it isn't life threatening!
Frenchie

[Wisconsin2007]

I can relate to checking more than you should.  Before I had this event monitor on I wasn't checking very much at all - just had some newish symptoms I wanted checked.  Then, when I had constant feedback on my pulse thanks to the event monitor, I was trigger-happy on the record button.  WHAT WAS THAT? -  I feel kinda funny - Better record it.  

Not that I'm a proponent of heavy internet research (because that can be as detrimental as any real symptoms), but if you read up a little on sympathetic and parasympathetic nervous systems, you'll see that what you're experiencing is normal and nothing to worry about.

[blondemiss]

Thanks Wisonsin and Jk.

JK, You make some very good point. And yes the most important thing is for me to stop checking.. that can raise it.lol

Wisconsin, I did the same thing when I wore my event monitor. Any slight pain or fast beat I hit record. I wore mine for 6 weeks.. and I bet the people at life alert were gald when I was done..lol.

Oh..I just wish I could relax. I think the lexapro is going to help with this.