Does you tachycardia cause chest pain when very high?

[Julyrose]

It only happens when standing, and not very frequently, but when my heartrate is above 160, (particularly above 175) it just feels like a fluttery pounding with a ton of chest pressure. it resolves completely after I lie flat for a while, but man! it is soooo uncomfortable. it is self limiting, because at that point, if I remain standing for more than 5 minutes of so, I faint. just wondering if anyone else feels “pain” at the upper end of their heartrate range?

[Pistol]

@Julyrose - yes, I get chest pain/pressure when my HR goes high. Most of the time my HR goes up I also have high BP, like HR 160-ish and BP 158/110. Then I feel like my heart is going to explode any minute. Usually though I either pass out or have an autonomic seizure before it goes any higher, that seems to be like a reset. When I regain consciousness both HR and BP are usually back down. 

[POTSie78]

My pulse goes to 160s and then sometimes it will drop to 30-40 bpm and my resting heart rate is usually 90-100.  I have bad stabbing chest pain during either extreme.  Other times my chest feels very tight.  I also get pain between my shoulders and in my armpit. 

[Pistol]

33 minutes ago, POTSie78 said:

I also get pain between my shoulders and in my armpit. 

@POTSie78 - I do get the same type of chest pain you describe and was diagnosed with Prinzmetal angina ( spasms of the blood vessels around the heart ). But when I had pain in my back, neck and radiating under my arm ( armpit ) it was not due to that but rather from a pinched nerve in my neck. There is a big nerve that goes from the neck across your chest under the armpit. I fixed this with Physical Therapy. Could this be the case for your shoulder/armpit pain as well? Applying heat and taking Motrin helped me with that as well. 

[Julyrose]

Very interesting about the pain radiating to the armpit. I mainly get a squeezing flip floppy feeling in my heart, and then painful downward pressure emanating from my diaphragm I believe. this is exclusively when standing so I believe gravity is a factor. This crushing sense of downward pressure and fluttering are intolerable. This morning, after if fluids (in my TPN), my standing rate is only in the 140’s, and I do not have any discomfort, just eventually feel fatigued and a bit foggy headed with prolonged standing. 
 

I will say, my cardiologist and I are confident that it is just POTS at play, but he tells me I am on the extreme end of severity, my heartrate goes much higher than the vast majority of his other POTS patients. I’m just an over achiever I guess. 

[yogini]

It may not make sense to try to remain standing when you experience this.  Dysautonomia involves sinus tachycardia.  Hopefully your doctor is in the loop and has ruled out other forms of tachycardia like SVT. 

[Julyrose]

Yogini: good point. But yes, my cardiologist has many POTS patients and I feel confident in his assessment . My tachycardia is entirely positional, resolving fully when I lay down. But of course, things can change, so good to be aware of any changes in pattern and bring them to your doctors.

[yogini]

On 3/23/2021 at 11:25 AM, Julyrose said:

Yogini: good point. But yes, my cardiologist has many POTS patients and I feel confident in his assessment . My tachycardia is entirely positional, resolving fully when I lay down. But of course, things can change, so good to be aware of any changes in pattern and bring them to your doctors.

I am not sure that positional tachycardia is necssarily limited sinus tachycardia.  If you are under the care of a good doctor that treats a lot of dysautonomia, then you are probably already getting the best advice!

[Julyrose]

So, update:

‘I ended up going to the ER for the ridiculous tachycardia because my heartrate even laying down was vastly higher than my normal, and unfortunately I had an infection in my port catheter. I was hospitalized for a week and the port was removed. I am home with a pic on IV antibiotics, and my heartrate is back to my normal. So, sometimes, an increase in hr can be a flare, but sometimes, there can be another cause, like an underlying infection. I am SO glad I trusted my gut that something was wrong and got it checked out. I use the port for fluids for the pots as well as for TPN for gastrogaresis. Though they are lifesaving for me, it comes with serious risks. I still hold hope that I can eventually exist without infusions.

[Pistol]

OMG @Julyrose - I am so glad you are better! I did not know you had a port! That explains the armpit pain!!! So glad you got help and wishing you a speedy recovery!!!!!!