Tachycardia?

[roxydoggy]

Hi,

I'm a 22 year old female who goes to the gym 5 times a week. I've had palpitations on and off for the past 5 years. My resting heart rate is around 65bpm.

Last Wednesday (five days ago) I was at my usual spinning class when I checked my heart rate monitor because my head all of a sudden came over very light. It said 200bpm (where I usually never exceed around 185bpm), before dropping to 120bpm, going back up to 190bpm, dropping back down to 90bpm, and so on. My arms and legs were going numb and I felt like I was going to pass out. I left the class and went home, where the episode carried on – I was shaking, I felt numb all over, was having strong palpitations, lightheadedness, and my heart rate was continuing to fly up and down.

I phoned a paramedic who couldn't get my heart rate to come down past 145bpm, even though I was sat resting for 2 hours or so. He phoned an ambulance and they took me to the hospital where they took multiple ECG's, a chest x-ray and a blood test. I know that my heart was palpitating during one of the ECG's, but when I saw a doctor I'm not sure he was looking at that one in front of him.

My chest x-ray was fine. My blood tests showed no problems, except a slightly underactive thryoid – something I know about and don't need medication for – and a reasonably high white blood cell count. He said that my ECG showed that my heart rate was regular, if a bit fast, but again I'm not sure whether I was experiencing any palpitations during that ECG. He said that it doesn't look like atrial fibrillation, since the beats are regular, and requested a 24 hour ECG and an appointment with a cardiologist the following Wednesday. He also gave me beta blockers to take: 1.25mg of Bisoprolol every day.

I left the hospital and felt totally drained, but I expected that since my heart was racing up and down, well above 140bpm for around 4-5 hours. I wasn't feeling well a couple of days later, but decided to get up and go for a short, slow stroll with my dog. Once I got back, I sat and watched TV and I had another episode – the same symptoms as before. Again, my heart rate was flying up to 170bpm, back down to 80bpm etc, along with the same lightheadedness, shortness of breath, etc. I went back to the hospital, where they basically just monitored me until it calmed down a bit and told me that there were no signs of damage to my heart, so I didn't have a heart attack, and to wait until my appointment with the cardiologist.

Ever since Wednesday I have been feeling really ill. I have no appetite whatsoever, I've lost around 9 pounds in one week, which is quite a lot for a 5ft 8, 126 pound (now 117 pound) girl. I am constantly exhausted. I have other feelings that come and go too: tightness in my chest, numbness in my left leg, pressure on my head and jaw, and still palpitations every day. I also get waves of what feels like adrenaline wash over me.

I'm sorry for the really long post, but my real question is – what is going on with me? The doctor wrote on my discharge form (from Wednesday, the first episode) 'ECG sinus tachycardia' – but could he tell if it were another kind of tachycardia if I wasn't having an episode during the ECG? I appreciate I should probably just wait until Wednesday and see what the cardiologist says, but I feel so ill and I've had what feels like two more episodes about to come on, that I've 'breathed away' – I wasn't measuring my heart rate then but I think it stayed pretty normal, nowhere near as high as the previous two times when I went to hospital.

I'm desperate to know why I'm feeling so poorly with such odd symptoms. People have suggested it could just be anxiety, but I'd love to know whether it's likely to be panic attacks, or a form of tachycardia, or could it possibly be a fever that's causing these episodes?

Thanks for reading and thanks in advance for your opinion.

[Jenn1302]

I would call the cardiologist's office at least once a week to check if there were any cancellations. Do the beta blockers help prevent tachycardia episodes? If they do, it would make sense to continue taking them, because once you get an episode the beta blockers probably get a while to kick in.

[roxydoggy]

Hi all,

I've had an update in the mystery that is my heart: my blood tests came back all normal. They checked my thyroid, electrolytes, full blood count, and two other tests for infection (ESR and CRP).

I guess that leaves either a type of SVT or anxiety... or a mix of the two. I have an appointment with a cardiologist on the 14th November!!! Seems like a ridiculously long time to wait. I guess they can't be too concerned by whatever it is. I should also expect the results from the holter monitor within 2 weeks.

Last night I went out for the first time to the cinema and I felt my heart start to race again. I'm not sure how quickly, but within a few minutes and some deep breathing I got it back to normal. If I have this kind of control over it with breathing, does this rule out an SVT?

I'm still taking the beta blockers that the doctor prescribed when I first had an episode, but I honestly don't feel like I need them. When I'm not having an episode my heart rate is completely normal, so keeping my heart rate down constantly seems a bit like giving treatment before a diagnosis has been made. What do you think – if you were me would you be reluctant to stay on the meds?

Thanks

Lara

[roxydoggy]

I'm from the UK so we don't have insurance for health care, we just have the NHS. Although we can pay for private health insurance, which is what I wish I had done! I will keep pushing to see a cardiologist and if I have no luck, I'll just pay to see one.

Thank you so much for all of those links. I have been drinking protein shakes to get some kind of nutrition in me! Yesterday I managed to eat a little and it definitely made me feel a lot better. I guess I just need to keep forcing it down until I get my appetite back!

Thanks again.

[roxydoggy]

Thanks for your advice. Just sharing my experience with people that can relate and give an informed opinion is really helpful. I guess we'll wait and see what the holter monitor and blood tests say! Even if they try to tell me it's just anxiety or panic attacks, I think I'll definitely keep pushing for an appointment with a cardiologist. If it IS anxiety, which I really don't feel like it is, then I can't learn to cope with that until I know for sure my ticker is okay!

Thanks again for talking to me about it.

[Jenn1302]

As achillea said, you should push to see a specialist. If your doctor refuses, you could go to some other doctor (assuming that your insurance allows it) and try to get a referral to a specialist. Also, it can't hurt to get a second opinion.

You mentioned that you're unable to eat and that you've lost weight. A few years ago I had medication/drug-induced tachycardia and I was also underweight and unable to eat for several days. I ate as much as I could (which wasn't much), drank lots of nutritional drinks, protein shakes, gatorade, ginger-ale and broth. I made myself eat a little bit of food (by forcing food down) and and drank as many nutritional supplements, protein shakes and sports drinks as I could. It was really really hard but doable. Also, lying down helped my tachycardia, nausea and dizziness and standing up and walking made it significantly worse.

Here is a list of nutritional supplements and protein shakes:
* Ensure (http://www.amazon.co.uk/Ensure-Plus-Vanilla-Bottle-220ml/dp/B002DQWAE8/ref=sr_1_fkmr1_1?ie=UTF8&qid=1409866191&sr=8-1-fkmr1&keywords=%22ensure+enlive%22)

* Boost/Build Up  
http://www.amazon.com/Boost-Plus-Chocolate-Brikpaks-case/dp/B001D3RRH2
I think the UK equivalent is Build Up Nutrition Shake:
http://www.amazon.co.uk/Build-Nutrition-Shake-Strawberry-sachets/dp/B0045XABAC

* Ensure Enlive
http://www.amazon.com/Ensure-Clear-Mixed-Berry-Brikpaks/dp/B004DJ2ZN4
http://www.amazon.co.uk/Ensure-Enlive-Apple-Brikpaks-6-7Oz/dp/B004HPJ1W2

* Boost Breeze
http://www.amazon.com/Boost-Breeze-Resource-Drink-Orange/dp/B004L5MYP4

* Scandishake (I wouldn't take much of this one because it contains trans fat!, http://www.amazon.co.uk/Scandishake-Vanilla-Mix-Axcan-Scandipharm/dp/B000GG0HM4/ref=sr_1_3?ie=UTF8&qid=1409865310&sr=8-3&keywords=Scandishake)

You should be able to get some of these at your local pharmacy or grocery store.

Dehydration can make your tachycardia worse. Ginger-ale, Gatorade/Powerade/Isostrar, and broth can help keep you hydrated.

You could also try consulting a nutritionist. Nutritionists often know how to give the body what it needs without having to eat much.

[achillea]

From your description of your doc's reluctance to work you up further or refer you to a specialist, I wondered if you were dealing with the NHS.  And you are.

Sigh.

By all means, continue to push to see a cardiologist.  The basic workings of the heart can be understood by anyone, but cardiology is a special business that shouldn't be attempted by a general practitioner, no matter how large his ego.  I I had extremes of heart rate, I'd certainly demand a referral.

Second, when the results of blood work come back, if your white cell count is still up, pin the doc down about details:  There are basically five different types of white cells:

http://en.wikipedia.org/wiki/Leukocytosis

so which were increased and by how much?  Is there evidence of a viral OR a bacterial infection (which would explain your feeling ill, of course)?

Finally, since you know you have a tendency towards anxiety, if you are offered pills for this problem, ACCEPT THEM, even if only to store for emergencies.  I know many people fear addiction or feel a kind of moral weakness about anxiety, but I believe this is an inborn trait that can be crippling, and sometimes a little medication is a great help in a crisis.