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What Causes Anxiety With Increased Heart Rate?
Question: hello I wanted to ask a second opinion from a cardiologist on this website .
I started having anxiety 2 months ago with high heart rate through out the day around 90-100and walking around it was at 110 and up to 130 it was very bad , I had ECG and echo of the heart, holter monitor for 30 days and blood work all came back normal during sleep my heart rate does go down to 60 and 50 which is good , but I have a few question past two weeks it's been getting a lot better, heart rate at rest in 80s and 70s but up on standing it jumps to 110 then slows down to 95 just standing still and as soon as I start walking around its at 110 even walking slowly doing house work like cleaning it could be at 130 , what's a normal for standing still and what's too high and also I heard that walking around the house heart rare should be at 70-90 mine is way higher then that , the doctor did give me metaprolol to take when needed but I naturally have low bp so I don't want to take a bats blocker because it lowers the blood pressure even lower , how long does it take and how high of heart rate would gave to be at to cause any damage to the heart ?
Brief Answer:
please see details
Detailed Answer:
Dear Madam
1. Normal range for resting heart rate is 60-100 beats per minute but not everybody having heart rate outside this range is abnormal. There are wide variations and unless you have some trouble/ symptoms because of your heart rate, it is considered normal for you.
2. Since your heart rate used to be normal during sleep but high during awake periods and exertion, that basically tells that your episodic increased sympathetic drive is responsible for increase in heart rate during day. This may occur due to anxiety, low hemoglobin, postural hypotension syndrome and a weak heart. Sincere your ECHO and blood tests are normal, postural hypotension and anxiety are two candidates. Postural hypotension is excessive fall in blood pressure on standing (more than 20 mmHg fall in systolic BP after 1-2 minutes of standing). Some people have a variant called postural orthostatic tachycardia syndrome, where fall in BP is not prominent but heart rate increases excessively on standing. I hope your physicians must have looked and examined for them.
3. Usually this kind of episodic excessive heart rate does not damage the heart. For heart damage the heart rate should be continuously high and mostly it is not normal sinus rhythm
Hope this answered all your questions. Let me know if I have missed out any of your questions. .
sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Prasad
Thank you , I have a normal sinus rhythm as it showed on the 30 day holter the doctor said he is considering doing a tilt table test, I did not have a fall in bp when stading up I tried it at home I do have a bp machine but my heart rate does go up from 80 sitting to 110 ammidetly after then about 20 sec after drops to 100 and as as soon as I start moving then it goes up to 110 does this sound like pots syndrome ? and what is the treatment for this syndrome ? and I'm constantly on my feet I hav two kids so it's around the 100-110 through out the day so that makes me worried that my heart is over working. One more thing at times it feels like its beating loud and hard not fast just hard is that as bad as fast or no ? I bought some compression pantyhose and they seem to help a lot with the symptoms of waking around , if so does that mean its a pots syndrome? And is there any side effects of wearing the compression nylons for too long and risks with that ? Thank you
Brief Answer:
please see details.
Detailed Answer:
Dear Ma'm
1. A TILT table test may show a fall in BP or increase in heart rate with tilt. This will help us understanding your reaction to standing and possible cause for your symptoms. For diagnosing POTS the heart rate should go up by 30 beats per minute from the baseline after standing 5-30 minutes. There should be symptoms for more than 6 months and other causes like heart diseases, dehydration and drugs like diuretics or BP lowering drugs should not be there. Your description is not typical for POTS but it may be a milder variant.
2. The treatment for POTS involve adequate salt and water intake, avoiding dehydration, eating small meals, regular exercise and certain medications like beta-blockers. fludrocortisone, ivabradine etc.
3. Do not worry to mush that your heart is working excessive. It will be detrimental to your health.
4. At times when there is increase in pumping of heart (along with increased heart rate due to sympathetic activation), you feel the force. Since your ECHO is normal it is unlikely to have organic basis.
5. Since you have lesser symptoms with use of compression pantyhose, the likelihood of presence of some element of postural hypotension is there. This will be best decided by a physician and work-up requires a consultation with a neurologist or an expert in AUTONOMIC NERVOUS SYSTEM disorders.
6. Long term risks of compression stocking/ pantyhose relate to local skin reactions/ conditions mainly or if there is a heart condition where peripheral compression is contraindicated.
Overall, I would recommend a consultation with cardiologist and neurologist to assess autonomic nervous system. A TILT test is also a step in right direction.
Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you , I didn't understand when you said about wearing the pantyhose for a long time if I have heart desiase it's not good for you to wear them ? and what other test should I mention to my doctor that he should consider ? And what is a normal heart rate for waking aroung is it true that islt is suppose to be 70-80 ?I did some research on nervous system disorders and they are pretty scary and some are even life threatening , is that true ? What are symptoms of nervous system disorders ?
Brief Answer:
please see details.
Detailed Answer:
Dear Ma'm
1. Compressive Pantyhose are to be avoided by those who have heart failure, uncontrolled high BP or anginal heart disease which you do not have.
2. They will decide the further tests after having a look on your TILT test. The neurologist may like to assess your autonomic nervous system through variuos tests after the clinical examination.
3. There is no single normal heart rate at time of awakening. Sometime when we are woken up suddenly or we woke up in a particular kind of sleep (i.e. REM sleep) we may have very high heart rates.
4. Please do not try to master the medicine by searching on net. You will get more confused than being "wise". Try to restrict your search to the particular condition which is proven in your case. Else, you will drown your self in a sea of "possibilities". The best person to clarify your doubts will be the man who will treat you. So have patience, do not lose heart and wait for your consultation.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello today I have had an episode of fast heart rate of 160 only for about 5-10 min the. After that I took 12 mg of motoprolol and I went down but my heart rate has remained at 100 all day Because I have been stressed about it what can I do about it when it's at 100 all day and at rest ? Is that bad for the heart
Brief Answer:
please see below
Detailed Answer:
Dear Ma'm
Since your holter monitor for 30 days was normal (during which I hope you had many similar events), the likelihood of this event (with heart rate 160 bpm) is less likely. You were anxious and this anxiety led to heart rate of 100 bpm. Such episodes of rise in heart rate that too of about 100 are not likely to cause heart damage. As I explained in my previous answers for "Tachycardia induced cardiomyopathy" the heart rate should remain constantly high and mostly it is an abnormal rhythm. Try to relax and do not let your anxiety be the primary cause for your bad health and bad quality of life. We all know life is unpredictable but that does not mean that we should be worried about its unpredictive nature constantly.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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