
Have Severe Sternum Costochondritis. Have Frequent Rapid Heart Rate And Pain. Fatigued, Nauseous And Feel Unwell. What Can Be Done?

1. Treatment of costochondritis involves use of simple pain relievers, rest, avoiding movements which provoke pain, use of moist heat (application of towel wet with warm water) and rarely local injections of steroids.
2. It is normal and common to feel forceful heart beat with increased rate when you suddenly woke up from sleep. This is especially true for early or deep sleep.
3. I hope your cardiologist have ruled out that there is any condition in your baseline ECG which predisposes you to rhythm disorders.
3. Most important factor in treating your episodic increase in heart rate is knowing the rhythm at the time of increase in heart rate. The management can only be decided after ascertaining the rhythm. The methods to determine the rhythm are ECG (at the time of episode), 24 hours holter monitoring (if the episodes occur daily) or loop recording for longer intervals (e.g. 30 days or more). Second important investigation is to see the structure of heart by ECHO.
4.If there is some other rhythm disorder or there is a structural heart disease, the treatment will depend upon the condition.
5. If the rhythm is simply a quickening of normal rhythm mechanisms (sinus tachycardia) and there is no structural heart disease, we look for other predispositions. These involve use of tea/coffee/smoking/drug abuse/anti-asthma drugs/ anti cold drugs/ over-treated hypothyroidism/ anemia/ significant lung disease/ Significant systemic disease. A cardio-pulmonary testing which involves exercise under controlled conditions with monitoring of heart rate, rhythm, oxygen saturation will also help in understanding mechanism behind your problem.
6. This is not likely to be due to costochondritis.
7. If you are really damaging your heart by exercising or not, is not possible to answer with the information available. This definitely needs your examination/ further work-up.
With this insight, you can discuss the case with your local cardiologist and proceed accordingly.
Feel free to discuss further.
Sincerely
Sukhvinder


1. If the SCS or "spinal cord stimulator" has not been placed properly, it may produce some effects on your autonomic nervous system in the cord. Autonomic nervous system influences your heart rate too. But it will not produce abnormal fastening of heart rate with activity alone. This is something not expected out of a mal-placed SCS.
2. You should seek the opinion of your cardiologist about this rapid heart rate. It does not seem to be related to costochondritis. This must be evaluated to establish a proper diagnosis. Once we know the cause, approaches to definite management can be tried.
Sincerely
Sukhvinder Singh

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