Superventricular tachycardia when i'm standing and normal heart rate when i'm sitting...

[txQC]

Hi Everyone!
                  First of all, I suffer from severe panic disorder with agoraphobia since more than 1 year now. I also have a severe cardiophobia, who mean that i'm A LOT worry about my heart and can't stop taking my pulse rate and my blood pressure everyday...

In the last year (2010), my main complain was a very slow heart beat with a weak blood pressure, usually a lot lower than my normal range (110/60) even when I had a panic attack, my usual pulse rate was around 50-55 for almost 1 year at rest... and that's when I start having the cardiophobia cause I was a lot worried about a heart failure or heart attack... The very low pulse rate appear for no reason, I remember that in December 2009 I was at 80-90 BPM at rest and I wake up one day in the same month and my pulse rate was down to the 50-55 all the time!!!

I'm 6 foot tail and my weight was 230 pounds at the time... So i'm not fit and don't exercise and I smoke (one pack in the past not down to 5-10 a day and less when the tachycardia is very bad) so the low pulse rate wasn't usual or normal. In March 2010 I saw the first Cardiologist who run some test, a stress test with an echography of my heart (was able to walk on the treadmill for 9 minutes in a row and my pulse rate raise to the 170 BPM but I had to stop cause I wasn't feeling very good)... anyway the Cardiologist don't see anything wrong in my heart, no ventricular problems or anything else. I also wore a Holter moniter for 24 hours and they only thing the Cardiologist notice was the low pulse rate but he told me at the time that it was not dangerous and probably related to my anxiety !!!

The main problem is that after those tests, I start having more and more cardiovascular symptoms...  After a BIG panic attack in my car, I faint and I start having a very fast pulse rate all the time when I had to drive my car... Then after that big panic attack I wasn't able to continue to drive my car so I give up on driving my car... In july 2010, I was alone at home and I took my shower and I start having a very fast pulse rate (like a panic attack but not with the usual symptoms of a panic) and I faint in the shower... Since then, I start having all the time a very fast pulse rate of 160 and more every time I have to take my shower!!! I had to stop taking my shower and start taking a bath.... I was able to return in the shower last fall but I continue to experience the very fast pulse rate in the shower...  I also faint while I was sit on the toilet while I had a bowel movement and since then I start having severe constipation and I have the very fast pulse rate every time I need to do a bowel movement!!!

After all those events, I start having tachycardia while I had to be a passenger in a car, not even while I had to drive... who is a lot crazy cause each time I have to get out of the house for an appointment and have to be in a car for 5 minutes or 10 minutes or less, I have the very fast pulse rate, I faint in the car, I can't go on the highway, I have strong chest pain and when i'm out of the car all the cardiovasculars symptoms stop!!!

[txQC]

Hey, i'm sorry to hear that you don't feel well also!!! I hope it will be better soon ;-)

You are right, the Cardiologist I have right now will not run other tests, especially the ones I already had... For the tilt table, I'm not sure but we don't have it where I live... OR it's not a common test they do here...

AT least you can have your cardiac test results, where I live they don't give them to the patient... each test we do we canno't have the results on paper... it's the joice of a public health system!!!

I will probably ask for another Cardiologist reference paper from my Family Doc that I see in 2 weeks... Cause the one I have right now don't care about me... I call today at his office and said it was urgent and he don't call me back, as usual...

What bother me the more is not the tachycardia but the HIGH DIASTOLIC bloos pressure I have since more than 2 weeks... The systolic number is ok, just a little bit over the 130 but the diastolic number is all the time higher than 90... if I do a panic it can go up to 115, who can lead to hypertensive crisis and organs dammages, stroke and heart failure...

I don't understand what happen with my blood pressure since 2 months... it was very low for all december and a part of january around 100/60... and now it's usually higher in the morning and in the afternoon around 135/95... and reduce a little bit in the evening to 125/90... but when I know I have an appointment soon, I start having higher blood pressure 2-3 days before the appointment cause I have to get out of the house and I don't want to live the same situation that I lived last week in the car...

I try everything to calm down, I already reduce my bad habit of smoking (I have an appointment for a laser treatment to stop smoking in 2 days), I cut all the salt in my food and read carefully the label of all the foods I eat to be sure I don't eat more than 500mg a day of salt, I drink less water to avoid an increase of my blood volume in my system who can increase the blood pressure, I don't drink coffee since more than 2 years, don't eat chocolate or drink tea so no caffeine in my system, I don't eat sugar (just whole grain bread in the morning), I eat more fruits and more vegetables...

If I compare my diet now and the one I had in december when I had a lower blood pressure, I was eating a lot of salty food since my Cardiologist told me to eat more salt, I was drinking more than 2 liters of water a day, I was smoking one pack of cigarette a day (now only 5)... So I really don't know what happen...

I try again the Ideral at 20 mg and was sick on it, felt dizzy, confuse, very anxious and tired as hell (I'm already tired all the time and can't exercise because of my heart), it didn't reduce my blood pressure and my pulse rate stay high, it was only lower when I was sit for more than 30 minutes... I try also the Acebutolol who is another beta-blocker that my Cardiologist RX 2 months ago and I had the same reaction...

I think it's maybe time to ask to my Family Doc to see an Endocrinologist, cause it's look like i'm having a problem with my adrenal glands... In december I had a blood work with a cortisol test and my cortisol level was very low for the morning (262 and the lower limit is 250)...  

Also, I loose a lot of weight since december, was at 206 pounds and now i'm at 187... that's a lot no?

And that pain in the chest, that's so annoying, I can't stop thinking about it!!!

Anyway, have to rull out what happen!!!

Ok, I know that anxiety can increase the blood pressure but again I don't understand why it was low in december since I was anxious at the same level that I am anxious nom...

I also know that fears and apprehensions can worse the anxiety, the brain keep in memory the bad event I lived last week and that's probably why I continue to have tachycardia and high blood pressure?...

I try severals things to lower my anxiety, deep breathing, relexation, meditation... nothing work... I even add 2 mg of Rivotril to my 8 mg and I see no difference...

Anyway, wish me good luck for my small road trip to my appointment in 2 days... I'm sure it will be ok, I will survive, but just writting it and I can feel the pain in my chest increase and my pulse rate increase as well... I really have to start again do exposure to the car gradually...

[r9c]

Hi,yeap i do know a lady who suffered from panic disorder do fainted when having a panic attack.I myself have lots of real bad lighthdeadeness daily and it started in july 2009,done so many cardiac testing from,twice ECG stress test where they dint found anything and the doctor said my BP response to excercise stress test were good,an echo in october 2009 came back normal after my previous ecg do indicates some LVH but it was rule out by that echo which stated all chambers and ventricles are in the normal range,and twice 24 hour holter where nothing significant expect for some bradycardia of 55 bpm in the night and 155 bpm sinus tachycardia during some activities in the day.I understand that if all these test are clear,your doctor n cardiologist will not run those echo,stress test or even holter again,at most they will just give you an ecg and if that came back normal more likely they are going to sent you home and said everything looks good even ur symptoms are there,there fore diagnosis ANXIETY or Panic disorder.How ever i think i have some ANS issues but some neurologist and cardiologist do not agreed with that as my tilt table test were neagtive,i did feel very dizzy during the test but BP maintained and pulse shoot up in the 140s but they said its just anxiety.

Can you seek another 2nd opinion from a cardiologist? i think thats the best choice and thats wat i am going to do too,probably take some of my cardiac test results with me too.

[bbxx]

good luck with it all. :)

[txQC]

Yeah, I had a very low pulse rate for a good part of 2010... I also faint while I had panic attacks with a very high pulse rate... It's not because it is not write in a book that it can't happen, the truth is that a lot of people FAINT while they have a panic attack... a lot more than what you can think and a lot more than what all the Docs think... I had a group therapy with 13 person in that group and half of them faint while they had a panic, so yeah it's possible, even if in a panic attack the blood pressure raise and it's seem to not be logical that someone will faint with a high blood pressure... but yes it can happen!!!

For the new Cardiologist, it's hard to find a new one where I live... And when they know you have an anxiety disorder, they don't believe you and think it's all in your head... so they start ignoring you and treat you like you are not important...

For my blood pressure, it's very weak since 2 weeks, I don't understand why I was down to almost low blood pressure level for 1 month and then up to hypertension state.  I never had a diastolic blood pressure of 110 and more, even when I have a panic attack... so I really wonder what happen with my heart, the best thing sould be to have a test to see my heart and the arteries, but they will certainly not do that on me since it's cost a lot and we are in a public health system, so they reserve those kind of more expensive tests to peoples who had a heart attack or who are at high risk (older peoples...)...

You see, that's why i'm a lot anxious about my heart cause no Doc want to give some answer to my questions... If I say to them that I have chest pain they told me it's my muscles and not my heart, if I told them I faint they will conclude that I have low blood pressure and ask me to eat more salt and drink less water... If I told them that I my veins on my left side of my head (near the temple) are bigger than usual and that I have pulsating pain in those veins, they say it's normal and only anxiety related...

My Cardiologist say I need to drink less water and eat more salty foods, he don't want to run other tests on me cause I already had all of them and he said that my heart was fine... but I feel sick and the pain in my chest is real and the high blood pressure is there too .... and the Doc I saw at the emergency last week told me I have superventricular tachycardia, who never happen in the past, ok I had tachycardia while I had panic attack but panic with a heart rate of 130-160 maximum BPM and the fast heart beat only last 5-10 minutes when it's a panic...  So basicaly I know how to make the difference between a panic attack and a superventricular tachycardia episode...

Well, tomorrow morning I call the Cardiologist again, he will find me really annoying BUT I need to have more tests done for my heart cause what I live now and what I feel inside my chest is not normal... the last time I call him he was not very nice with me on the phone... if he act in the same way, I will told him what I think!!! I'm tired to be treat like a piece of s h i t ...

[bbxx]

First of all, I may be wrong, but I never heard of low pulse with anxiety. Only the opposite. I know you have anxiety--thats a given, but I would find a new cardiogist. Something seems strange to me, but I am not a doctor. Anyway, those are my thoughts. Oh, and you were fainting when your heart raced---that is odd in my uneducated opinion, because when most people dont faint from a panic attack.

[txQC]

Anyway... I saw another Cardiologist to rules out other heart problems... and the new Cardiologist told me that my blood pressure was low and that I need to eat more salty food!?!... He don't even RX some tests for my heart he just took my blood pressure...He said to me to call him in 6 months and see what happen with the more salt in my food!... Of course, I had a RX of a beta-blocker call Acebutolol (200 mg x 2 a day) but when I took it I faint, so I divided my dose into 50 mg piece and I had the same reaction and I faint... so I never take it again... My Family Doc RX another one (Inderall) at a very low dose but I had the same fainting reaction with it and see no change for the fast pulse rate...

The main problem is that in last December 2010, my blood pressure was even lower than before... under 100/55... and the slow pulse rate return ... all of this happen only in December 2010!!!

I saw my Family Doc again last December and to his big surprise he take my weight and saw that I loose more than 40 pounds in 1 year! He RX some blood work for the cortisol level as well as a lot of vitamins, hypoglicemia, TSH, T3, T4, infections... name them... I had a complete blood work and all the results was perfect!!! No thyroid problem, low cortisol level only...

Since January 2011, my blood pressure start being high again!!! I don'T know why, nothing happen in my life, my anxiety level is the same (now it's 10 times higher than before).... but well, my blood pressure is all the time in the 140/90... if I do a panic attack it can reach 170/115, I don't care about the forst number but 115 for the diastolic is very high!!! So I call again the Cardiologist and he RX a blood pressure monitoring of 24 hours... I had it last week!!!

I really don't know what happen AGAIN  but since 2 weeks, I'm having tachycardia almost 16 hours a day!!! I wake up and my heart go very fast and it's all the time irregular... I also have more chest pain especially in the evening and strangely the chest pain is worse when the tachycardia stop in the evening... but the tachycardia don't stop al the time in the evening, I can have it also in the middle of the night or 24 hours a day... My pulse rate is now all the time in the 130-160 range... if I lie down on my bed or sit on the couch, my pulse rate will be down at around 100... but when I get up the pulse rate increase of 30-60 pulses and more... who is a lot... I feel like I will faint often, i'm a lot dizzy, can't eat a lot cause it's increasing the fast pulse rate, I have stronger eyes pain, my head hurt a lot all the time, my pulstaing veins on the left side of my head hurt a lot.. I try almost all the meds for the stomach cause I was thinking that the chest pain was comming from some stomach acid problem but they don't improve the chest pain... I also have jaw pain ( had it already since last fall but it's worse than before), the numbness of my left arm and hand is worse than before, same for the numbness of my legs with blueish feet.. I sweat a lot from my hands, feet, face... I also have irregular pulse rate all the time and a pounding heart beat all the time also, if I look at my shirt I can see my heart pounding very strong... even if my tachycardia stop in the evening, my heart is all the time irregular, pounding and I have A LOT of skip heart beat...

Of course, all of this trigger more panic attacks and a lot of anxiety who i'm sure can worse the tachycardia and the chest pain... I saw my Psychiatrist Doc and he say it's all in my head and since I can't tolerate the antidepressants meds, he don't RX anything to calm me down, with the exception of the Klonopin-Rivotril, who is a benzodiazepine but I take that med since 5 years and i'm addicted to it and it's not working anymore to reduce my fear and panic... I take 8 mg a day and feel very anxious... but if I skip a dose the tachycardia will be worse... very weird...

Anyway, when I had to bring back to the hospital the blood pressure monitor last week, the nurse who remove the machine saw that my last blood pressure reading was very high and saw also the fast pulse rate and the pounding heart beat and she do a ECG and told me to go to the emergency with the ECG paper... I went to the emergency and 5 minutes later another nurse ask me to remove my clothes and put the hospital gown and to lay down on the stretcher. She took my vital signs and strangely the high blood pressure was down to normal range and my pulse rate was around 80!!!

They plug the monitor machine for my vital signs, took some blood, I had a X-Ray of my chest and my lungs... and the Doc at the emergency give the results 2 hours later... All the cardiac markers in my blood was ok, my lungs and my chest X-Ray are normal... The ECG was also normal with only superventricular tachycardia and no ventricular problem, so he told me that I have superventricular tachycardia and say it's not dangerous...

The main problem is that he RX a holter monitor test and say that I will have it next week... he say that they will see how fast my heart beat can be and they will be able to choose the right meds to treat me... BUT the Doc at the emergency forget to write on the RX paper that it was an emergency so when they call me back yesterday to give to me the appointment date, the wasn't able to find a place for me before 3 weeks!!!

Since I know it's superventricular tachycardia, I google it and saw that some symptoms dont match what I feel... Normally the tachycardia is not linked to an increase of the blood pressure but more a lower blood pressure no???

Also, my tachycardia is worse since 2 days... now the only way to have a heart rate of 100 is to be sit or lay down on my bed... I also have more chest pain, can't eat a lot but I try to drink more liquid... I can't even take my bath cause it's trigerring a faster heart beat... just climbing the stairs make my heart race at 180 and more... I feel very bad!!!  Last evening while I was sit on the couch I start feeling panic attacks comming and I had at least 10 panic attack in a row, who increase my pulse rate at 200 and more... I'm extremely tired, I feel a lot dizzy, I feel like I eat something very bad and that I will be sick....

I want to know if it's normal of not to feel that way??? And if so, what I can do to lower that fast heart rate? I try to take some magnesium pills yesterday without any success... I try to avoid cold drink... I try to eat only small things at the time (fruits, vegetable, no fat, no milk product and little to no bread...)...

I need some tips please!!! I feel very bad!!!

I think I should ask my Family Doc for some X-ray of my adrenal glands no? Maybe it can be related to that? Too much adrenaline will cause a drop of the cortisol who will lead to more anxiety and also to weak blood pressure...

One thing also I notice, I do the test to see if I don't have hypotension orthostatic and no I don't have that problem... I took my blood pressure while I was sit and it was at 130/88 - 115 BPM and I get up and take it again and it was at 140/94 - 165 BPM... So even if I have some symptoms of hypotension orthostatic like the dizziness, fainting feeling... it's not seem to be related to that...

Thanks  and sorry for the long post!!!