Anyone feel worse when heart rate is normal?

[Stephanieann8131]

So I was noticing today. My heart rate was low for me meaning about 85 sitting and 95 to 100 upon standing. It’s normally 95 sitting and up to 115 to 120 standing.  I seem to feel better when my heart rate is higher. I felt faint. Chest felt heavy. Like I couldn’t breathe. Almost like my heart wasn’t keeping up like normal and pushing my blood around. I don’t usually experience this. Has anyone else noticed this? Ironically my dr wanted me to try ivabradine but I’m on the fence with lowering my heart rate 😂

I’m currently only on fludrocortisone. I’ve been diagnosed with pots for 4 years after pregnancy tho I first experienced symptoms as a teenager. I’ve been back to pretty good with mild symptoms tho I’ve been getting more and more flares. trying to get back to where I was 😞

[Pistol]

Hello @Stephanieann8131 - welcome to our forum! --- Yes, I feel faint and have chest pain as well as breathing difficulties when I have increases in HR and/or BP. I was told that this is due to changes in circulation in the chest from dilating or constricting blood vessels. 

3 hours ago, Stephanieann8131 said:

Ironically my dr wanted me to try ivabradine but I’m on the fence with lowering my heart rate

I am not sure why you would be concerned about lowering your HR when your resting HR is so high? 85 to 95 BPM when sitting seems very high, 

 

3 hours ago, Stephanieann8131 said:

It’s normally 95 sitting and up to 115 to 120 standing.

Are you sure your sitting HR is 95? From 95 to 120 is 25 BPM - for POTS the HR increase is 30 BPM or more within 10 minutes of standing. 

I am happy to hear that you have been experiencing mild symptoms, and I hope it continues! Are you experiencing any unusual stress or change in diet, exercise or health that could contribute to your current increase in symptoms?  Have you checked your BP when you feel faint? I can feel that way with either high or low BP. 

[Pistol]

Another thought - has your doctor considered IST ( Inappropriate Sinus Tachycardia )? POTS and IST often get confused since both share tachycardia, but in IST the resting HR is usually high, whereas in POTS the resting HR is normal. 

[Stephanieann8131]

5 hours ago, Pistol said:

Another thought - has your doctor considered IST ( Inappropriate Sinus Tachycardia )? POTS and IST often get confused since both share tachycardia, but in IST the resting HR is usually high, whereas in POTS the resting HR is normal. 

When I first was having symptoms my heart rate would jump up higher. Over years of florinef and time, (this was right after pregnancy) my heart rate changed. I’ve always had a high resting heart rate which was just considered my normal. I see that symptoms are similar and ivabradine is prescribed in ist so we will see how it goes. Thanks for your input. 

[merkat30]

9 hours ago, Pistol said:

Another thought - has your doctor considered IST ( Inappropriate Sinus Tachycardia )? POTS and IST often get confused since both share tachycardia, but in IST the resting HR is usually high, whereas in POTS the resting HR is normal. 

I was going to mention this I deffo ask about this .

[Stephanieann8131]

I have issues with position changes. I realize my heart rate is high but isn’t IST not positional? Without florinef I’m sure my heart rate would go back to rising higher upon standing. that’s where the pots diagnosis originally came from. Technically I realize I could probably have both? But he’s treating me in the high heart rate because he didn’t like me sitting in his office with my heart being 95. I was like meh. It’s usually always like this 😂 thanks all! 

[Pistol]

@Stephanieann8131 - is it possible that your resting HR has always been that high and you are so used to it that you feel different when your HR is normal? Maybe that is why you felt faint - your body is not used to going below 90 - ? Now I can see why you don't want to take meds that bring your HR down to normal! -- I have the same thing with my BP. I always had a very low BP and only when I started with HPOTS did my BP ( and HR ) go way up. I feel absolutely HORRIBLE when my BP goes up! Since I am well controlled with meds right now my BP runs as low as 80/50 - most people would feel very faint, but I feel great! So I don't go by numbers, I go by how I feel. If my BP goes around 120/70 I start to feel it. 

3 hours ago, Stephanieann8131 said:

I have issues with position changes. I realize my heart rate is high but isn’t IST not positional?

Yes - POTS causes orthostatic symptoms - I don't believe IST does. Do you still have orthostatic symptoms, even with Florinef?

[Elizaangelica]

I think I can relate to what you’re experiencing. Sometimes for periods my heart rate drops well below my ‘normal’ sitting rate (about 85). I can tell when it gets close to 70 by how I feel, without even looking at my Fitbit. I feel incredibly weak and a heaviness on my chest, like someone’s sitting on it. When I was on beta blockers that lowered my heart rate into the 60s my breathing became a real effort, so severely I had to come off them. Sorry I don’t have any answers, but I think I can understand.

[Stephanieann8131]

On 1/16/2021 at 7:09 PM, Pistol said:

@Stephanieann8131 -

Yes - POTS causes orthostatic symptoms - I don't believe IST does. Do you still have orthostatic symptoms, even with Florinef?

Yes I do.  Standing up after sitting for a bit still gets me lightheaded and I have to be careful when bending down or crouching. I usually feel faint after doing so. 
 

@Elizaangelicayes! Like an elephant on my chest! Lol

Update on ivabradine. It was covered by my insurance and it actually helping. My heart rate is about 10 bpm lower on average (I’m taking 2.5 mg) and I have much more stamina and less dizziness. It took a few days to adjust but overall the slightly lower heart rate has been a success.  So @Pistol yes, it might have just been a case of letting my body adjust to the change!