Ongoing Heart Rate Concerns: Seeking Answers
Demographic Information: 22 years old, female, height 5'8", weight 170 lbs. Current Medications Include: Vyvanse (10 mg), Lexapro (5 mg, taken twice), Blisovi Fe, Metformin ER (500 mg), Famotidine (40 mg, taken twice), Evening Primrose Oil (1300 mcg), Vitamin B12 (500 mcg), Vitamin D3 (25 mcg), Biotin (6000 mcg), Winlevi, Clindamycin lotion (1%), Tretinoin cream (0.025%). Medical Conditions Recorded: Generalized anxiety, ADHD, scoliosis, high cholesterol with elevated triglycerides, endometriosis, autism spectrum disorder (high functioning), polycystic ovary syndrome (PCOS), pectus carinatum, paroxysmal tachycardia (diagnosed by primary care physician), non-alcoholic fatty liver disease. For the past year or so, I have been experiencing chest discomfort following a COVID-19 infection. Last summer, I had an event monitor attached after my EKG and echocardiogram results appeared normal. The monitor revealed frequent episodes of increased heart rate, chest pain, and skipped beats during episodes of normal sinus rhythm, with reports of sinus tachycardia. In light of these findings, I discontinued Vyvanse, thinking the stimulant might be a contributing factor, yet I continued to face similar challenges. Recently, I resumed taking Vyvanse as non-stimulant options were ineffective. During my visit to a cardiologist, a more senior practitioner attributed my chest pain to potential arthritic changes in my sternum connected to my pectus carinatum, while attributing the other symptoms to anxiety. I presented him with data from my Apple Watch showing heart rates spiking from 150 to 190 bpm consistently, and I clarified that these increases occur solely during routine walking—I am not engaging in exercise. Moreover, I have begun to experience dizziness after standing for long periods during my work shifts, along with persistent chest discomfort. Recently, I've also noted throbbing sensations in my forearms near major arteries, which is concerning. Determined to find more clarity, I’ve scheduled an appointment with a different, younger cardiologist in mid-April. My mother, who is a nurse, suggests that I might need a beta-blocker similar to what she has been prescribed. What could be contributing to these issues?
Answers (1)
3/31/2025, 5:10:41 AM
OpenHealth AI
It sounds like you're experiencing complex heart-related symptoms, including rapid heart rates, chest discomfort, and dizziness. It's understandable to seek clarity about these ongoing concerns, especially given your previous COVID-19 infection and the various medical conditions you have.
Key Points:
- Your symptoms might be linked to a combination of factors, including anxiety, autonomic dysregulation, and potential physical changes related to your pectus carinatum.
- Monitoring your symptoms is essential as you prepare for your upcoming cardiology appointment.
Explanation:
Heart Rate and Symptoms: The high heart rates you mentioned (150-190 bpm) occurring during routine activities like walking can be alarming. Episodes of palpitations, skipped beats, and chest discomfort can stem from multiple sources:
- Anxiety: You mentioned generalized anxiety, which can significantly influence heart rate and perception of discomfort.
- Physical Factors: Your pectus carinatum may contribute to discomfort, and the sternum changes suggested by your cardiologist could also be a factor.
- Post-COVID Effects: Many people report changes in heart rate and overall physical sensations following a COVID-19 infection, often referred to as post-viral syndrome.
Next Steps:
- Symptom Monitoring: Keep a detailed diary of your symptoms. Note when they occur, their duration, and any triggers. This will provide valuable information for your new cardiologist.
- Hydration and Nutrition: Ensure you stay well-hydrated, especially if you experience dizziness upon standing. Eating smaller, more frequent meals can help manage any blood sugar fluctuations that may contribute to symptoms.
- Limit Stimulants: While you've resumed Vyvanse, be cautious with other stimulants such as caffeine. They can exacerbate symptoms of tachycardia and anxiety.
- Consider Lifestyle Adjustments: Practice stress-reduction techniques like deep breathing, meditation, or gentle yoga, which can help manage both anxiety and heart rate.
- Discuss Medications: Bring up your symptoms and the possibility of a beta-blocker with your new cardiologist. This medication can be effective in managing heart rate and associated symptoms.
It’s great that you’re taking proactive steps by seeking a second opinion. I hope your upcoming appointment brings you more clarity and a path toward managing your symptoms more effectively. If symptoms worsen or new symptoms arise, ensure you seek immediate help.
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