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Heart Rate goes up 100+ when I wake up at night, or during extended sitting


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I'm 46yo, 6'1", 220lbs, in relative good shape, a little overweight. I'm having recurring symptoms, which I am trying to find out if they are Dysautonomia related. I went to a Dr. Aziz Shaibani in Houston,TX that did some tests and they came back negative I'm on Multaq for AFIB, low dose Bystolic (beta blocker), and Xarelto for past DVT/PE blood clots. I use a CPAP/BIPAP machine for sleep apnea. I was disappointed with Dr. Shaibani since he just had an assistant run the tests and I was in and out of his office in an hour. He never talked to me afterwards.

My symptoms.....

I usually sleep on my back most of the night, due to wearing my CPAP mask. If I wake up during middle of night, and move around just a little. Like just move one of my legs. My Heart Rate shoots up to 100+ bpm! I use a Contec SpO2 device to measure my HR and oxygen levels. I also take my pulse and it also shows my HR very high. My HR spikes up to 100+, then eventually goes back down to normal in the 50-60's. This has been happening for a long time. Before I had my first AFIB incident, I was not on beta blockers and my HR would shoot up to 130+bpm. This eventually caused me to go into AFIB one night. If I sit for extended periods at work, or if I lay in my recliner at home for awhile, and then get up quickly, I get major palpitations, and my HR shoots up 100+bpm.

This all started happening several years ago or longer, from what I remember. Some nights are good. Other nights my HR goes crazy fast 100+. My cardiologist and Electrophysioloigst have no answers.

 

I'm getting a referral to another dysautonomia doctor in Austin, Dr. Yessar Hussain. Is this some type of dysautonomia and should I get retested?

 

 

 

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1 hour ago, WarpedTrekker said:

Is this some type of dysautonomia and should I get retested?

It could be, but is complicated by your other issues and medication. Have you had a tilt table test done? Do you have any symptoms with your fast heart rate? What is your blood pressure like? A lot of patients with POTS seem to focus primarily on their heart rate, but to me what's always mattered is how I feel rather than numbers. My main problem is lightheadedness & presyncope. I know I have POTS because I've been tested (and now wear a Polar heart rate monitor) BECAUSE of my symptoms, but I would've never been checking my HR in the first place if I felt well. Also how bad I feel doesn't necessarily correlate with my HR. 

I think it is a good plan to see a dysautonomia specialist & hope your appointment is helpful. 

B x 

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My question would be did they run your tests while you were on the beta blocker. That would definitely skew any tests. I would definitely go back or see another. My specialist was dismissive at first but as I got to know him and him me he is much nicer now. He re ran all of my testing so he knew it was done right and then confirmed my diagnosis. He even agreed to see my 15 yo son to test him because it can be genetic. I almost didn't go back after my first visit (it is 3 hours away one way) but he has made it worth my while to see him. 

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With dysautonomia the HR usually stays up with standing. When I could not control my tachycardia in the past we increased and then switched my beta blocker, which eventually fixed the tachycardia and palpitations/PVC's. Would a different beta blocker help?

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On 11/21/2018 at 9:49 AM, bombsh3ll said:

It could be, but is complicated by your other issues and medication. Have you had a tilt table test done? Do you have any symptoms with your fast heart rate? What is your blood pressure like? A lot of patients with POTS seem to focus primarily on their heart rate, but to me what's always mattered is how I feel rather than numbers.

Yes tilt table while off of my beta blocker was done. I went to a Dysautonomia doctor in Houston, Texas. Dr. Aziz Shaibani. I was not impressed because he only talked to me a couple minutes then had an assistant do all the tests. And then sent me home to follow up with my cardiologist on the results. Supposedly they found nothing wrong.  They did tilt table, sweat test and some other tests. 

The issue is, my tachycardia doesn't happen every day. Nor do the symptoms. But lately it has been happening more often. When my heart races, it somehow triggers extreme anxiety episodes. On Thanksgiving night, I was about to go to bed and then it triggered. I rushed to the ER. They gave me IV fluid and said it appeared I was dehydrated. But I still think something with dysautonomia or POTS is happening. 

Just now, today I started feeling bad. I don't notice any palpitations but I did notice faster then normal heart rate. I'm at 100+ just standing at my desk and it won't go down. If I sit down for awhile it only goes down to around 88. I'm usually in the 50-60's sitting down and still less then 100 standing. So something is going on. 

I found a doctor in the Austin Texas area that does dysautonomia testing and I'm going to schedule with him more testing. 

My heart rate seems to get worse sometimes depending on if I eat a lot of food. I'm also wondering if it has something to do with the food I eat. Next month I'm scheduled for allergy testing. My cardiologist had already done some blood work and said that I had some inflammation going on and to get on a Whole 30 diet. But I have not done that yet. 

Also must add... When my heart rate stays elevated like this and I'm just sitting down. It makes me feel like a headache is coming on. And then makes me feel a little faint when standing. I think I have exercise intolerance too. Because a month ago I tried going back to the gym a few days. Each time I just walked very slowly on treadmill my HR shot up to easily 120+. Going up one flight of stairs slowly at work shoots it up over 130 sometimes. This is when I'm on my Multaq and Bystolic beta blocker. I'd hate to see it if I stop both medicines! 

 

 

 

Edited by WarpedTrekker
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Is your CPAP machine working to treat your apnea?  What are your BP and pulse ox when you wake up with your heart racing? The heart rate usually increases to improve circulation and if you aren’t getting oxygen due to apnea a HR increase would be a normal response. The worst symptoms in Dysautonomia occur when standing. If your symptoms occur while sitting or sleeping it might not be Dysautonomia. If you have already been diagnosed with apnea I’m wondering if it’s that. Keep us posted. Also let us know if the doctor in Austin is helpful.

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Warped.......I have the same thing going on with me only mine is every day........I think it has something to do with 2 things....one the VAGUS nerve gets irritated ? when we eat too much...I was just considering going on Liquid diet only for this reason.....also HISTAMINE is linked with POTS ..there is a huge connection between people who have Mast Cell Activation Disorder and POTS.....so please look into HISTAMINE...especially if you can link your worst symptoms to eating....then try to figure out which foods make it worse...and eliminate those foods and see if it helps....also many of us with MCAD have to take an H2 blocker....I wish this thing could be cured without any meds but it looks like that is hard to do.......exercise increases the histamine so that is why you get symptoms when trying to exercise....I too have the same issue....I get on the treadmill at a VERY slow pace and can only do 10 minutes .....it is so discouraging since I used to do 20-30 minutes at a pretty fast clip.....I have learned with this illness you have to take one day at a time...one hour at a time..etc.....

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