Rapid heart rate and doctors stumped: any CC ideas?

Parent Cafe
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I ended up in the ER again last night because I had chest pain (more pressure than pain) and my heartbeat was extremely irregular. Luckily, it wasn’t a heart attack or blood clot but the ER doctors, my cardiologist, and my PCP are all at a complete loss. So, I know it’s a long shot but I’m throwing this out there to see if the CC hivemind has any ideas.

I was diagnosed with lupus and other overlapping autoimmune diseases in February and began treatment right away. Around May, my heart rate jumped up to the 140s for no apparent reason. None of the meds I’m on should be causing that.

They put me on a 48 (72? can’t remember now) hour holter monitor and it came back normal other than my heart rate ranged from 110s to 170s even though I was on bed rest for the duration. I was put on a beta blocker and my heart rate went down to the 110s. We tried a different beta blocker and the same thing. Tried upping the dose and my blood pressure went way too low so back down the lowest dose possible.

About 3 weeks ago, I finally got into a cardiologist. He put me on clonidine to try and lower my heart rate overnight. In the morning, my heart rate is in the 90s but it quickly rises back up to the 110s. He ordered an echocardiogram which came back fine.

I have heart palpitations every day. When I lay down, I can often hear my heartbeat and see my heartbeat through my shirt. Standing up makes me really light headed and sometimes my vision blacks out.

At the ER, my heartbeat was jumping all over the place between 90s and 130s but the sinus rhythm (I think that’s the right term) was normal. EKG was normal. CT scan and ultrasound (leg for blood clot) were normal.

I’m following up with my cardiologist but I figured reaching out here couldn’t hurt (especially since CCers were right about both my gallbladder disease and lupus before the doctors caught on!).

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How’s your thyroid? Maybe Graves’ disease ? Dehydration ?

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@carolinamom2boys thanks for the reminder! I meant to include that.

The ER doctors kept saying they were going to test my thyroid but I don’t think they ever did. My mom has Graves’ and my TSH levels get checked every 6 months or so. They’ve been fine thus far but I am sure my PCP will order a blood test ASAP if the ER docs didn’t.

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I was also thinking dehydration may be playing a part. My mother has several autoimmune issues and has experienced many of the same symptoms that resulted in a hospitalization. After testing ruled out a multitude of causes, the symptoms were chalked up to dehydration. Try to really up your fluid intake and see if that helps. Feel well!

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medical diagnosis via the internet…oooh, you are sensible enough to be careful, but…

thyroid
dehydration

but also, have your magnesium levels checked…

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I would ask for possible tick bite test. My husband contracted Ehrlichiosis from a tick bite, and his heart was racing…had doctors stumped even though we told them about the tick!

http://www.cdc.gov/ticks/diseases/

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My brother (70 y/o) had the same symptoms you did, and did eventually pass out one morning where he was volunteering. They put him the hospital (at the Texas Medical Center, so no rural community hospital) for three nights, ran every test imaginable, and finally determined he was dehydrated. This is a guy who does have cardiac issues - had a stent put in when he was in his late 50s, so they did the whole cardiology work up on him. He has been a huge iced tea drinker for as long as I can remember, and evidently, he reached a point where he wasn’t drinking enough water (really, iced tea was the only liquid he was drinking) and those symptoms hit him.

I’d also add potassium to the list of asking whether it’s been checked; I ended up in the ER one time when my potassium was low and was told it happens to a lot of people. And there’s always the possibility that one of the meds you’re on for your autoimmune disorders could be at the root. I am one of those people who has the odd drug reactions that are at the bottom of the prescription disclosure. Otherwise, I’d ask for a second opinion from another cardiologist. Are you near a major medical center?

FWIW… when I had sepsis (you obviously don’t have that), my heart rate was in the 130s-140s for several days, and it was a miserable feeling. I really hope you can get to the bottom of it!

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Maybe its love. Your heart is racing.

Do you have chills? Are they multiplying?

Do you find yourself losing control?

or it could be those serious things everyone else mentioned. Fortunately for you, laughter is the best medicine. You are welcome. :wink:

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Greenbutton, no worries. Not looking for a diagnosis, just anything that my docs might be missing. I learned long ago that doctors are human too :slight_smile:

The dehydration is an interesting thought. I was hospitalized with dehydration back in late July/early August. It wouldn’t surprise me if it happened again but it does leave me wondering why the heck that is happening. I drink water all day because I have dry mouth from lupus and the meds.

Thanks for the laugh, torveaux :). Luckily I have been keeping a sense of humor through all of this.

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Oh Romani…You have been through so much and now this.

I can tell you what happened to me and my heart rate (and still is to a lessor degree), but please don’t take this as medical advice. I will tell you my story just in case one of my issues leads you to a solution.

  1. Dec 2012 led a normal junk food always got my shots life. I had a tetnus shot combined with whooping cough and to this day certain preservatives cause my heart rate to soar (usually occurs a couple hours post ingestion). Best list would be to look at the European E 200 food additive list.

  2. April 2012 had a CT and reacted to the dye (Omni Pacque 300 or 3000?) I developed what they call POTS postural orthostatic tachycardia syndrome - which is neurologic not cardio. I lost 23 lbs in 3 weeks from my high HR. Have them test your blood pressure from a lying to a sitting to a standing position and there is a formula of bp rise/drop that will help rule this in or out. I spent almost 6 months having my heart rate go crazy from things like standing in line at grocery store or washing my hair. There is a risk factor for a cardiological and or neurological side effect to the Omni Pacque.

This gets more complicated as it is believed that the CT dye reaction set off my mast cells to a mast cell activation syndrome. This is an interesting one to look into as it can trigger autoimmune diseases. For a time my body thought everything going into it was a histamine. (including allergy drugs) If you are early on in this they might be able to test your cyptase levels.

I have to control my food histamine intake, be very careful about food preservatives, etc. I react not to the drugs / supplements they were giving me, but to the additives in those drugs. I can only take single dose vials and at the dentist I need a novacaine with no epi.

  1. June 2012 I had neck surgery and had the joy of having a code blue called to my room. Potassium level was dangerously low, thyroid level had suddenly dropped to almost zero, I was reacting to the preservatives in the drugs used during the procedure. During my quest to understand what was happening, my doc had a genetic test done to determine how my body metabolizes different categories of drugs. (see cytochrome P450) It turns out my body is a poor metabolizer of CYP2D6 drugs which includes many used in and post surgery, fentanyl, morphine, hydrocodone, etc.

Def have your thyroid checked and maybe even your potassium and def keep up your positive attitude.

Hugs, Kajon

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a shot in the dark
postural orthostatic tachycardia syndrome
.
http://www.medicinenet.com/pot_syndrome/article.htm

I see kajon mentioned it.

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I vote for Graves or thyroid, but I’ll also ask about stress and caffeine just in case?

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Caffeine, other foods? I know if I eat much chocolate my heart rate rises and I have trouble sleeping. Happens with pizza too. From what you’re describing though, it doesn’t sound like a food phenomenon. I don’t suppose there could be something in the water that your drinking? Seems unlikely.

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I also thought POTs after thinking more about it. A friend’s daughter has it , and while she drinks water regularly , it seems that she only is able to remain hydrated through regular IV fluids .

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A couple of things to consider…birth control pills, and marijuana. Google them, if you haven’t already, both can definitely cause high heart rate and palpitations. Marijuana has carcinogens, and apparently causes a 5 fold increase in heart attacks within the first hour after smoking, due to the palpitations, heart rate increase, and arrhythmias.

With all the things you’ve been experiencing, have you been tested for mercury poisoning? Do you eat shellfish, and other sorts of fish? Trace mercury is often in water. A woman that I worked with said that she almost died because of mercury poisoning. She had terribly high blood pressure. Apparently toxic molds and heavy metal poisonings are supposedly part of the picture with Lupus.

I had palpitations starting about a year ago, every time I laid down. It kept me awake, woke me up, drove me crazy. It wasn’t a high heart rate, but I could feel my heart pounding hard enough to keep me up. And I don’t like being kept from sleep! I found one thing that helped a lot was propping myself up on two pillows, and not laying down too flat. Even though they did all the heart tests, they found nothing, but it still happens every now and then. Only when I’m lying flat.

So when this happened to me, I just tried to take everything out of the picture, because nobody could figure out what the problem was. I stopped drinking coffee and wine :open_mouth: , stopped taking all my supplements, bio-identical hormones, and birth control pills. Lowered stress as much as possible, tried to stay hydrated, eat well. Just took everything out of the picture that could possibly be a problem. And you know, they mostly went away after a bit. So then I started adding things back, slowly. Started with coffee (yay), and a glass of wine, you know, the important stuff. It seemed like one of my hormones was a problem, so when the palpitations came back, I stopped taking that one.

However, your problems seem far more complicated than mine. I just had one issue.

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Just to answer a few questions:
-I’ve been on birth control for well over a decade. I haven’t been on pills in about 4 years though. I can’t go off BC because of cysts.
-I haven’t used weed since school started over a month ago and I have been upfront with my doctors about my use of it.
-I’ve eaten fish only once in my life.

I haven’t drank alcohol in well over a month.

I do drink a lot of pop but I have been cutting back. I don’t drink coffee or anything else with caffeine.

POTS is something that’s been mentioned to me by more than one person. I did tell the doctor about the lightheadedness when I stood up and when they lowered my bed at an angle to do the ultrasound of my leg.

Also, my blood tests came through my portal. They didn’t test anything related to my thyroid. >:P

I love my UMich doctors but their ER leaves something to be desired. Unfortunately, my other hospital options are far worse and they don’t have all of my medical records in their system. :frowning:

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That rules out a number of things, but have they done heavy metal testing on you? I believe you can get Mercury poisoning even if you don’t eat fish. You just have so many symptoms that they can’t figure out, and the high heart rate is alarming.

It seems at this point that they should just run tests for everything and anything, instead of hoping to happen upon the problem, like they usually seem to do!

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you should be able to call your pcp in the morning and have them put in a lab order for your thyroid…Saves on a doc visit.

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And do you have Hashimotos disease, or only Lupus? Cuz some of the things you’ve said sound a lot like Hashimotos.

Sorry I can’t read your response for awhile, time to sleep!

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As of now, only lupus (and RA and fibro and secondary secondary Sjögren’s… I think those are my only official autoimmune diagnoses). My mom has Graves.

I’m looking over my previous test results and did have something catch my eye. I had a slightly elevated Thyroid Peroxidase Antibodies result in February. My result was 39 IU/mL and standard is < 30. Thyroglobulin Antibody test was negative though.

My last TSH test was in May and I was smack in the middle of normal range.

I want to go in to see my PCP anyway. I can ask her about the metals test. She’s very good about taking suggestions from me because she is as lost as the rest of my doctors and she’s followed me down every rabbit hole I’ve brought up.

And tonight I have a fever which may be related, may be something completely unrelated. :-??