Tachycardia with chest pain

[Marilynn04]

I have been experiencing a fast, pounding heart rate for over a month now. It gets worse when I stand up. I get light headed, very short of breath, dizzy, weak, and feel as if I'm going to faint. I went to my dr a couple of weeks ago, I had a normal bp and a normal EKG, other than the tachycardia. But my resting heart rate was 117 and when I stood up, it was 180. I have been keeping track here and there and my heart rate on any given day is still in that range. My dr performed a multitude of labs including thyroid, CBC, electrolytes, vitamin, and minerals, blood sugar, and more all normal. She also gave me an anxiety medication, which didn't help because I'm not anxious. I don't smoke and my bp was also normal. But now, I'm getting a sharp pain right below my left breast intermittently. I've also had a horrible headache in my temples this whole time, along with neck pain. Should I be concerned?

[spade22]

I'm sorry you are going through this but am glad to hear this is finally being addressed appropriately and is no longer a case of "you must have stood up too quickly"!!!!!!  The arrhythmia specialist (an EP) will be able to diagnose your condition and provide treatment options.

Like Michelle, I agree that if your symptoms become worse you need to call your cardiologist right away or head to the ER.  I'm also a little baffled that you wont be seeing the EP for another month.  I would definitely call and let them know how you are feeling and request a much earlier appointment.

[MichelleP_3811]

You definitely have some sort of SVT.  It could be a number of different types.  The arrhythmia doctor may be able to give you a better idea of which kind.   The fact that it is not stopping is concerning.  Has your doctor prescribed Beta Blockers initially to help lower your rate?  There is a trick that sometimes works to get it to stop.  Hold your breath while bearing down like going to the bathroom.  It is called vasovagal manuever.  Keep trying it to see if it will work.  The fact that your pain isn't constant is a good thing but if you at all feel like your life is in danger do not hesitate to call an ambulance and go to the ER.   In general most fast beats are not an immediate danger to your life but you appear to be in tachycardia for over a week without any sort of intervention.   The heart is very reslient but please let the cardiologist know how poorly you feel tomorrow and do go to the ER if things get too much to bear.  Considering you passed out I might even suggest having someone else drive you to your visit.  Take it slow and please try to avoid standing as much as possible until you can get your rate down.  I might also ask if you could get in to see the arrhythmia doctor sooner than a month.  Hang in there and maybe get pushy.  A beat over 200 isn't anything to mess around with.  I had a beat at that rate of 230 for around 8 hours once and it darn near wore me out for a good week.  The good news is your heart can recover from this once the tachycardia is resolved but it is important to get this resolved as soon as possible.  So don't be meek with your doctors about how this is making you feel.  This is your life after all we are talking about.  Please be safe and keep us posted on how you are.

[Marilynn04]

Again, thanks for your concern and input, I don't really have anyone to talk to about this. My cardiologist just called with my holter results. U guess there were multiple periods where my heart rate went above 200 and it was rarely lower than 140, so she referred me to an arrythmia specialist who I'll see next month. I also follow up with my cardiologist and get an echo tomorrow, so we will see ehat happens. I haven't been feeling too good lately. My heart just keeps beating faster and faster when I stand and I've been getting sporadic chest pain that lasts anywhere from a couple of seconds to an hour. I'm assuming that's normal though. :(

[tom_h]

I'm assuming that she also gave you an ECG when you saw her.  If you were in SVT at the time, I'm sure she would have told you.  How are you now?  Please keep us informed of your status.

[Marilynn04]

Thank you for all your input, I really appreciate it. I went back to my dr today. She ran more tests and I actually fainted in her office. She immediately sent me to a cardiologist who had the nerve to tell me Ive just been standing up too fast, "young women do it all the time", (I'm only 25)).  I wanted to slap her. She put a holter on me and is going to do an echo next week anyway, seeing how my resting heart rate was 170. Guess I'm getting somewhere. Thanks again!

[spade22]

Well definitely ask for a referral - you need answers!

In the meantime, you might try keeping a journal to document  the episodes  and severity with any factors which might be making them worse.  Eg they might  be much worse after eating or after drinking caffeine.

[Marilynn04]

Yes it drops significantly. When I saw my dr, she had me stand up and she immediately took my pulse and bp. My pulse was 180 and my bp dropped so low and so fast, machine actually errored because it couldn't read it. I'm so frustrated, I can't stand up without feeling like crap, much less do anything that causes any type of exertion

[spade22]

I would ask her if she thinks its appropriate, and she would be able,  to refer you to an electrophysiologist (or cardiologist).  

Do you know what happens to your blood pressure when your heart races and you feel dizzy?  Does it drop? Something like POTS "might" be what is going on in your case but again, you  need to be seen by a cardiac specialist who can run appropriate tests (not available to your PCP) and diagnose your condition.  POTS is just one condition that your symptoms seem to fit.

[Marilynn04]

Thanks for the response. I have seen my primary, but just that one time I described. My normal dr, who I loved, left the practice, do this was the first time I saw the new dr. She seemed very concerned, especially after all my labs came back normal, and she did a lot of labs. But she didn't offer up any advice or anything to help. Not sure where to go from here.

[spade22]

Just to add, some arrhythmias/palpitations have a cause (thryoid issues, electrolyte imbalances etc) but others are caused by structural or electrical issues within the heart and need to be diagnosed and treated by a specialist (electrophysiologist or cardiologist)  

[spade22]

Your symptoms are not normal and are impacting your life.  Are you being seen by a PCP? A cardiologist is the specialist you need to be seen by.  I would suggest you ask for a referral.