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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Palpitations And Abnormal Fatigue?

Hi ! My english is not good, i'm a french canadian from Québec.
I'm a 30 years old women. I can say that I am in good health but have malaises since i'm like 15-20 years old. Lightheadness (like bizarre vision), abnormal fatigue, eat intolerance +++. When doing physical efforts, I can feel bad for a few hours after, extreme fatigue, I need to rest absolutely. I eat great, drink a lots of water. Last year I pass a test (MAPA) to mesure my blood pression for 24 hours. It looks ok in the day (like 110/80) but at night it drops a lot. I didn't really sleep the night I pass the test because it was inconfortable, and it drops at 70-80/50 when I was pretty relaxed. So i said to myself that when I sleep profondly, maybe its dropping more than that ? And sometimes, when I wake up in the middle of the night and have to go see my son or go to the bathroom, if i'm not really good awake when standing, I experience BIG malaise. At firt, i was thinking about the too big drop in blood pressure since it is really low. BUT it's not just that. When I stand up (even if I take my time) I feel like i'm weighting like 300 pounds and my breathing is not great. My heart goes REALLY fast (it must start at like 40-50 BPM then goes to 100 and ++ BPM just to sit in my bed) and when I return in bed after and sit it takes like 5-10 min. to my heart to re-ajust and I'm feeling that i'm gone to die, my heart is not going ok at all, it's difficult to breath normaly, I've taken my pulse and my heart is going crazy and not beating regularly or normaly at all, become nauseus and bizarre in my stomach and intestins. It's like my heart have a lot of difficulties to re-ajust after that and makes me feel really bad. I'm really afraid that I have something wrong with my heart since I have a lots of problems exercising too for so many years. I've take the stress test last year too. It take like 10-15 min. my heart was up to 190 BPM and everthings looks normal but he writes : sinus arrythmia... something like that. The doctor I consult after said it was normal at that rate (190 BPM). Now, I would like to take the holter test too. But I don't have those malaises at night everynights... But for the exercising, it's since I'm a teenager I have problems. I don't smoke, i'm not overweight (135 lbs.) I lost a lot of weight in the past (was at 210 pounds at the age of 12 and lost a lot of weight at 14) and it's mostly after that that I became to experience more problems with exercising, malaises etc. I was back to 200 lbs at 20 and now, I have a stable weight since 4 years. But I remember at the age of 10 doing a marathon at school and have ALOT of difficulties finishing it and recuperate after. I've take many blood tests that was all ok.
And for the big malaises at night, it happen too when I drink alcool. Just changing positions in the bed makes me having palpitations and feeling real bad !!!! So I don't drink anymore or if I want 1-2 glass of wine I take it at like 6-7pm. and not before going sleeping. I feel like i'm 80 years old and feel very very handicaped by this condition. Do you think I can have a problem with my heart ? Do you think that if I have a problem it would have show at the effort test or not ? Thank you and very sorry for my english.
Wed, 28 Jun 2017
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Cardiologist 's  Response
You clearly have a difficult and frustrating problem. Problems with blood pressure and high heart rate are not uncommon. When they occur in young people, they are often discounted because everything is normal while you are flat on an exam table. This leaves you frustrated and still uncomfortable. What you are describing sounds a great deal like a disorder of the nerves that control blood pressure. It can occur for no good reason or sometimes after viral illness. It is called postural orthostasis tachycardia syndrome (POTS). There is no easy fix with diet or exercise. Discuss the possibility with your doctor. Sometimes, the symptoms can be recreated with something called a tilt table test. That is not the purpose of the test but if your symptoms are recreated with a lowish blood pressure and high heart rate, you have evidence. Your doctor can suggest medicines that may help or have you see a specialist.
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What Causes Palpitations And Abnormal Fatigue?

You clearly have a difficult and frustrating problem. Problems with blood pressure and high heart rate are not uncommon. When they occur in young people, they are often discounted because everything is normal while you are flat on an exam table. This leaves you frustrated and still uncomfortable. What you are describing sounds a great deal like a disorder of the nerves that control blood pressure. It can occur for no good reason or sometimes after viral illness. It is called postural orthostasis tachycardia syndrome (POTS). There is no easy fix with diet or exercise. Discuss the possibility with your doctor. Sometimes, the symptoms can be recreated with something called a tilt table test. That is not the purpose of the test but if your symptoms are recreated with a lowish blood pressure and high heart rate, you have evidence. Your doctor can suggest medicines that may help or have you see a specialist.