Advice please re: Inapproprite Sinus Tachycardia

[springflowers]

Hi everyone. I hope that someone can give me some advice please.

I was diagnosed with Inapproriate Sinus Tachycardia in August 2009 (through a 24 hour ecg monitor thing - is that a halter test?) following a severe virus illness during May 2009. My heart rate suddenly went high (about 140-150, and settled to about 110 after about 30 mins) in June 2009 just when I was nearly over the virus illness. My pulse was initially about 100 when lying down but would jump to about 130 as soon as I stood up. It gradually reduced over the next few months so that lying down it about 90 and would jump to about 120 as soon as I stood up. (From June onwards I was aware of every heart beat) I was desperately thirsty all the time too, I had weird sensations in my chest and my back muscles felt trembly. I'm not actually 100% convinced the diagnosis is correct and that POTS wouldn't be a more approrpiate diagnosis. (I have read the POTS threads on medhelp)

There was some confusion over the medication I should take because I use a preventer inhaler and apparently that means that you can't take beta blockers but by October the cardiologist said that I should start on Ivabradine. The cardiologist discharged me from her care saying my gp cold take this over. However, during September blood tests showed that I had a bacterial infection. It was assumed that it was a sinus infection as I'd had painful sinuses all through this period. It took four courses of antibiotics over about 5 weeks to get the sinusitis to nearly go away. After about 2 weeks on the antibiotics I felt massively better. My pulse when sitting came down to about 95, I became unaware of my heart beat and I felt able to go out shopping etc for the first time in months. I felt a little worse after finishing the antibiotics, my pulse went up slightly and I started on the Ivabradine. This brought my pulse when sitting from about 100 to 80 and I felt much more comfortable both when resting and when going out shopping etc.

By the end of January I had a recurrence of the sinusitis and all the sypmtoms started returning. My heart rate went up a bit, trembling muslces, being thirsty etc. I had two courses of antibiotics, felt very much better again and now my gp says I don't need any more antibiotics. I'm not feeling as well as before this recurrence of sinusitis, my pulse is slightly up and I'm aware of odd beats all the time, though much better than last summer.

Now for my questions and hopefully some advice.

Firsty, could an underlying infection be part of the problem causing the IST/POTS? (whichever it is) Wouldn't all of these antibiotics have sorted out an infection by now?

Is this likely to be IST or is it more likely to be POTS? Does it matter having the correct diagnosis?

How much activity should I be undertaking? I lost my job last August because of this but now have a second interview for a part time desk job. If I'm offered this job should I take it? Or might it make my symptoms much worse?

Should I start getting some exercise? If so then how much, how long, what type of exercise, what should I let me my pulse rise to when exercising?

All health services, whatever country you are in have problems but I feel that I've not been given the support and advice that I need to know how to live my life. Any advice would be greatly appreciated.

Thank you.

[questionnone]

I too was just diagnosed with IST and have met another person on another health forum who had IST who had PSVT episodes as well. I contacted him since it is sort of rare to find someone else with two tachycardia conditions that are the same and maybe they were both related. He told me that his doctor (they're from the Czech Republic) believes it has to do with his autonomic nervous system being off balance from a viral infection (meningitis). This can be true because half heart doctors believe the Sinus Node of the heart is at fault whereas another half of half doctors believe IST or POTS has to do with the nervous system. Unfortunately, there is no definite reason known yet. Now that I have read your post it seems like you're another person that I have heard having experience IST after a viral infection. I get sick quite often and was wondering if one of the reasons why I have this condition now is from a bad flu or something. As far as exercise, I would get an opinion from an EP doctor. I am waiting for my appointment later this week to get the "okay" to exercise again or not.

[medicmommy]

Hello!
I've just read your post and couldn't help but wonder if you'd ever had your thyroid levels tested? Thyroiditis often comes on from a viral infection, and sometimes causes damage to the thyroid making it hyperthyroid, or hypothyroid...Your continuing issues sound as if you are in the hyperthyroid realm, and this would explain sinus trouble, difficulty fighting infections, etc. Please look it up -you may find the answers you need...Good luck! ~MM