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POTS or Anxiety? Tachycardia, fatigue, ectopic beats, please HELP!

Hello, I am 22 years old male and I need your HELP! I had to quit work, I did not leave my home for 2 and a half months, my family thinks I am crazy, I beg your help. I had lots of tests done that I will provide after I write my symptoms. My heart rate upon standing goes from 80 (sitting) to 120-150 (standing). I know about POTS but no one believes in this condition and everyone says it's only anxiety. Sometimes during the evening (never in the morning or early day) my heart rate upon standing can be normal ~100. I also feel at least few hundred ectopics beats daily. My hearrate during sleep is 60, and it's 70-80 when I sit relaxed at my home. Last 2 months I also experienced lots panic attacks where my hearrate can go as high as 180 (example: I was far away from home and I knew I had long way to walk but I already was out of breath and suddently felt fear that I won't make it, that's when I had to lay down not to pass out because of tachycardia, so I called my family to come and take me with the car). I also experience fatigue, sometimes it's even stressful to go to the toilet, because every time I stand up I hate that heart pounding feeling in my chest. I forced myself to do some walking every day so for the past 2 weeks I do 20-30 minutes of walking in the fresh air in my garden (I can't go far away) and I did help a bit. I have tachycardia and anxiety symptoms for 2.5 years (I was able to exercise a lot in the first 1,5 years) but it's only 2 months since when I can't do much at all and I feel like 80 years old grandma, sitting at home all day. When I wake up I feel no anxiety at all I just stand up I breath deeply with my belly, I think about good stuff and my heartrate is still at least 120. Also 90% of the time when I sit after standing or any exercise I feel lots of ectopic beats for the next few minutes. I have sweety hands most of the time and I started to be very very pesimistic about my life. Now I met 3 cardiologists and 1 pscyhologist and they all said I am fine. These are tests I had done: Echocardiography (mitral valve prolapse which is very small and they said I cant have any symptoms from it), thyroid tests (all good), blood tests (all good), 8 EKG (all sinus tachycardia, heartrate varies from 105 to 130), 2 stress tests - all fine except synus tachycardia and 1PVC+1PAC (I was anxious so resting heart rates were 110 and 130, BP 130-80 140-90, HR reached 170 and 180). My relaxed BP is 120/70. So cardiologsists said dont search for anything just live your life or try pscyhologist. Psychologists said I just need to live my life or try cardiologist again. Is it possible it's all anxiety? I can't live normal life, I feel like 80 year old grandma inside young male body. My symptoms started to appear when I was 19 and I had huge amount of stress constantly for a year.
10 Responses
Avatar universal
You are young, and though males have statistically more heart problems than females, your risk of heart disease is very, very low at this point.  You have had extensive testing of your heart and circulatory system, and you are healthy in that department.

The general tone of your post suggests that you do indeed suffer from fairly severe health anxiety, with amplified attention to insignificant bodily 'noise,' so to speak.  

If you do not wish to spend the rest of your life as a prisoner of your fears, I strongly suggest you seek treatment from a psychiatrist who specializes in this problem.

There is help for you, but you have to ask for it--and then accept your doctor's advice.
Avatar universal
I'm sorry to hear all that you are going through. I am a 40 year old male and experience a lot of the same symptoms you do.

I have panic and anxiety disorder and health anxiety. I am very aware of any body noise and I can become obsessed that I am going to die from PACs.

I have had all the tests over the years and several ER visits and they all say the same thing.  "Yes you are having PACs. Sometimes a lot of them but your heart is healthy so you need to learn to deal with them ". I find mine come on at the most stressful times in my life.

I also find that as I become fixated on my PACs my anxiety goes through the roof and I slowly become fatigued and totally worn out.

What you are experiencing is extreme anxiety over your non life threatening heart condition. If you don't seek treatment it will deminsh your quality of life as it has already.

This won't get better over night.  But you have to accept your health is fine and your anxiety has taken over your life.

You have to admit you are helpless to the situation and seek professional help and possiblly get on some meds for a little just to gat your mind focused on the therapy.

I'm in the same boat with you and I know what a struggle it can be. Please feel free to nessage me anytime if you have any more questions
19745875 tn?1483638911
Sorry to hear about your struggles. Unfortunately I can relate. Being an anxious person and having symptoms escalate because of your anxiousness is absolute hell. Best thing I can tell you is to try and live through them as normally as possible. It is not easy, especially when the symptoms (such as PVCs/PACs) come in swarms. I just had an episode earlier as I was leaving class. Started having PVC's and went into a full blown panic attack. Tried to drive home on the highway and was just a panicked mess with frequent ectopic beats. I often feel terrified and overwhelmed after episodes like that, but as I said, life goes on. feel free to reach out if need be. It's helpful to vent to someone that understands.
Avatar universal
First of all, I thank you for your support, thank you for reading and understanding my problems and for your honest opinion, I appreciate that a lot, thank you thank you thank you!!! I remember myself few years ago when I was able to work all night and then without going to sleep I could play soccer for whole day and it was always fine. I was able to do everything that young people are capable of doing like walking tens of kilometers, working 24/7, I was junior world chess champion, one of the best students in the university, had a girlfriend, lots of friends etc. and then just like that it all switched to nigthmare, I dont have anything now, it's all lost. There are few things that do not give peace to my mind:

Exercise intolerence: how is it possible that 22 year male (which is his prime years) can get out of breath only by taking shower and walking a little bit. My heart rate can get up to 150s 160s and higher just by making easy gymnastics for 1 minute. I can't stand still for longer time, I get so dizzy after standing only for 3+ minutes. After any exercise when make HR comes back to normal I get lots of ectopic beats. I agree that I have anxiety but I should be able to to walk long distances, I should be able to to stand for as long as I want even if I do have severe anxiety. I wish I never did read about POTS because I got lot of stress from it because - I did lots of my HR measurements with my iphone and my hearrate went from 80-90 (sitting) to 120-140 standing and then again it went down to 100s 90s after sitting down (I know that normal person would never do that, and they are not aware of their heart rates at all). I know I had 2 stress tests done which where totally fine except sinus tachycardia (anxiety can cause that, I agree), but there is no such a test like tilt table test here, and NO ONE knows anything about POTS in my country so I can't test it + my family doctor says that I have severe anxiety (I accept that). Whenever I read about POTS patients, their symptoms seems familiar. I remember the first year when I had this tachycardia all I did was walk walk walk, and whenever I had anxiety I would just go out and walk for hours. Now I think that I won't make it to the supermarket because that's too far away. Maybe that's because all I did for the last 2+months was laying in my bed, reading about different health conditions and walking 15minutes daily so I might be totally out of shape and maybe thats the cause of very high hear rates during the exercise. Maybe I just should ignore all my tachycardia and ectopics and just do lots of walking while I will get back into shape, but on the other hand this seems to be dangerous and those symptoms do cause anxiety + when I do feel tachycardia, diziness and ectopics it seems that I shouldn't continue walking. Conclusion: I know my anxiety can cause high heart rates but, I need someone to help me believe that this exercise intolerence, tachycardia upon standing, ectopic beats, diziness can be caused by my anxiety condition alone. Any opinion is appreciated.
1 Comments
"I need someone to help me believe that this exercise intolerence, tachycardia upon standing, ectopic beats, diziness can be caused by my anxiety condition alone."

Describing your symptoms again and again at this site will not help you.

The person you need is called a psychiatrist.  You have received plenty of advice regarding this, but it is the one thing you avoid doing.

What do you have to lose by talking this over with a shrink?
19745875 tn?1483638911
I second achillea, some therapy could be very useful for you. We can only do so much to help you here. I will leave you with this. The past two days, every time I walk to my car in the cold, I get 15 or so ectopic beats. It happened once, and now I anticipate this to happen and I work myself up enough that it does. Health anxiety and anxiety in general is a self fulfilling prophecy. I've been there, I've done it. I continue to do it. Your mind will make you believe anything and go as far as to give you the physical symptoms associated with whatever you're obsessing over. Perhaps in the mean time, until you find some help, you could ask a close friend or a close relative to accompany you on a walk. There will be a safe person there to distract you (hopefully) and if nothing else, someone to help you should you feel you can't walk anymore.
1 Comments
This is SO true!  I was diagnosed with PVC's back in 2007 and for 2 years thought I was dying every single day and the PVC's wouldn't let up.  I finally believed my doctors and guess what....they didn't go away but they lessened and I was able to function normally.  I have now been dealing with some other issues and my anxiety has come back doublefold but I am determined by God's grace to get it under control....again :-).  Therapy is warranted and will help tremendously!  
Avatar universal
I agree that your symptoms do sound like POTS however anxiety and panic mimic so many of these symptoms.

First thing is stop looking at the internet. This just puts you in a fear, adrenaline fear cycle. It does not help your condition only makes it worse.

It is common for your body to have a high heart rate due to you being sedatary for such a long time. Your nerves are hyper sensitized right now. You expect your heart rate to go up when u stand. Your adrenaline glands are more sensitized and firing off due to your fear. You live in fear constantly all day. This WILL make your heart rate go up, you will feel dizzy, tired and feel like you can barely function.

When I was 23 I had a horrible bout of panic for several months.  My heart rate would go up to 130 140 just upon walking. I was dizzy and tired and felt like I could barely function. I got phyciatric help and the symptoms began to deminsh and after 2 months I began to get my life back. I was just like you and I don't have POTS.

You need to go see a psychiatrist and begin working on healing. I promise you will begin to feel better. In doing this you will be able to manage your life better. You symptoms will slowly begin to heal.

But as long as you stay at home avoiding, fighting your symptoms, reading the internet, living in fear your symptoms will continue.

Look at what you are doing now.  It isn't working. You need to begin healing your nerves. I'm just reading your post we anxiety sufferers can feel your fear and anxiety.

You have a problem and it is fear and anxiety. There are plenty health professionals out there that can help you. It's time for you to get your life back. You can learn to control how you react to these symptoms.

I urge you to see a psychiatrist and begin the healing journey. Please keep us updated on your progress.
Avatar universal
Also get the book Hope and Healing forYour Nerves by Dr Claire Weekes. It explains exactly what you are gong through. If you can't afford the book message me your addesss and I'll send you a copy. It will change your life.
1 Comments
Thank you for your encouraging words, I am so glad that someone had same symptoms and he worked it out. I accept I have severe anxiety, I have to stop measuring my HR every hour and I will give my best to get my life back. I will keep you updated every few months in this forum.
Avatar universal
By the way guys, till I am getting psychological help, do you think I should ignore my HR of 130-150 when I am gently walking in the garden? Whenever I used to measure it shot up from 130 to 150 (or even higher if I felt anxiety about it) but I am not feeling this HR at all and I am not fainting, it's just that I might be a little bit dizzy. What makes me happy is that sometimes (usually in the evenings) I can get HR of 95-105  when walking, but when I wake up in the morning it shots to at least 140s upon walking but I don't feel heart palpitations. When I sit however it get's to 100s in a matter of seconds and I usually get around 5 ectopics upon first minute (I learned not to care about those). It just seems that If i don't mind that heart rate I could walk a lot longer, because I am not fainting or having any pain but I am afraid that my heart is telling me to get rest  because of that high HR eventhough thats probably how I lived my last 2 years without knowing it.

p.s I am seeking psychological help
3 Comments
Yes, you have anxiety. But, you absolutely have all the symptoms of POTS syndrome. The sweaty hands are from pots, not anxiety. Your heart rate shoots up when you stand, this is a real medical condition, not something in your head. The test for pots is called the tilt table test, have that done. Anxiety & pots are two separate issues, both can be treated & you can live a normal life.
UPDATE!!!: Actually I am better last 2 days. I am standing up like a man, I will said to my self I will keep fighting, I drop away bad thoughts, I know that if I start to help my self then God will help me too. I am doing very very simple exercises like gentle walking for 10 minutes 5 times a day and I feel better. 2 days ago I had severe anxiety and I had at least 1000-1500 ectopics in that day, HR of 140 on standing but last 2 days I felt not more than 100 ectopics. I have no more sweaty hands, my hr at standing up sometimes was only 105-115, but If i start measuring it it skyrockets to 135+. I still have hope guys that it's only anxiety, let's hope I continue to improve.
I don't see the point of taking tilt table test, because even it's POTS, I will still have to do same things I am doing now, also we don't have any doctors who are familiar with POTS here. If I can get so fit that I keep my HR lower than 110s or 120 upon walking and doing simple stuff, I don't see the problem, right? I am just trying to focus on positive things, and I hope it's was all due to severe anxiety and bed rest for 3 months.
Avatar universal
I understand some of the things you're going through. I suffer from pvcs as well. I think they are mostly likely caused from an extreme panic/anxiety attacks I had last month in January about not being able to get in touch with my mom. Since then they've been coming and going in waves. It's totally annoying.
1 Comments
I do not think you need a psychiatrist. Whats happening to you is real,   I would suggest an electrophysiologist cardiologist, not a regular cardio doctor. My heart rate goes from 40-to 130's also and regular cardiologist was no help.  I went to an EP cardiologist who recommended a cardiac ablation, but the day I went in for it my heart was behaving perfectly, so I couldn't get it done.  I am waiting for it again right now.  Best wishes.
Avatar universal
I'm a similar age to you but female not male.
I've been having the same issues as you for a few years, too.
Everyone keeps saying POTS, but, health care here (UK) refuse to diagnose me with this.
I also don't think it is actually pots, as it's way way worse in the morning and during the day, and totally calms down most evenings. Normal standing pulse of about 100 instead of what it's like during the day (120-150 standing). If I had proper POTS, it would be in effect all the time, not pick and choose when it's in effect... if that makes sense.
x
6 Comments
Thanks for your comment. I have few questions for you. Are you able to work? How long do you walk with such a heart rate? Are you able to fully take care of your self with this condition (going to shop, working studying, cleaning house..)?
It depends if I'm having a bad day or good day I guess.
But in general if I'm out walking I often need to stop or sit down. Uphill is a real struggle and I'll avoid it where possible as my heart goes so fast and then I'll get a few ectopic beats/PVCs. If I'm walking on a flat/down hill then I can and I do, but my heart is still fast, and I still need breaks.
No I don't work I'm a stay at home Mum. Putting that aside, I don't think I'd cope with work unless I can be sat down to do it.
Yes I can look after myself but I'm very thankful to have a husband who does a lot for me. When he's at work I just move at a slow pace, and only do what I NEED to do (stood up and moving around I mean).
I typically feel better in the evening. Less anxious, and more able to do things. It's odd, the morning is the complete opposite usually.
But I have some days when my pulse is high lots, and I get lots and lots of ectopic beats/PVCs. And then I'll have other days when I only get 2/3 ectopic beats/pvcs and my heart is on the calmer side.
I hate bathing/showering as it always triggers my heart. Not sure why.

I've previously taken the lowest dose of beta blocker and it worked.... made me have a normal pulse, no ectopic beats/pvcs, anxiety vanished, it was great. But when they told me my pulse was going to 40 when sleeping, it made me worry, so I came off them.... silly really.
I want to go back on them now but as I'm pregnant, I refuse to. It'll have to wait until the baby has been born.

I've been told my heart is structurally normal. And I don't feel this is POTS despite having lots of symptoms... because it's not constant, and the days do vary. I don't know, it just doesn't seem to add up. My instinct is telling me that my autonomic nervous system is a little off... and seeing an osteopath or chiropractor may help re-align and calm things to help it stop and be normal again. But again, I can't do this until I've had the baby.
I think perhaps our adrenaline is just super sensitive and swims out just because we are standing and walking when it shouldn't be so reactive? Hmm.

x
Wow, you really have symptoms similar to mine. I live with my mom too, but right now she is thinking that I am pretending to be ill so she is forcing me to be the *MAN, saying I need to go to the army and even considering kicking me out. If that happens I have no idea how I could survive on my own because I literally can't do much at all. For couple of days I might feel better, get optimistic but next day I can't do much at all. Even every time I have to get up and go to the toilet I am preparing for that tachycardia. It really ***** when it feels  like 150s or 160s. What I also noticed that if it's let's say 100s or 110s upon walking then those are strong beats, but when the heart rates are high it seems to be lots of weaker beats.

I investigated A LOT and besides POTS we could have few other things like severe anxiety which lays in our subconscious. Also adrenaline rushes seem to be a problem for us too (but again, we have good thyroid tests). When I had stress tests done, my BP seem to go up which is not so often in patients with POTS. I also have a problem of thinking about my life and symptoms over and over and over again and trying to think what's wrong and how do I help my self. I believe that our parasympathetic nervous system is messed up a lot and that might be the cause.The problem is that I am right now in such a condition that I feel I am not ready to go for a tilt table test. Also let's say the doctors agree that you have POTS, and then what? There is no cure, there is no help, you just have to change your life style which we are already doing. We have to keep fighting somehow...

I have this tachycardia for 2.5 years but first year I could do lots of exercise, I would play basketball every day all day. Then I got sick, couldn't workout for 2 weeks and BOOM I could not keep up with my exercise routine and eventually I had to quit it. Since then I have these POTS symptoms, but for 9 months I was able to work without noticing ( I am a teacher) that I feel bad only after standing up. There were times when I needed to stand for 6-8 hours straight, and I felt soooo dizzy, that was a nightmare. When I came back home after work like this I had A LOT ectopics beats in the first hour. And for the last 3 months I'm staying at home trying to get back but...

It's really good to be able to exchange opinions with someone who really understands feels symptoms that you feel. I really wish you the best with your baby!
It's usually like this: sometimes upon walking I can get HR of ~95 and I think, hey it's only in your head, wow I feel great! And the next time you get hr of 140+, dizzy and tired, can't do much and you think damn, what is wrong with me. And I was really thinking about the triggers and I can't understand them because sometimes even when I am angry or anxious I can get low HR upon walking and sometimes I can get high HR when I am very positive and happy. That's why there is hope that we don't have POTS since your symptoms are different on different days too.
Yes! It's really odd isn't it. It just can't be POTS, it doesn't make any sense. I think it's an imbalance in our systems or something.

My triggers seem to be standing up, walking, uphill, taking a hot bath or shower, etc. (For the PVCs)
And then triggers for the tachycardia seem to be the same but also if I eat loads of sugar (stimulant I guess) or if I panic or feel anxious etc.

I can have a really good day where my mind set is like "you're fine, there's nothing wrong, you can do this! Shrug this off because you're totally fine.." and I'll have positive thinking. But then a few days later I'll have a really fast heart and the damn PVCs for no apparent reason and my mind set will be back to "what is life... this *****, I hate my body" etc. It's horrible.

I'm sorry your Mom is being that way. That's not fair atall. I'm sorry. Have you tried explaining everything to her and having a proper conversation? Hugs to you.

I thought I was the only one going through this exact thing.
Oh and also, my blood pressure goes up slightly upon standing... that to me doesn't say 'POTS'...
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