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Avatar universal

Inappropriate sinus tachycardia

I'm 19, male, and skinny

About two months ago I had to go to the ER because my heart was at 150 and I was palpitating pretty bad. they did EKGs and didn't find anything other than the fast heart rate, but they told me I was severely dehydrated. I went through like 3 bags of the IV stuff quickly. they were trying to get a urine sample but I went before I got there so that's why I was on IV I guess.

So anyway, I made an appointment with a cardiologist, supposedly the best in the state. I was supposed to do a stress test but on the way there I got nervous and started having symptoms again so they sent me to the hospital. I was there for two days. They did an echocardiogram and an EP study where they stick a catheter in my leg vein and wire it up to my heart. they were going to do a tilt table test but I couldn't take being strapped in so I had to bail out. But they took my blood pressure standing and found that it drops when I stand and takes a few minutes to go back to normal.

anyway, they didn't find anything else besides my heart beating too fast. A week later I go for another echocardiogram at the cardiologist and told I have a "dynamic" mitral valve prolapse and either bicuspid or tricuspid valve prolapse, in other words it only shows up at certain times and that's why they didn't find it at the hospital. And I was told I have inappropriate sinus tachycardia, nothing else wrong besides my heart going too fast. I was told to exercise, go out walking for 15 minutes every day and gradually increase it. and for the past 3 years since we moved to the new house I haven't been doing much so that makes sense.

Now the problem is, everything I do makes my heart go up. when I'm laying down I guess it's between 100 and 120 and just standing up it feels like it's around 150 or higher. I also get mild shortness of breath too and feel like I need to take a deep breath often, but that only seems to show up when I think about it. Swallowing food makes it go up, pretty much everything makes it go up. And my arm veins stick out so far when I stand up. I'm on a beta blocker and it helped for a while but now that I'm up during the day instead of night it doesn't seem to work so good. Night time my heart rate seems to go down.

Sorry for the long post. So I want to know what you guys think, is it dangerous for my heart rate to be so high? I've told them this but they don't seem to be concerned. I have anxiety issues and I have that nervous feeling in my stomach most of the time. I imagine that doesn't help any. I'm just worried about fainting if I go out for a walk. I did it once with not much of a problem but I just can't get rid of the worry.
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Avatar universal
I take 25mg once a day. I was taking it at night but then last week I changed my sleeping pattern to the day time so I couldn't do that. now I'm taking it as soon as I get up and it doesn't seem like it's working. It's weird because at night it feels almost normal, even standing it's a little fast, but doesn't seem nearly as fast as during the day.

The sharp pain I'm not really worried about being a heart issue but I worry if it's not a lung problem or something ruptured. they did a chest X-ray and find nothing.

Yeah when they did the EP study they didn't find anything. In fact they said they didn't find anything at all the 2 days I was in the hospital but then the next week I went to the cardiologist for an echo and they found a mitral and I think tricuspid valve prolapse. they said it was 'dynamic', like it only shows up at certain times. So that makes me wonder if it doesn't get worse at certain times too.

I usually don't get any symptoms except palpitations when it's going real fast and I'm nervous at the same time. sometimes it seems like certain positions make it happen, like laying down real fast or leaning up on my right side. I don't drink caffeine. I used to drink nothing but soda but it was stuff like sprite and root beer that doesn't have caffeine. now I just drink gatorade. No smoking or drugs either.

Honestly I don't think the medicine was ever working because I was taking it at night and it seems my heart slows down at night anyway.  I don't wanna get a pacemaker cause I've always thought of those as for old people.
Helpful - 0
264156 tn?1206986994
Well how did the doc tell you to take your meds? Just 25 once a day? I have a bp cuff machine that goes on my wrist too. I'm just curious...take your bp/pulse with the machine while squatting. Like squat down in a ball and take it. Let me know what your pulse is then.

Yeah I get sharp chest pain too, what the heck?!  Mine is mostly between my 3rd and 4th rib, a real sharp stabbing pain. Sometimes if I breathe deep or exhale deep I feel it, but not always. I think it's more of a cartilage or muscle strain cuz I notice if I twist a certain way I feel it. BUT nonetheless I don't like having it cuz it's on the left side of my chest above my heart so I always kinda link it to my heart. I think I would feel better if it was on the RIGHT side of my chest know what I mean?!

It takes years for cardiomyopathy to happen. You are still young and have a structurally healthy heart. I have faith that you will get this under control well in advance to anything bad happening. I still haven't had an echo done. It was one of the first things the cardiologist wanted to have done, but I got real bad real quick so they just sent me to EP. So when you went to have the EP study done they didn't find anything besides sinus tachycardia?

So do you have symptoms along with your tachycardia? Like when mine was goin fast all the time I was really dizzy and got tired really fast. Do you drink a lot of caffeine? How about smoke or do drugs? I'm hoping the answer is no to all these as they can all seriously make things worse.

Anyway, I think you may need to up your dose or possibly try a new beta blocker or maybe even a calcium channel blocker. Sometimes people with IST don't respond well to these drugs though. They say you can't die from it, but you can't die from slamming your hand in a car door over and over again but who would want to live like that right?  :)
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Avatar universal
well I can tell you that today it's been about 120 all day today, or at least every time I felt it, and higher when standing up. I have a blood pressure monitor you put over the wrist and even though it doesn't show the right BP readings, it showed my heart rate as 119 laying down. So when you say 'sustained' I hope you mean years and not days. How long would it take this cardiomyopathy to happen? weeks, months or years? The last echo I had maybe five or six weeks ago showed my heart as strong. now it's 11:30 PM and my heart feels slower even though the medicine shoulda wore off by now. I don't get it

I take 25 mg once a day. I was taking it at 8 at night but then as I changed my sleeping pattern I was getting up later and later so I had to take it later. took me about 4 days to make the change and now I take it as soon as I get up which today was around 9 in the morning.

yeah I look up too much stuff on the internet. I started doing that about 3 years ago when I found a lump on the left side of my neck. still have it and I mentioned it in the hospital, turned out they said it was nothing.

Something else I didn't mention is I get very sharp chest pain, usually in the upper left side. it changes depending on how I move, twisting my upper body or moving my left arm. the pain can also be in my shoulder, my back or the base of my neck. It feels closer to the surface, maybe in the bone or above, but I don't know. and I've been getting the sharp chest pain for years on and off. when it happens it feels like I knife cutting through me. the back pain is more of a 'punching' type pain. any idea why? it doesn't really happen enough to be a big problem though.

anyway I hope everything works out for you. I know it must suck for you cuz it sucks for me.
Helpful - 0
1 Comments
The chest pain is most likely from your anxiety. I get the same thing on and off for years.
264156 tn?1206986994
Gosh I can't tell you how much this all just sounds the same. You said  "didn't really think about stuff happening to me, but I've always had that feeling in my stomach of unease or nervousness about what's going to happen tomorrow, the next day, the next week, the next year. And it wasn't always about bad stuff either. I guess it's anticipation. "  That was me to a tee. I saw a psychologist a couple times too. She said that I was "overly ambitious". Whatever. So I quit seeing her. I REALLY think that if you started working on your stress levels, how to cope with stress that sort of thing and tried to work on controlling your thoughts of what's going to happen tomorrow that sort of thing you will see a huge change. I know easier said than done right? Well I can tell you that there was a point where my mind was constantly racing, what if this, what if that, maybe I should do this, maybe this means that...It was SO annoying. I was like man can't I just have silence in my head for once!? Turns out I was just trying to take on too much at once. I wasn't sleeping like I should have been, so my body wasn't fully rested therefore my mind wasn't fully rested. I can also say that I worried myself SILLY over looking up things on the internet. What if my heart does _____ maybe it could lead to ____. Maybe I have _____ symptom. I can tell you the mind can do crazy things. You can read something and actually convince your body to have that very symptom. Not even kidding. So my advice to you about that....just STOP looking for answers on the internet. Stop trying to find symptoms or whatever. Cuz could you die someday far from now from a heart attack or whatever? Sure. Could you die tomorrow in a car accident. Sure. You just don't know. So just make the absolute best of things now. Take care of your body. Take care of your mind. See doctors if you aren't happy with how you feel but don't obsess over it.

Oh you also asked about the concerns of congestive heart failure that sort of thing.  Unless your heart is continually beating at a fast rate, like 110+ for a sustained amount of time than you don't have anything to worry about. There are some complications like tachycardia induced cardiomyopathy. Sometimes your heart may FEEL like it's beating fast when it actually isn't.

The thing with people who have IST is that their SA node is very sensitive to adrenaline. The SA node is the hearts natural pacemaker, it sets the beat for the rest of the heart to follow. When I say adrenaline I'm talking about the bodies own natural hormones it creates like epinephrine adrenaline that sort of things. By the way, I STRONGLY suggest that when you go to a dentist if they have to do a procedure you say you are allergic to epinephrine. I know you said you didn't go through with the tilt test. I know that's next on my list of procedures, but honestly I don't know if I want to do it. I'm just accepting what I know now and am going to deal with it as it comes to me. I know one of the things you can do to keep your blood pressure from dropping so low when you stand is to work on your leg and calf muscles. When you stand gravity is working against you and the blood suddenly rushes to your feet. Well if you increase your muscle tone the muscles sort of prevent the back flow of blood and therefore your blood pressure doesn't drop so much. This has helped me a little bit.

What strength of metoprolol are you taking? If it's no longer working you may need to increase the dose. Also about the night/day thing. When I switched to working nights at a hospital my whole body got thrown out of whack. Then switching back to days I went through the same thing. Give it a little bit of time, it will figure it out.
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Avatar universal
and yeah about stress, since I got out of the hospital I've been seeing a psychologist for my anxiety. A few days ago he made me a 'relaxation tape'. I haven't been able to play it at home because the only thing I have to play cassettes is half broken and has to be weighed down with books for it to work. I've always been a worrier though. I didn't really think about stuff happening to me, but I've always had that feeling in my stomach of unease or nervousness about what's going to happen tomorrow, the next day, the next week, the next year. And it wasn't always about bad stuff either. I guess it's anticipation.
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Avatar universal
funny because the beta blocker I'm on is metoprolol too. Only it doesn't seem to be working as good for me. I was staying up at night and sleeping during the day because after I graduated high school I didn't have much to keep me in a good sleeping pattern. So anyway when I was doing that, my heart rate was staying down below 100, didn't have a stop watch to measure it but I'd guess 80's or 90's. I don't know if that was because it was night time or because of the medicine, but once I changed my sleeping pattern a week ago to be up during the day, the medicine hasn't really worked. laying down I'm about 120 and when standing up it was higher, maybe 150.

"My arm veins do the same thing when I stand up. It's because when you stand your blood pressure drops down and your heart has to beat harder and faster to make up for the fall in blood pressuree."

does that seem dangerous to you? like eventually do you think I could get congestive heart failure from it having to pump harder and faster like that?

and it's not just when I stand, like if I lay on my side, the veins in the other arm get big and if I hang my arm over the bed laying on my stomach, they get huge. whenever my arms go below my heart it seems. I'm just worried my heart is going to give out, or in 20 years I'll have congestive heart failure because it's going so fast all the time. you know what I mean?

I don't like medicines either. Because you don't know what else they're gonna do to you. They could be having unseen effects. And plus you always see on TV how they had to recall this medicine and if you took this medicine and got seriously ill, call up this lawyer. when I was 6 years old they had me on Ritalin during school hours because I was hyper, and now I find out there's a danger of having cardiac arrest?? that's screwed up man. So now I don't take medicines unless I have to, like if I'm seriously sick or it could hurt me if I don't.
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264156 tn?1206986994
Well ya know what, you and I have a lot in common. I have to start off by saying I'm actually very thankful to find someone with the same problem as me! Not that I wish this upon ANYBODY, it's just nice knowing I'm not alone. :) I am a 24 year old female, prior to June 1st of this year a super healthy person. I worked out most days of the week, high intensity cardio workouts, weight lifting, ate healthy, don't smoke or drink and have never touched a street drug. That all being said...we recently bought a house and was doing a lot of moving and painting walls and unpacking yada yada yada. That along with an 8 month old daughter, very little sleep due to moving and not eating right, I wasn't being very kind to my body. Anyway one morning I decided to try a cup of coffee to give me an energy boost. WORST idea EVER. Couple hours later I was in the ER with a heart rate around the 180's. Hours later all they could tell me was I had a sinus tachycardia, and to see a cardiologist. I thought  maybe I just needed to get the coffee out of my system and I would be fine...WRONG! Next day same thing. My heart rate was all over the place. Little exertion would cause it to go crazy. So back to the ER I go, same thing see a cardiologist.

So I see a cardiologist, go to an EP lab. At this point I had seen 4 different cardiologists and they all agreed I had inappropriate sinus tachycardia. Soooooooo they recommend metoprolol, a beta blocker and they wanted to follow up with me. 2 months pass and I still hadn't taken the medicine. Why you ask? Well I just am not a big believer in medicine. Even though I myself am IN the medical field, I just had a hard time accepting the fact I had this illness. I guess in the back of my head I was hoping it would all go away. I should also mention I too have some very bad stress and anxiety issues. The Army was trying to deploy me to Iraq, I was a full time student, I had a new baby, we just bought a house, and so on and so forth. In general I was a pretty pessimistic person. But over those 2 months I was able to accomplish a WHOLE lot on my own, without the medication. In my opinion mental health (stress anxiety and lack there of) is a HUGE part of overall health. Period. I worked on being a more positive person. I did relaxation techniques, deep breathing exercises, yoga. That sort of thing. I couldn't work out like I use to because I was scared to death of my heart going crazy. Although my condition didn't go away, I was able to somewhat "control" it. However I went to follow up with my cardiologist, THINKING I would get a good EKG and good appointment. I felt like I had gotten better. But I layed down to get the EKG and next thing I know I felt a huge panic come over me, I guess a flash back to the ER with my heart rate going crazy. Well then my heart went up to the 190's again and the sent me to the ER. It came back down after a while. Same thing about a week ago. I went to Dallas to see a very well known skilled cardiologist. Went to get the EKG and the SAME dang thing happened. They rushed me off to the ER and I said LOOK, I'm going to save both of us time and just refuse care. There is nothing that sitting in this for hours on end is going to accomplish. I went to see my cardiologist and he said look we have 3 options. We do nothing (which is what I had been doing), we take the medicine (should have been doing) or we ablate your SA node and implant a pacemaker (in my opinion not an option). So I left, feeling VERY down about the whole day. I felt like I had come along way in getting better, but given a stressful situation my heart would go crazy. I also should mention that any time I stood up my heart would go up to about 110-140. Resting my pulse was around 80-90. After practicing relaxation techniques and deep breathing I could seriously bring my resting pulse down to the 50's-60's and upon standing it would go up to max 130. So I was content with this. Not that I felt my health was perfect, I was "okay" with this over being stuck up in the ER with my heart going 180 or so.

ANYWAY (are you still with me or have you fallen asleep) :-)

So I decided OKAY I'm going to just try the medicine. I only take a small small dose. 12.5 mg in the a.m. and boy has it done me WONDERS. Now my resting pulse is 60-70 and upon standing it will max out at maybe 110 but will come back down to 80-90 after a second. The medicine only lasts for me about 7-8 hours but I find that at night I don't have as much tachycardia. I do have some slight side effects, some dizzyness, but the doc said after two weeks I shouldn't feel it anymore.  I just HOPE with all my might that this medicine will continue to give me this effect. I truly believe this is just a temporary bump in the road, and it will just kinda go away like it came on some day.

PS. The deep breath that you feel you have to take is because you are weighed down by stress. I had the EXACT same thing. For me personally high sugar things agitate my tachycardia, heavy starchy meals like breads pastas potatoes that sort of thing agitate it. My arm veins do the same thing when I stand up. It's because when you stand your blood pressure drops down and your heart has to beat harder and faster to make up for the fall in blood pressuree.

In conclusion to my novel ;-) I have to say really try to work on anxiety and stress. You are more than welcome to contact me, ***@****. I would be more than happy to talk to you or answer any questions for you. Take care and best of luck sweets, your not alone.
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1 Comments
Hello, I'm very curious on how it all turned out for you. I was just diagnosed with IST. You can email me at ***@**** I'm 35 years old  and female
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