Tachycardia; Shortness of Breath; Asthma... Oh my!!

[bookworm818]

Hi! I'm hoping for some feedback. I have pots. I also have asthma. I've landed in the ER several times this year for my asthma. I get extremely short of breath and wheeze and can barely talk. My o2 levels differ. Sometimes they are perfectly normal and other times low 90s high 80s (not sure if I am getting false readings). I've also noticed during these awful shortness of breath flares my tachycardia acts up. Do the two go hand and hand? Does anybody else get SOB with tachycardia? My cardio wants me on a beta blocker but I heard they aren't great for breathing issues.  Any insight or experience with that? 

So I guess long story short I'm wondering if the tachycardia and sob go hand in hand? What does everybody else do for it? For those that have asthma, is it well controlled? What do you take? And is there anything else to help breathing and heartrate in general? Also what HR meds do you find that don't affect your breathing or asthma? Thank you!

[Pistol]

2 hours ago, bookworm818 said:

I've also noticed during these awful shortness of breath flares my tachycardia acts up. Do the two go hand and hand? Does anybody else get SOB with tachycardia? My cardio wants me on a beta blocker but I heard they aren't great for breathing issues.  Any insight or experience with that? 

Hello @bookworm818 - I get short of breath when my BP is up or when my HR is up, but not wheezing. I think the shortness of breath you describe sounds more like asthma. In asthma, often we develop tachycardia because that comes with breathing problems. In POTS we often develop shortness of breath WITH the tachycardia, both from a change of circulation to the heart and due to the accompanying anxiety. I myself do not have asthma but my daughter and BFF both have it and I am very familiar with it. My daughter also has POTS and takes an Albuterol inhaler as needed ( Caution - this med causes tachycardia as side effect ). She also took Singulair most of her childhood ( no longer needed since her asthma is allergic in cause and her allergies have been treated successfully ). 

Are you seeing an allergist for your asthma? They usually are the ones treating asthma. A beta blocker is appropriate for POTS related tachycardia, and your cardiologist should know which ones are safe to take with asthma, not all beta blockers are the same. Actually - they all differ quite a lot, and many POTS patients tolerate some and not others. I would give it a try if I were you. 

[bookworm818]

2 minutes ago, Pistol said:

Hello @bookworm818 - I get short of breath when my BP is up or when my HR is up, but not wheezing. I think the shortness of breath you describe sounds more like asthma. In asthma, often we develop tachycardia because that comes with breathing problems. In POTS we often develop shortness of breath WITH the tachycardia, both from a change of circulation to the heart and due to the accompanying anxiety. I myself do not have asthma but my daughter and BFF both have it and I am very familiar with it. My daughter also has POTS and takes an Albuterol inhaler as needed ( Caution - this med causes tachycardia as side effect ). She also took Singulair most of her childhood ( no longer needed since her asthma is allergic in cause and her allergies have been treated successfully ). 

Are you seeing an allergist for your asthma? They usually are the ones treating asthma. A beta blocker is appropriate for POTS related tachycardia, and your cardiologist should know which ones are safe to take with asthma, not all beta blockers are the same. Actually - they all differ quite a lot, and many POTS patients tolerate some and not others. I would give it a try if I were you. 

I am seeing an allergist and a pulmonologist.  My allergist is not helpful at all. My pulmonologist is at least trying to help. Lol 

My cardiologist didn't seem to think any beta blocker would cause an issue with my asthma or my low bp. I have been told by my previous cardiologist otherwise though so I'm nervous about trying it.

Sometimes I find it extremely difficult to differentiate between pots tachycardia and sob and asthma tachy  and sob. 😭

 

[RecipeForDisaster]

I have bad asthma AND very low BP, and I’ve tolerated and done well on metoprolol. I was hesitant but this one is very selective and never gave me an issue. Fast heart rates in themselves can make you short of breath, and being short of breath can make you tachycardic.

 

Non-selective beta blockers could definitely be a problem with asthma. I only had a very small number that were deemed safe for me to try... some of those lowered BP more than others. 
 

I take a lot of meds for my asthma and I have a very clear difference in shortness of breath from that vs. the other stuff.

[bookworm818]

6 hours ago, RecipeForDisaster said:

I have bad asthma AND very low BP, and I’ve tolerated and done well on metoprolol. I was hesitant but this one is very selective and never gave me an issue. Fast heart rates in themselves can make you short of breath, and being short of breath can make you tachycardic.

 

Non-selective beta blockers could definitely be a problem with asthma. I only had a very small number that were deemed safe for me to try... some of those lowered BP more than others. 
 

I take a lot of meds for my asthma and I have a very clear difference in shortness of breath from that vs. the other stuff.

Thanks for your response. What do you take for your asthma? And how can you tell the difference between the two types of tachy/sob? 

[RecipeForDisaster]

I take a lot because I used to be steroid resistant and really sick. Zafirlukast, spiriva, formoterol, and budesonide. I use CPAP at night which really helped me a lot (but I have sleep apnea which is how I have that). 
 

The tachycardia or dysautonomia cause an air hunger type thing, where I just " need" to breathe a lot (but it isn’t hard to). The asthma makes it difficult to do so without making me feel like I need to breathe extra. They really feel different.  

[shoshan]

I find that when I get extremely tachycardic upon standing, my O2 saturation goes down to about 80. I also have asthma and have a really hard time differentiating which condition is causing the problem during an episode. I reason that breathing is an autonomic function, so they may very well be intertwined.

[bookworm818]

On 1/7/2021 at 1:48 PM, shoshan said:

I find that when I get extremely tachycardic upon standing, my O2 saturation goes down to about 80. I also have asthma and have a really hard time differentiating which condition is causing the problem during an episode. I reason that breathing is an autonomic function, so they may very well be intertwined.

I've seen my O2 dip as well. Does anything make your breathing better? Do you take any meds for it?

[shoshan]

I've taken steroid inhalers for asthma prevention, although I'm not on any currently. I do have albuterol inhalers and EpiPen in case of emergency, but I don't take them often because they make my heart race. I find that sometimes it helps my O2 levels to get into a supine position. I assume that's probably when POTS is the main issue, not the asthma, because during a traditional asthma attack it's easier to breath in tripod position.

[Crazy Tired]

I use a daily asthma steroid and a puffer.

 

I also carry prednisone at all times.

 

And a klonopin tablet for the panic and sob