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poslisa

Heart Rate

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Hi everyone, I have a question regarding your heartrate. My biggest problem is my fast heartrate and I'm wondering how many of you have a fast rate on a daily basis and how fast does yours actually go? I've been fighting tachycardia since 1995, I'm back to work after being home for 2 yrs. and my resting heartrate hardly ever goes under 110 bpm. I normally run 130-140's while at work and then in the evening run around 100-110 (right now sitting at the computer I'm 105). I think in the past 3 wks. I've only had 1 to 2 days that my heartrate actually went under 100 bpm for any real amount of time. I'm going to Phildelphia on 10/10 to see 2 EP doctors at Pennsylvania Med. Ctr. and hopefully they will be able to help me out with controlling my heartrate better but in the meantime I was interested in seeing if I'm the only one fighting the tachycardia on a daily basis. Thanks.

Lisa

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Hi there Poslisa,

usually with POTS, the high heart rate is functional. By "functional", I mean that the heart is trying to keep your heart, lungs and brain protected and perfused with blood--the rise in heart rate can be triggered by a falling or unstable blood pressure. So, just decreasing heart rate, alone, will sometimes make folks with POTS feel sicker, be more likely to faint due to lack of blood flow to the brain, etc. This is why some folks who have various types of cardiac ablation to slow the heart rate (ablation kills some of the tissue that may help the heart kick up the pace) have done terribly afterward There are a few who've done well afterward...but I don't know many. The folks I know of have all done much worse after ablation.

This is why the first line of treatment is usually to find a way to stabilize the bp. This is done using the simple stuff first: total blood volume expansion by increasing salt and fluid intake, and the use of support hose to force blood to the upper body more effectively. If these low tech things do work, there are meds, some which expand blood volume by various means, and others that constrict blood vessels to force the bp a bit higher.

My heart rate, lying down, is between 60 to 80. Upright, it can be normal at about 80, but I know at work it goes well into the aerobic range, in the 130s... just driving my car today, I know I was in the 110 to 120 range. This is my norm and I guess I've just gotten used to it. When I wear support hose, I do better, but it's a catch 22 b/c it was about 80 today and the hose are so HOT and uncomfortable in the heat. So, instead, I sweat just doing nothing, but at least I don't feel constricted. Have you tried Rx support hose? These are not the standard off-the-shelf support hose--these are rated something like 30mg of mercury--sturdy, indeed :D

Nina

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Oh, one more thing! I have an ep cardio, Dr. Francis Kempf, at U of P also!!! He's not an ANS specialist, but he's a really good doctor--was genuine, interested in learning about my disorder and was super helpful.

If you have a good experience and find a doc who knows this stuff, be sure to let me know! I always like to know what my options are locally--and it's nice to know that I can see someone nearby instead of driving hours and hours to see someone knowledgeable.

Nina :D

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My heart rate is basically stabilized for now because I am on a beta blocker, but without the meds, it would go from 80-90 sitting down up to as high as 150-160 standing. Now I'd say it goes from 70-80 sitting to maybe 100 standing- which, for me, feels much better!! I'm still not feeling well at all, however, because I am not currently taking anything to help stabilize my BP, I was trying to get by on as few meds as possible. But I know at my next appt my doc os going to put me on the Midodrine, because as Nina said, the BP has to be stabilized before the heart rate- and right now I'm backwards.

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Hi, Poslisa!

My heart rate is usually 120 when sitting,or laying down. When I'm standing or doing other activities It goes up to 170-200 or a little over. Then my blood pressure will go very high. But recently it's been doing alot better ever since I went on proamatine. It's still a little high at times, but i feel alot better. When I'm sitting/laying down it's about 90-120, and when I'm standing it's about 140-165 ish..not a big improvement..but it keeps me from feeling better, and not passing out all the time ect.

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Thanks everyone for your responses. We just recently increased my Florinef to .2 mg BID and it has actually brought my standing heartrate down to the 120's now the only problem is that my ankles are looking like the Michelin man!

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Poslisa,

Proamatine and salt/water seem to lower my heart rate greatly. I have a question also about heart rates. My rate was 90 resting 110-160 standing. I am on proamatine now 5mg 2x day and my rate goes as low as 50 resting and the highest standing has been 90. Are these numbers good or is 50 too low?

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Nicole - I don't think that 50 is too low unless you are symptomatic when it goes down to 50. By symptomatic I mean feeling dizzy, lightheaded or extreme fatigue (sounds kind of the symptoms with the fast heartrate, huh :D ). I work in cardiology and have plenty of patients with resting heartrates of 50 and they feel best when it is that low. Glad to hear that the Proamatine works for you. One question, how much salt/water do you have in one day. My regular cardiologist has not had me increase my salt just yet (perhaps after I see the dr. in Philly) and I've noticed that if I do not drink enough water in a day I really don't feel too good.

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i used to get down to about 40 sometimes in the early morning. it sucked. the internist i was seeing at the time who noted it told me that below 50 is considered bradycardia. so i think 50 is ok. bradycardia is a common side effect of taking the meds...

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Poslisa

Thanks, I was just a little afraid when it dropped. I drink about 8-8oz waters a day and I add in Gatoraide in the middle. I eat small meals (cup of soup alot) about every 3-4 hours with alot of salt added. When I wake up I drink a small can of V8 it has 480 mg of salt in it. In my car I carry around little salt packets (like the ones you get from fast food resturants). I can tell by my ankles if I have overdone the salt but the next day I will feel great. My doctor told me to just add lots of salt to everything. I feel good most of the time. My main problem is that when my pressure goes low I have more of a mental breakdown then a physical one.

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