tachycardia

[jen21287]

Hi Dr. McWilliams,

I hope I am not repeating this post but it didn't seem to get posted the first time...

I am 21 years old and was diagnosed with tachycardia within the last 2 months and put on 120 mg of Cardizem. I am also currently taking 300mg Lamictal and 200mg Seroquel. My HR has apparently been above 100 for a long time now but my doctor did not bring it to my attention until it was 120 in his office. My blood pressure has always been normal and lab work has always come back clean. He ran an ECG and I was subsequently put on the Cardizem. He did not go into details regarding the results except to say that I have an unusually high heart rate. In the evening, after I take the Seroquel and Lamictal, I experience "episodes" where my heart is racing and I feel like I cannot take in a deep enough breath. I become lightheaded and dizzy and fall asleep within seconds of lying in bed. I had never told the doctor about this until he told me my HR was 120. When it is at 120 during the day - I do not notice it at all. I only notice this in the evening after the meds. My doctor said the Seroquel could be causing it. He told me that having an elevated heart rate is damaging to my heart which is why he put me on the medication. Even after taking the heart medication, I have found my heart rate to be 160 bpm during all of this. Should I seek a second opinion? I have no idea what is going on and I feel my doctor thinks the same thing.


Thank you. Any advice is greatly appreciated.

[lb1965]

My 20 year old daughter has a similar problem. Her resting heartbeat is between 115 and 140. It never goes below 115 or so. She is exhausted all of the time, can't sleep, is down to 80 pounds (she is 5' tall), and has all of the other symptoms like fatigue, stress, and sweating. She has been through the endocrinologist screens, gastroenterologists tests (thyroid uptake, EGD, etc.) and no one can find anything wrong with her. Her internist just keeps saying we'll figure it out. In the meantime, she has yet to see a cardiologist. I read about a problem with the firing mechanism in the heart (laymans terms), but no one seems to think the heart is the problem. It is getting to the point where I am scared all the time for her. She can't gain weight no matter how much she eats. It can't be normal for a 20 year old to be this exhausted and have this many problems. The only drug they have prescribed is beta blockers, which didn't help at all. Any thoughts? THANK YOU.

[cmadean]

What are the causes of Tachacardia? Also what are some ways this is controled?

[jen21287]

This never bothered me before. I actually went in to go over liver enzyme tests when my doctor informed me about my HR. I had an EKG done in the office, he came in 2 minutes later, told me my HR was abnormal and then wrote a prescription. This only worried me because he said this was damaging my heart. I have not had any other tests done since the initial EKG. He told me to come back in 2 weeks – and there was no change. A month later, still no change. I do not have anxiety and have never had a panic attack. My HR is elevated all day but the only time I notice it is in the evening after I take my meds. Only then do I feel my heart racing and experience the other symptoms. I forgot to mention that during all of this is I almost lose the ability to swallow. Sometimes I feel as if I am choking on my tongue. I have absolutely no idea why. If this is caused by the meds that I am taking, will that cause any long-term damage to my heart? I have been on this combination of meds for 2 years and have experienced this since going on Seroquel. I do not want to take any more meds than necessary. I do not even take motrin. If this condition isn’t damaging my heart, I do not want to take a medicine that isn’t helping.

[Michael J. McWilliams, M.D.]

If you have a normal TSH (thyroid) and your heart is structurally normal, you probably have "inappropriate sinus tachycardia." (IST) This is a fancy way of saying that your heart rate is faster than average and that we don't know why.  When I see people like yourself, I will often start medications like diltiazem (cardizem) to slow the heart rate but to be honest, this has never been studied to show if slowing the rate is helpful.

IST is often associated with a lot of other symptoms like lightheadedness, dizziness, anxiety, irritable bowel syndrome, sweating, etc.  Even when the heart rate is controlled, many of the other symptoms will often persist.  People don't die from the fast heart rates -- but, they often convince them self that they may and that is where the problem starts. IST is a tricky problem to treat and in my opinion, requires the ability of the person with IST to calm themselves down when they get panicky about their heart rates or the symptoms escalate.  

If you think you aren't being managed correctly, a second opinion never hurts.

I hope this helps.