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High Resting Heart Rate

I am 22, female, and have been experiencing a very high heart rate (100-130s) that constantly fluctuates (never staying the same for more than 2 seconds - I have a HR monitor watch that I use from my running days). I suddenly got horrible chest pain in July, so I went to the hospital and that's when I found out my heart rate was high. It never was before, it usual is around 60-65. I was in the hospital for 5 days where they ran tests: EKGs, x-rays, CT, and an echo; everything came back normal so I was discharged. I saw a cardiologist a week after being discharged and was put on a 24 hour holter monitor which showed no irregularities, an average HR of 88 and the highest 170. After that one test and seeing the cardiologist only that one time he diagnosed me with 'inappropriate sinus tachycardyia' and wanted to prescribe me a beta blocker, however, I have a low BP and don't want to lower it more and add another problem.

Six months later and things still haven't improved; the chest pain is worse. I saw another cardiologist a few weeks ago and got a tilt table test and another 24-hour monitor. The tilt table didn't show orthostatic hypotension, but it showed drastic changes in my heart rate. The holter monitor showed my average HR was 100, lowest was 74, and the highest was 179. I was truly resting, only going up one flight of stairs to my room or walking around the house to cook, etc. My HR is obviously getting higher and the pain worse.

I do have Wegener's Granulomatosis and am on several meds to treat that, but none of the meds should be causing the high heart rate, nor do they interact to possibly cause this. I also have hypothyroidism, but my levels are good, and that wouldn't explain my high HR either.

The new cardiologist wants to schedule me for another test to rule out everything, but thinks inappropriate sinus tachycardia (IST) could be a diagnosis. I am just hesitant to take a med to lower my HR without a definitive diagnosis. Should I start the med and hope that helps? Or just not take it since if it is IST, it isn't life threatening. Any suggestions are appreciated. Thanks. :)

Rebekah
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Avatar universal
Thanks for the response, Michelle. I've discussed this with my endocrinologist and he doesn't seem to think that it could be from possible hyperthyroid symptoms, but I'll be sure to bring it up again at my next appointment; and discuss it with my pcp, too. When I was in the hospital in July when this first started, the doctors there had me stop synthroid. They said that could cause a high heart rate, but after being off that for over a month it my HR didn't change; my TSH increased and I was put back on it the end of August.

I used to run half-marathons, but when I was diagnosed with Wegener's in January 2012 that stopped as I have lung involvement. Now I can barely walk 1/4 mile now without getting worn out, and like you say, the high heart rate isn't helping. Going up one flight of stair it gets in the 170s, but I do try to get out and at least walk a little bit each day.

Thanks again, I hope you're doing well and have a wonderful year! :)
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1807132 tn?1318743597
Unfortunately you are in a bit of a dilemma as IST is a bit hard to treat.  I would say try the meds to see if they help.  If they cause more problems then good then you can stop or change the meds.  I would also discuss this with your endocrinologist as fast heart rates is a symptom of Hyperthyroidism.  And from what I understand you can be within limits and still have some symptoms.  It is possible considering it is a symptom of hyperthyroidism maybe they have a suggestion for the high heart rate as well.  It is worth a shot as you do want to try and bring it down if you can.  Do you do any cardio?  I know with it being high it might be hard for you but the more conditioned your heart the slow it will actually beat on a normal basis.  That said, with it going as high as it does on small exertion I would consult with your cardiologist before engaging in any cardio routine.  Best of luck getting a handle on this as you enter the new year.
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