Rapid heart rate concerns!

[Jim2010]

Hi, Doctor. I'm 40 years old and until the last 5 years or so have always been very active. I had a pretty good scare the other night though. While simply sitting on my couch relaxing and enjoying a movie, my heart began racing. I had never experienced anything similar, at least anything that I became aware of. I tried to relax for a few minutes. I then stood to get some water and felt a little dizzy. After about 15 minutes, without improvement, I asked my wife to call for help.

En route to the ER, my pulse slowed and blood pressure began to drop. Within a half hour of the onset of my episode, my pulse had dropped from somewhere above 100 (didn't measure at onset) to the low 80's neighborhood and my blood pressure from 150 over 90 to 130 over 80 and within the hour to 120 or so over 75. It's typically in that area.

The doctor ran several blood tests, an EKG (or ECG?), took a chest X ray and monitored me for about 4 hours before getting my results. Everything looked completely normal except for high cholesterol and high triglycerides. No heart enzyme in blood stream. Chest great. Everything checked out fine, so he released me and told me I could resume normal activities but to follow up with my doctor. He said there could be any number of reasons for the episode but it could also be as simple as caffeine related or due to the large sugar intake from my admittedly overdone dessert.

Well, it's 4 days later and I've begun a new way of eating (reduced fats, sugars and caffeine...although I don't feel a Coke or two each day was excessive). Regardless, I awoke from a very realistic and stressful dream this morning to another rapid heart beat. No dizziness. Yet, another 15-20 minute session of the rapid heartbeat. I'm definitely experiencing anxiety about this second incident. Is this warranted? I know dreams can cause an elevated heart rate. Is it coincidence or more? I'm scheduled to see my doctor this week but am obviously very concerned. Is there something I should look for beyond my recent heart rate elevations to indicate a very serious heart condition?

Thank you for your thoughts.

Happy New Year!

[itdood]

Even if it was just plain 'ol sinus tach, what you had falls under the broad scope of being SVT.

The concerning SVTs are usually distinguished by abrupt onset and stop and have much higher rates then what you experienced.

It sounds like you ramped up to the tach then slowly came back down.  This would indicate a sinus tach SVT, which is almost always just a nuisance but should be evaluated.

Your BP responded the way it's supposed to.  Increase when rate goes up, decrease when it goes down.

If you felt the need to go to the ER, then I feel this warrants a consult with a cardiologist.  Begin with a visit with your PCP to see who they prefer to work with.  If the tach continues get an event monitor to further evaluate.  

*Do not* rely on an ER to diagnose.  They are there to keep you alive in an emergency to get you to the next step.  It's a triage step in the art of medicine.  I think most people get too comfortable with the ER's assessment and don't look further.

In the meantime research "SVT and vagal maneuvers" to see if these help while you wait for your PCP appointment.   Vagal maneuvers can stop SVT in its tracks if you hit it soon enough.  The trick with a vagal maneuver is to bear down hard for at least a few seconds, release slowly, and repeat until you stop the SVT.   Don't be concerned if you feel a sudden drop with tach while doing these, as a VM can have that effect even on sinus tach. There are various vagal manuevers to try, google 'em.

[cindy707]

Hi read your post Jim......sometimes anxiety is our worst enemy when something is going wrong with us and is cause because of the simple fact that we don't know why and that is why seeing your doctor is such a great idea on this.  The dizziness could actually have been caused by a little panic because of something you have never experienced before but they ran a good run of tests on you.  Just to be on the safe side i would ask your doc to refer you over to a local heart doc so that you can put this at rest.  As far as a coke/pepsi not being excessive drinking two a day that is not correct.  You may want to go on line and look up the ingredients and do a comparison of what one coke is equal to in terms of say versus drinking a pot of coffee or iced tea.  Because you were inactive on the couch has nothing to do w. what happened to you....or sleeping for that matter.....its electrical based if it is even your heart and if your tape the emt's put on you w. the ECG was clear and the doctors was clear i wouldn't worry too much about it because if your wife call them i am sure they got to your place within 10 minutes and had a tape rolling on you so they caught whatever it was fast.....as far as looking for indicators for more serious heart trouble....why look for trouble because the botton line Jim is when we have something bad going on with us we don't have to look for trouble because it finds us pretty quickly and lets us know it.  There are very specific things that we feel and experience when it is something worse and you'll know it....count your blessings because believe it or not you sound like you are in  pretty good shape here....when you feel dizzy make sure that you put your head between your knees until it passes which it will.....like Jerry said we are just a support community on this site w. varying degrees of PERSONAL experience to support each other and our professional backgrounds do not enter into this site which is nice rather than speaking in a language that no one can understand or have not personally experienced...that is why this is such a unique and wonderful site.....good luck Jim.....relax and don't look for trouble where there may be none and if there is your doc will let you know...smart man making an appt. so fast!!!!

[chuparosa]

Sounds like it could be svt. My svt is almost the same as yours. I've had two episodes where I was just sitting on the couch in the evening watching tv with my husband and had an attack but all my others have come when I was alseep. I have had svt start as a result of a freaky dream also but mine typically start with an ectopic beat. I don't ever get dizzy though.

I've had several doctors tell me to stop caffeine intake, which I did, but it has made absolutely no difference in my condition.

And there is no way you can't help but feel anxious when these things happen. Personally it has taken me years to not totally freak out.

Good luck with your follow up at the doctor.

[Jerry_NJ]

First, hope you are feeling better and second, this is a fellow-patient community/forum, and is not directly supported by medical people.  Collectively we have a wealth of experience and knowledge we share in an effort to help others decide what is best for them.  In most cases, one should discuss their symptoms with a medical doctor.

Sounds like you've made some good life-style changes, so the episode has returned one benefit.  You might try to drink caffeine-free cola, and decaf coffee if you drink that too.  I've been no the low caffeine regiment for years, no decades.

You may also want to take an aspirin a day as an extra safeguard.  Discuss this too with you doctor before taking it long term.

I think the signs are good, and from what you said you HR isn't dangerously high, over 200 say.  A resting HR in the 100 range is just a bit above normal - most are more like 70-80, some are much lower, of course.  

Try to be calm and optimistic/positive and carefully document your symptoms to help in you discussion with your doctor.