Undiagnosed tachycardia

[Tralfaz]

I've been experiencing periodic spells of tachycardia off and on for about 6 months now. Was hospitalized overnight once, and all bloodwork, X-Rays, echocardiogram and so forth came back fine. I've been going to see an EP for 3 months now, have worn the event monitor, and all they came up with was sinus tach. My EP hasn't come up with a specific diagnosis, but suspects either Inappropriate Sinus Tach or an Atrial Tach that they haven't caught yet. The highest my pulse has gotten during any attacks has been about 140. At rest it can get as high as 95, up to 115 or so when standing. Exercise or eating doesn't seem to trigger any attacks. I don't have attacks everyday, and since I've been taking betablockers, I rarely ever have them. Resting blood pressure is good, standing as high as 140/100. I've tried 3 different types of betablockers, all low doses, and they all make me feel ill (exhausted, headaches, nightmares and insomnia). No PACs or PVCs that I'm aware of. Oh yes, I'm a 33 year old male, and have been in good shape for the past 18 years.

Questions:
1. My EP says these problems may just go away on their own? Is this possible?
2. I'm scared to death of problems with impotence from the betablockers. Should I be concerned?
3. Do calcium channel blockers produce less side effects then betas?
4. Should I even be taking meds for these symptoms, or just deal with it?
5. Has anyone tried supplementing with magnesium or Hawthorn to control arrhythmias?
6. I've read that viral infections may cause arrhythmias. What type of doctor would I see to test for this?

[bjm]

I began suffering from tachycardia, especially at night, after a bad episode with a pesticide (organophosphate) application in my home.  A few days after the treatment, we called 911 when I awoke so disoriented and with extremely bad tachycardia. For months and months after this, I would have strange disoriented dreams and awake to discover the tachycardia which would only last a brief period of time.  I had a complete physical about 2 months prior to this and by blood pressure was 130/80.  A day or so after the 911 call I saw my doctor and my blood pressure was 190/115. It went as high as 210/115. It remained this way, despite treatment, for several months and has gradually come down but averages about 145/90 now.  (After a month or so, I did not take medication anymore as it did not seem to affect it.)

Since then (6 years now) it is not quite as bad, but I have often been told I am suffering from stress or panic disorder.  I never suffered from stress or panic disorder before the pesticide, however.  Has anyone else thought that it might have been chronic exposure to a pesticide?  From my readings, I have found this is a side effect of these pesticides and they are the most common in use.  I also can't handle caffeine anymore.

[stella1]

I'm a 53 yo female,122 lbs., non-smoker,jogs or power walks 4 1/2 miles everyday,no caffeiene, cardiac and diabetic diet(I'm not diabetic, my husband is) with recent very high bp and hr  160/106, 100hr.  My normal was 100/70 with a 70 hr.  High bp and hr is due to probable Post Traumatic Stress Syndrone from an injury last November. Cardiologist put me on Atenolol 25 mgs twice daily.  I am much better with relieved bp and hr.  I am not panicking quite as much although I still awaken from the bad dreams with elevated bp and heart rate.  I had the nightmares or bad dreams before taking the Atenolol but are worse now on the meds. I am also diagnosed with Fibromyalgia which I believe I control very well.  I, too, had the palpitations, arrythmia or whatever you call them but did not worry about them.  Discussed it with Cardiologist and  didn't go on any meds.

My questions is does anyone take antidepressants with their Atenolol?  I feel I need them for my PTSD which I soon have an appointment with shrink.  I am very uncomfortable and jumpy and just not myself.  I used to take Doxepin, up to 75mgs a day with good results (sleeping)but the effects wore off after ten years.  Any suggestions on the antidepressants?

Thanks.  I feel I am pretty much a mess right now.

[razal]

My wife is 52 and has noted in the last 6 months elevations of her pulse to between 90 and 105.  She is in excellent cardiovascular condition and not overweight.  In fact, she has been on the Atkins diet for 6 months and lost 20 lbs..  She is still on a maintence regimen of the Atkins with slightly higher carbs now.  Prior to the weight loss, she had blood pressure readings of 150/100 and went on hydrodiuranol which give her regular readings now of 140/86.  The pulse elevations begin just after she awakens in the a.m. when she also has her highest systolic readings at that time.  Additional substances that she takes regularly include celexa, 5 mg; Vivactil, 5 mg; Prem Pro, .625/5mg; omega 3-3 tabs at bedtime; Taurine, 500 mg; GABA, 500 mg; Potassium, 99 mg; GTF Chromium, 200 mcg; Co Enz. Q, Zone perfect; Niacin, 300 mg; B12, 400mcg; Folic Acid 800mcg(alternated with the B12 weekly); Occasional Vit C; and Calcium Citrate Supreme, 4-6 tabs at night.  At the health club, on the stationary bike with pulse monitors, she gets a 120 reading just as she begins her exercise.  She comes up a short flight of stairs a few minutes prior to beginning to bike.  Do any of these factors contibute to her higher then previous pulse rate?

[ClevesGang]

Hello, you asked for symptoms other people have experienced who have Tackycardia. I will give you my symptoms and experience since being diagnosed with Tackycardia about three years ago, (I am a 44 year old female.)
  I originally began feeling the occasional flutter of my heart when I was 16 years old. I talked to a couple doctors at that time and they patted my leg and said,

[dmdj]

Hi!  Thanks for your post, I appreciate you responding as well, every little bit of info helps a lot.  Yesterday I decided to start taking 81mg aspirin twice daily.  So I am not on the very low dose, or the original strength either, but hopefully still benefitting from it.  Until I fully know if what I have is a mild/benign arrhythmia or full blown heart disease (at risk for heart attack) I will take the aspirin.  I have an appointment with a new internal med doctor next week (my insurance changed this year), so I am eagerly anticipating what she might have to say.  I am at my wits wondering whether I am going to have a heart attack (I've experienced off and on mild symptoms since October 1st) or if I am so anxious that I am making myself feel like it.  It sounds like aspirin has really worked well for you and you were approximately my age when you started on it.  Thanks for sharing with me, dmdj.

[jobob52 ford]

Hi, I'm 50 y/o male, healthy. Have been taking 1 asprin(325 mg) daily for 15 years. Was taking with other meds, lanoxin, atenolol, and flecainide for arrythmias. I had a successful ablation last September and after that the Docs. perscribed 81mg asprin, without any other meds. It took about 6 weeks to finish my bottle of 325's and as soon as I started on 81mg I started getting several flutters a day. After 10 days or so I went back to 325mg and the flutters went away (except for when I have too much caffine).
I'm not sure what the asprin does other than thin the blood which make it easier for the heart to pump. It works for me.
I think the horror strories we've heard about asprin perforrating the stomach lining came from cases of people taking 8-10 asprin daily, day after day.
Hope this helps.  Bob

[dmdj]

I so, so appreciate your responses, I hope you know.  I haven't heard from anyone else and I find it impossible to get through to docs.  I am not allergic to aspirin, nor do I have stomach probs, but after searching the internet for info on taking an aspirin a day, I decided to take the 81mg instead of full strength.  I am going against docs orders here, but many, many of the sites stated taking 81mg is sufficient for patients with arrhythmias.  The 325mg is more for patients who have had a first heart attack, second, etc... or who experience angina and other symptoms.  I suspect my doc will be frustrated, but I am simply having a very rough time and don't feel comfortable with a full aspirin a day.  What do you think?  
Regarding the event monitor...I had a very difficult day yesterday.  I had 4-5 what I call 'spells' for lack of a better word, when I suddenly out of the blue my whole body goes weak, like my body will shut down (they only last 3-5 seconds).  My feeling is it is related to an irregularity in my heart, but I have to wonder if is an anxiety-type spell.  I am having such a difficult time distinguishing between the two, that is why I am contemplating insisting on an event monitor.  Otherwise I will forever be walking around with my fingers on my pulse.  Not fair to my family as I completely check out into another world.  Why do I feel so bad about bothering the cardiologist?  It is my health after all.  Thank you, thank you, thank you for your support, dmdj.

[dmdj]

Have you heard that taking an aspirin (325mg) a day can cause internal bleeding if you don't absolutely seriously need it?  I guess that's where my anxiety about taking it stems from.  And the not knowing what kind or how bad/often my arrhythmia is.  The aspirin was prescriped after I went in complaining of a flip-flop once a day after taking ToprolXL 25mg for 2 weeks.  It was sort of an afterthought for him before I left, like "oh..and take an aspirin a day too."  I suppose for you it has other benefits as well, not just for the heart.  

I hope I don't sound like a broken record with this aspirin scare I have.  I really do appreciate your replies.  They are so prompt and just someone I can bounce this off of really helps.  My feeling is there is something else going on inside my body that is causing the heart probs that has yet to be found, because I also experience various other symptoms off and on since the Oct.1st event.  But that's a whole other subject!!

Hope your ankylosing spondylitis (sp?) is in check. Hang in there and once again I send you my gratitude for taking the time to listen and respond, dmdj.

[dmdj]

Hankstar,
Thank you for taking the time to read my post since no one else I know has this problem!  I will have to look up what paroxysmal atrial fibrillation is.  Is it serious or dangerous?  So you feel taking an aspirin a day will not hurt me?  That was my biggest concern, so to hear that is a huge relief!  And what happens when you stop taking the aspirin a day, can there be risks once you go off it??  I've spoken with a couple of family members who also believe it is not a big deal.  Should I insist on an event monitor so I know exactly what kind of beats I am feeling?  Sorry for all the questions, but I'd appreciate your feedback again.
Thanks!

[dmdj]

Hi everyone,
I have been reading your posts 3 or so months now, thank you for sharing your info.  I have finally decided to join because I need advice desperately, don't know what to do, and can't think straight.  I am a female, late thirties who experienced a weird sensation of near passing out, like the body was shutting down back in October (very frightening).  Since then, I have had all kinds of weird symptoms including palps, so...I have had several EKG's, an echo, brain scans, chest x-ray, blood work and worn a 24-hr holter.  Everything was negative, except the holter recorded sinus tachycardia at rest or with little effort.  Was put on ToprolXL 25mg (it's been 2 weeks).  It has slowed my heart rate down (I'm very relieved!) and pretty much rid my heart of what I considered skipped beats, but now I feel flip-flops once a day, or every other day, with exercise more often, like an old car that's chugging and trying to catch up.  When I called cardiologist, he had me come in for an EKG.  Of course, it was all fine, I knew it would be because the flip-flop is not going to happen right then and there.  So he said to stay on the medication and in addition to that, which is why I am freaking out here, told me to start taking an aspirin a day (325mg?) because with arrhythmias you can develop a clot.  This is where I need your guys' help:  First of all, I don't have a name for my flip-flops, like are they PVC's, PAC's, skips, I have no idea, and it's not like I get them all day long either.  I asked him for an event monitor and he said "not needed", I already know what the treatment is and I know what the evaluation is, so not needed.  Can he prescribe a 37 year old female aspirin just like that?  I am so freaking out about taking this.  In the meantime I live with the fear and anxiety of developing a clot and dying.  Are any of you taking an aspirin a day for a slight arrhythmia?  Should I be soooo worried????  Please, please any advice would be greatly appreciated until I can seek a second opinion.

P.S.  I tried posting a question to the doc's here, but impossible to get through.  So...Doctor...if you are reading this, please help too.  I would be so grateful!!!!!!!!
THANK YOU

[Mel22]

Hi,

I didn't meant to suggest that there are not people who have significant problems associated with PACs/PVCs. I was referring to what seems to be a "normal" condition for up to 80% of the population--occasional premature beats. For those people, anxiety seems to be a major contributor to how much they suffer. I would not consider "normal" what you describe. And though the docs may insist that what you describe is not dangerous, I would have a hard time being complacent under those conditions. I know how freaked I was when I would have a period of 10 or 20 a day--or those occasions when I would get a real "chest thumper". I can't imagine living day to day with that kind of discomfort. I don't know that I would stop seeking answers. I hope you find yours.

Good luck,

Mel

[Mel22]

One more thing: About driving kids in cars and getting an attack. Ok, count these times as some of the most frightening of my life. Driving my two in their car-seats and then getting a chest thumper or several in a row. I remember being at a stop light, frozen, except for my fingers tapping against the steering wheel, trying desperately to calm the panic attack that was beginning. Other times were late at night when my husband was away on business. What would happen to my kids? I had some very dark and scary hours. During my worst periods I would suffer from panic attacks that were worse than the PVC's. I felt like I was either going to pass out from the PVCs OR from the panic attack. Either way I was always so worried about my kids. Since then I learned a lot about panic and that's helped. But anyway, just wanted to let you guys know I *completely* understand that one.

[Sherbert1972]

hello
I recently got put on inderal to help with what the doctor thought was a SVT.  I have had heart tracings done twice but nothing has showed up, I have never been asked to wear a halter for 24 hours.  If you had an SVT would it not show up on the hear tracing. I have been getting fluttering in my neck for a while now, really bad tightness in my chest since December which my specialist put down to viral in my muscles and chest wall.  On wednesday I had palpitations which came on after Ibent to pick something up and  my heart just started racing, I felt realy weak and had to lie down.  Normally I can get it to stop but on this occasion it lasted an hour and guess what stopped just before the doctor was due to see me. I don't tolerate meds well and they are making me really sleepy and chest feels tighter than normal.  Has anyone got an SVT who can descibe the symptoms they have and the frequency.  I'm kind of wondreing if I'm not just competely stressed out after having being sick for over 6 mnths and trying to hold down a job and a "regular life" at the same time..Nightimne seems to be the worst and first thing in the morning.  I'd appreciate any help as I think my anxiety over this isn't helping!!

[LynnSB]

>>My cardiologist told me that approx. 80% of the population experiences PVCs or PACs at least every now and then.<<

I could never " every now and then".. it is when they come every hour or every other other day after day, week after week, year after (*&^%  year.. when they come in flips and skips and runs and sometimes make me feel, momentarily, as if I will surely die because I am so weak  .. but only for a few seconds... it is all that that is so hard to blow off, ignore. The self talk , the ignoring it sounds good but when I truly feel as if the breath has been knocked out of you and/or that my heart is totally out of control beating irregularly--even if it is only for seconds but those seconds come so often -- and I'm driving and my child is in the car or I'm calm and feeling well and out of the blue , there it is again, the palpitations for no discernable reason, again and again and again..it is hard.

[Tralfaz]

Thanks for all the replies. Much appreciated.

For the Doc:
1. What are the "typical" side effects one can expect from calcium channel blockers? Are they as effective at lowering heart rate and blood pressure as beta blockers?
2. What type of side effects are you talking about with magnesium?
3. "Hawthorn is also used by some for arrhythmias, but it is associated with "activation", which might actually be worse for you."   Could you elaborate on this? I'm unsure of what you mean by "activation".
4. Should I be asking my EP about Autonomic Dysfunction?
5. Should I even be considering ablation at this point, or stick with medications?
6. Are there any risks with taking betablockers for many years (I'm only 33, and don't look forward to taking them for the rest of my life).

Since finding this forum and realizing that so many others are going through the same thing I am, and much worse for many of you, I already feel 100% better about my "condition".  Thanks again for all the advice and support. My prayers go out to the rest of you.

[Mel22]

Just a comment about "normal heart rhythm". I wondered that also. My cardiologist told me that approx. 80% of the population experiences PVCs or PACs at least every now and then. He said that the major difference is that some people are more sensitive to them. He went on to say that if anxiety figures *anywhere* in the equation (hello?) then these would be the people who "suffer" from the phenomenon.

It took me years and lots of tests but now that I finally accept this, it's made all the difference. Oh, that and a little magnesium. ;-)

[heartdancer]

As I have mentioned my 20 year old daughter has episodes of sinus tach. It doesn't seem to bother her in the least. The cardiologist did not see anything on her holter results that he was concerned about. Our primary care doctor said he can put her on a low dose beta blocker if she wants....her choice. But of course as her mother I worry that the tachycardia will damage her heart. I would like to think that this would all just go away and stop happening to her....it scares me way more that it does her...she doesn't even seem fazed by it...she just goes on about her business whether it is happening or not. I have had episodes of tachycardia myself because of anxiety and panic disorder and I know how frightening they are. I have PVC's too...but I have learned to pretty much ignore them since the dr. says my heart is fine. You know with so many of us suffering from racing hearts and flip-flopping hearts I wonder how many people in the world actually have normal sinus rhythms? Take care all...

heartdancer

[starion]

Hi!  I have tachycardia & just finished a 24-hour holter monitor test.  I will see the cardiologist next week to get results.  I have severe lung disease (asthma & emphysema).  What are respiratory effects of the various meds available to treat tachycardia?  (At the moment, I don't know WHY I have it; suspect some orthostatic intolerance, poor lung function & lung meds cause some/most of it; will see what cardiologist says.)  In any case, we're doing all we can to optimize the lung function & there aren't many current options for my lung meds.

Any thoughts on cardiac meds?  My son has mild intermittent asthma & is on very low dose Toprol XL 25mg/day.  It hasn't affected his lung function & is SUPPOSED to be a cardio selective beta blocker.
Thanks!
Aloha,
Starion

[tlcjuliet]

I have noticed if I have the flu or a cold etc, that palpatations seem to get worse.  When I am over it, they seem to gradually dissappear.  
Like Hank says, don't dwell on the fact of ED, I take 240mg of sotocor twice a day, and even tho being female, it does cause a lot of lethagy etc.  But you have got to make your own fun :)

Hope you are feeling better Hank  *hugs*

[pandora9048]

LoL @ CCF MD RCJ and the being attracted to beta blockers part of the post.

[bama jane]

I have had episodes of sinus tach for about 4 years, and had additional atrial arrhythmias develop.  No one knows why it came on. Written diagnosis is multiple atrial tachycardias reason unknown  Could have been associated with a virus like cold I had. Hospitalized numerous times in past. Had ep study couldn't figure out why, just sinus tach to 150. Have seen some very good ep doctors.  Had Dr. Natale look at my records from Cleveland Clinic. I am on low dose beta blocker and while it doesn't completely keep them from happeneing (have it about once a month now) it has made the rate slower and they don't last as long. It has kept me out of the er and from being hospitalized for 2 years.   Have been on most of the heart meds and the side effects of most were not tolerable for me. Everyone reacts differently to these drugs. Some made condition much worse. I am  on atenenol which does seem to have given me bad dreams. If it helps to know this I have had this a long time and am still here. It is never easy to deal with and it is scary but it becomes a little easier when you realize that it hasn't killed you. The best thing for me was finding a good cardiologist that understands how scary this can be at times and is very knowledgeable about your condition and your options. Hope this helps you.  Sometimes it has helped me to know that there are people that have lived with this a long time successsfully.  I still exercise an hour a day on treadmill, and have learned to sit down and relax and not panic, the last was and is the hardest to do, but I realized I was making it last longer.  Good luck I hope your problem goes away on it's own, I have been told that sometimes that can happen.  I always hope for that.

[CCF-M.D.-RCJ]

Tralfaz,

Thanks for the post.

Q1:"My EP says these problems may just go away on their own? Is this possible?"

Possible-yes, probable-no.

Q2:"I'm scared to death of problems with impotence from the betablockers. Should I be concerned?"

You've never really been attracted to beta-blockers?  There is some truth that beta-blockers can cause some men to have erectile dysfunction (ED).  Most of the men who develop ED while on the beta-blockers have some other risk factor for ED: increasing age, hypertension, diabetes, etc.  So if you have a tendency towards ED, beta-blockers may increase the chance of developing ED.  However, if you develop ED while on the beta-blocker, stopping the beta-blocker should revert you back to your previously potent self -- the effect does not "build-up", so to speak.

Q3:"Do calcium channel blockers produce less side effects then betas?"

No, just different.

Q4:"Should I even be taking meds for these symptoms, or just deal with it?"

This is a judgement call, and depends on 2 issues: (1) are the side effects from the meds worse than the symptoms from the spells, and (2) is there any damage being done to your heart by the spells.  If a person develops long-lasting periods of tachycardia (I'm talking days on end), then that person's heart muscle can weaken, which is obviously undesirable.

Q5:"Has anyone tried supplementing with magnesium or Hawthorn to control arrhythmias?"

Some people claim that magnesium helps them, but it certainly cannot be expected to be a panacea, not devoid of side effects.

Hawthorn is also used by some for arrhythmias, but it is associated with "activation", which might actually be worse for you.

Q6:"I've read that viral infections may cause arrhythmias. What type of doctor would I see to test for this?"

I'm not aware of any viral infection that leads to rhythm disturbance outside the setting of viral cardiomyopathy.  The echo should have excluded this possibility.

Hope that helps.