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resting heart rate of 200bpm
I have seen a cardiologist for having a rapid heart rate during rest so he referred me for a event monitor then after that to see an electrophysiologist, After that visit he ordered a holter monitor witch showed extra beats the fast heart rate but normal rhythm, this causes palpitation and episodes of fainting and near fainting, he referred my back to my original cardiologist since he can't help me since there isn't a rhythm problem, so I am really confused always fatigued during any type of physical exercise and always feel like i am going to pass out.
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1807132 tn?1318747197
A resting heart rate of 200 isn't normal just that the beat itself looks normal to some degree.  Though at 200 I am not sure how normal it would look.  I have to say my svt which was avnrt looked kind of normal to me so not sure that they always look specifically one way or another but the EP apparently thinks you have some sort of sinus tachycardia and not an accessory pathway svt.  This is generally treated with meds to slow the heart rate.  Have you had your thyroid checked?  There are some issues outside the heart that can cause tachycardia.  You could also have what is called inappropriate sinus tachycardia but unfortunately the only way to fully treat that if meds fail is to ablate the sinus node and put in a pacemaker.  I would say go back to your cardiologist but maybe even seek out a second opinion from a different EP.  Do you know if your major symptoms were caught on the monitor?  If you did feel the worst of it then your main issue may not have been caught which would make you seem normal.  When the fast beat occurs do you feel like it starts and stops on a single beat or does it seem to start an slow gradually?  I would say until you get this figured out make sure you eat well, maybe put a bit of extra salt in your diet to counter the low bp you may experience with your high heart rate and drink lots and lots of water.  This will help your heart function better then if you haven't go and get your thyroid checked to make sure that isn't what is causing your tachycardia.  Unfortunately sometimes it can take a little while to get this all straightened out but just keep at it and eventually you will find a solution that works for you.  Hang in there.
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1423357 tn?1414258965
200bpm is what a person experiences under heavy physical stress.  Yet, some cardiac condotions such as supra ventricular tachycardia will cause rate of 180-250 and even higher.  These can often occur at rest and can be precipitated by a body movement such as bending over, rolling over in bed, etc.  I had many of these situations occur over the years I had SVT.  What I need to ask you is how do these occasions of rapid pulse start.  Do you suddenly feel "Ooo!, what is that?", or do you feel you pulse begin to increase for normal rates.  Also can you tell us how it terminate?  Does it vanish suddenly, or does your pulse slow return to normal?  I seriously doubt that you've had pulse rates at 200+ for days on end, so there has to be a beginning and end to it that you haven't related yet.  Can you tell us more?
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I have had all blood work done along with them checking my thyroid and it's all normal, have really high blood pressure that they were finally able to control with labetalol, but the heart rate comes and goes 200 was the highest it has ever been the episodes last anywhere from a few minutes to a few hours. When it occurs it is suddenly I will start to feel my heart pounding  and pulse is up there, it never feels gradual, but the minute it starts I'm dizzy, light headed, chest pressure, and it feel like I can't enough oxygen sometimes, I do have asthma but this feels completely different than that.
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@Michelle It would be hard for me to get a second opinion, I do not have insurance and am on a program through the hospital that is taking care of the bill and if I would seek out another EP it would be a colleague of the one I am currently seeing so I am not sure how much of a difference it would make, and because off my high bp they have me ona real low sodium diet.
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1807132 tn?1318747197
If you have high BP then no you should not add sodium to your diet.  I have low bp so adding sodium helps me.  When you are in tachycardia though your bp is likely very low because of poor cardiac output which is why you feel you may pass out but if you are normally high then it is not wise to add the salt.  Like Tom I also had svt, one called avnrt that happened because of an extra muscle fiber leading into my avnode.  It is the most common of the svts and as Tom stated it starts and stops suddenly on one beat.  I can only assume you did not have an actual svt episode while you were on the monitor or he would not have labelled it normal.  Do you recall if you felt the full issue or not while on the monitor?  If you did my concern is that the procedure is expensive and maybe they are putting it off since you don't have insurance.  Hopefully Obamacare will work in your favor because it does sound like you have classic accessory pathway svt.  I had mine all my life with episodes as long as I can remember but it wasn't until my late 30s that they started to disrupt my life.  If your heart is healthy you should be able to tolerate it well until you are able to get it officially diagnosed and fixed with an ablation.  Until then I would say make sure you sit down when you are having an episode.  Try to learn vagal maneuvers like bearing down while holding your breath or try drinking a very cold glass of water to get the episode to stop.  So long as you manage your episodes wisely you should be able to protect the health of your heart.   You may also want to start doing cardio to build up your heart strength.  Before I started cardio I would have to lay down when I had an episode but once I started doing cardio everyday I found I could almost function even with having a heart rate around 230.  Obviously you should stop if an episode comes on while you are exercising, I had to stop a few times but just be mindful of getting the episodes to stop.  If you find it going on for hours then head to the er to get them to help you get it to stop but try the tricks I mentioned to see if you can avoid that.  But that said, if you go to a cardiologist they may suggest trying meds.  I will say my cardiologist didn't think they did much.  They may help slow it down when it was going but they really didn't do much to keep them from happening so if you are not on bp meds already for your high bp and you are offered some use your gut whether or not you want to take them.  Doctors are mixed on their usefulness in regards to heart rhythm issues.  But in general svts can be hard to catch.  if you know you will have an episode within 30 days then ask for an event monitor so you can catch it and get it properly diagnosed because it can be kind of frustrating getting it documented but you do need it documented before any intervention will happen.  So just keep pursuing that and try not to fret too much.  SVT is more annoying than anything else and like I said, if you do your best to protect the health of your heart by being mindful of the episodes you will likely need not worry about the effects on your heart.  Anyways, we are here if you ever need to talk.
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Well I thank you very much for the input, I go back to my cardiologist on the 12th to see what he has to say. I used to to cardio exercise regulary but have not been able to the lastmonth and a half as when ever I do anything strenuous I get tired and dizzy really fast and need to sit down, I have been dealing with high blood pressure for 13 years was on 6 meds at one time all of witch did nothing, now since they added the labatelol I am on only 3 and it seems to be controlling it at around 140/85 which is down from 220/120 so I am happy with those results. I will let you know what the Dr. says, thanks again.  I just needed to talk  to someone because I was feeling like my Dr was just not beleiveing what I was experienceing
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1807132 tn?1318747197
I know doctors do have a habit of disregarding us unless they see the issue themselves.  Just be persistent that you have a problem and keep going back until you get it captured.  The more you visit a doctor the more serious they will take the issue but they do need proof so to speak before they will treat and unfortunately these heart rhythm issues can be a bit hard to catch.  I wonder if all the meds are depressing your cardiovascular system making it a bit more tough to exercise.  I would say as opposed to going all out just try and do a bit of fast walking or jogging.  Nothing too strenuous but just a little bit may help. Also if you don't make sure you drink lots of water while doing it as well.  It should help your heart function a bit better.  Well best of luck at the doctors.  Please do let us know how it went.
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612551 tn?1450025775
You have a HR that goes as high as 200 at rest, what is it usually?

Your BP medicine, I do not know the brand name, should also lower you HR, and it can cause fatigue as a side effect.
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1423357 tn?1414258965
From your description, you would seem to have some variety of SVT.  Remember that most patients will show a completely normal EKG when SVT is not occuring.  Also, Many hearts will appear structurally normal as well.  Until you can receive care for it, learn to control it as Michelle suggests.  Vagal maneuvers like Valsalva are very effective in terminating an episode.  One formum member reported headstands were effective in stopping hers.
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my heart rate is usually around 100-120, I have been on meds for years now, currently on HCTZ, Losartan, Lebetalol and have had no fatigue issues with it, they had upped the lebetalol in hopes to help the heart rate issue but it has not, they had wanted to take me off of the lebetalol and put me back on metorporol to help with the heart rate, but I had informed them I was on the medication before and it does nothing for my blood pressure, so if I go back to that med my bp goes back up to 220ish
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612551 tn?1450025775
I still assume, have not tried to look up, one or more of your meds is a Beta Blocker.  

I took Metoprolol, and the patent Toprol SR, for many years to lower my HR, my BP was fine.  This lowered my BP too much, but my body adjusted and my BP is low normal now and my HR was held in the 80s at reast.  I requested a change to Atenolol and it is much more effective.  I now see resting HR in the 70s land sleep time HR in the 50s... When I wake up in the early morning hours I always check my pulse and find it in the mid-50s many times.  Is-Something-wrong did a great write up on several beta blockers - I'll look to see if I can find it, perhaps you've already seen it.
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612551 tn?1450025775
Here is the link to the tread with the great information on various beta blockers.

http://www.medhelp.org/posts/Heart-Rhythm/Beta-blockers-for-heart-rhythm/show/1949498
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Had my cardiologist apt today, had went over what symptoms I have been experiencing, always feel worn down after just walking, bouts when my HR jumps up really fast, dizziness, fainting. He told me after talking with my EP who had looked into the holter and event results didn't see anything that required treatment and that there is definetly something wrong with you but we can't find it. If you have any other concerns go see your PCP........
I said is there anything I could do or change medications cause I can't live with these symptoms let alone work. all he said was I am sorry the tests have cam back normal.
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1807132 tn?1318747197
I am sorry to hear you haven't gotten any answers.  You say you have bouts of really fast heart rates.  How fast, is it at 120 or 200?  Did you catch one of these episodes while you were on the monitor?  If you are having rates around 200 and you didn't catch one while you were wearing the monitor you will come back as normal.  Many people have gone through that. It can take many visits to the doctor to finally get properly diagnosed.  The hallmark of a classic accessory pathway svt that causes the heart to race over 200bpm is that the episodes start and stop on a single beat.  If this doesn't occur with you then it is possible you have an issue outside the heart that is causing your heart to beat a bit faster than it should.  This could be something as simple as electrolyte imbalances or hyperthyroidism. It is also possible you had caught a virus and your heart was a bit affected and it will get better with time.  I would say do as your cardiologist suggested and go see your primary care doctor.  Keep pursuing a cause so that you can eventually find a way to a solution.  Until then try and keep your stress down and drink lots of water.  Persistence will pay off in the end so just keep pushing.  You have a right.  Stay strong.
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Yeah it starts and stops with one beat, it has been 200 a few times most of the times its between 160-180 and it just happens there is nothing specific that triggers it, it seems it just happens when it wants too.
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1423357 tn?1414258965
This classic symptoms of SVT; the sudden start and stop.  Holters aren't worn long enough usually to capture an event.  A 30 day monitor does a great job in accomplishing that.  I was getting them 3-5 times per month, and of course I got a couple of good recordings of the event starting, and then terminating.  The recorder auto triggers and jumps back 30 seconds to capture an event, then records for a specified amount of time before stopping.  My event longer the the recording, so when I was finally able to terminate it by Valsalva, I pressed the button to trigger a manual recording.  That caught the termination.  Once my cardiologist could see that it was classic SVT, I was referred to a couple of electrophysiologist, and I selected on for the study and ablation.

It's importenat to remember that very often, a person with SVT will have a perfectly healthy heart with normal electrical waveform.  As a young adult and former competitive athelete, I was once in superb physical shape. Yet I was plagued with SVT out of the blue.


A word of advice.  At this point, your physician should have enough information to begin to zero in on you actual situation be in SVT or perhaps something else.  DO NOT, let anyone talk you into it being anxiety in nature.  SVT is fairly common, yet I can't tell you how many doctors were perplexed with my situation when I told them of my symptoms, yet when they examined me, my heart appeared perfect.  One doctor, a young cardiologist interogated me on cocaine use.  It was like he had never seen a person with SVT before.  So be careful and get to the bottom of this.  If it's SVT, the condition is fairly benigh but is troublesome,  As you age, SVT can become a more serious condition on an aging heart, and is the prime reason I got mine doe at 59.  After a lifetime of it, it had become a way of life for me.  My cardiologist was quite alarmed when he saw my heart rate at 240 during the recorded event, and encouraged me to get it fixed.  It's really been a blessing.
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1807132 tn?1318747197
If it starts and stops in one beat then that is classic accessory pathway svt.  An extra muscle fiber that is causing a secondary pathway that causes the heart beat to get caught in a loop.  Mine was into my avnode (avnrt) and caused my heart to race at 230bpm.  The fact you are on meds may be why it is a bit slower.  The best way to capture it is with an event monitor that you wear for a month to record the episode.   My first attempt at diagnoses I wore a holter for one day.  I had an episode the day before but not the day I had the monitor so I was deemed fine.  I still had the condition but didn't get it caught for another 4 years.  If you know you will have an episode within at least a months time I would say go back and ask for an event monitor.  If not you may need to wait until you are more active to get it corrected.  I will say after an episode my heart would be faster than normal resting in the low hundreds and going into the 130s or more on small exertion.  The heart gets a workout after one of the episodes.   I would when you notice an episode come on try vagal maneuvers like holding your breath and bearing down as if to strain to go to the bathroom or drink a very cold glass of water and see if you can break the fast beat as opposed to waiting for it to stop on its own.  If you can manage it well the episodes should not have any undue adverse affects on your heart.  Then just keep going back to the doctor to get this properly documented.  doctors can only go by what they see in front of them and if you did not have any svt episode while on the monitor they chalk it up to stress.  The second doctor I went to about the issue didn't do that, they took my word and had me do the event monitor but most experiences I have had with doctors I had to go back a number of times to get them to figure out what was really wrong.  Well hang in there.  I am sure eventually you will get resolution to all this.  Until then just try and do your best to stop the fast beat episodes and that should help your heart on the other days you don't have episodes.  Take care.  
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I thank you all for the advice.  I feel terrible that I cant do anything without feeling like I am just going to drop to the floor I have to rest after I do anything. Three months ago I was feeling fine, exercising losing weight and this hit me out of no where. they did an event monitor for 20 days that only caught rapid heart rate and extra beats but he said he didn't feel concerned about that. It was really discerning when the doctor told me yesterday theres nothing I can do for you go see your pcp and she'll send you back if she feels she needs to. Not having insurance makes this so hard. I am on a program with the hospital where the cardiologist and ep work but they are not helping.
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1807132 tn?1318747197
Well try to not get too discouraged.  Taking care of our medical needs can be a bit of a process in and of itself but we do need to be our own best advocates.  You know something is not normal, something changed for you at one point that is not normal.  Keep repeating this to your doctors until you find a solution.  Do you know for certain that they caught an episode of a fast beat that started within a beat or just a faster than normal beat?  I have had sinus tachycardia from a night of drinking and being dehydrated that feels pretty similar to what my svt felt like but that kind of tachycardia doesn't stop and start on a beat and is a bit slower than my svt was.    
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Talked to my Dr again passed out again same symptoms, told me its not cardiac related, go see your PCP it must be a nuerological issue.
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1807132 tn?1318747197
I know you have bp issues bur are you keeping track of it?  I wonder if your meds could maybe be making it too low now?   Passing out can be a sign of low bp which can elevate the heart rate.  In any event, I would make sure you have had your thyroid checked and then go see a neuro doctor as well maybe seek a second opinion from another Cardiologist making sure you tell them your fast episodes start and stop in one beat if they do indeed do that.  I know you have insurance issues but you have to keep trying.  I am still not clear whether or not you feel that your biggest problem happened while you were on the monitor or not but again, I can't stress enough a doctor will state there is nothing wrong if they do not get your main issue captured on a monitor.  If you have not had your 200bpm rate captured then keep trying until you do.  Even go to the ER if you can get there in time before it stops or better still call an ambulance.  They will do a reading right away.   I know it can be a bit stressful to feel like you are not getting help but it is a process getting yourself diagnosed for pretty much any medical condition so just keep trying to find help where ever you can until you do.  Best of luck and hang in there.  Something will come about eventually.
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Afib is the leading cause of rapid heart beats.  mine were at 202.  I now take medication and it is under control
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Dear all,

One day i drunk a lot of alcohol and was smoking a lot of weed, I went to bed at 2am got up in the middle of the night to go down stairs to get some water as I came up the stairs my heart was going mad, so I called the amberlance and a Medici came and said my resting heart was going at 200 beats a minute. I was so scared even they put the lights on. I would never do that again. Could of died
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