unexplained tachycardia

[Joolebot]

Hi,

I have had unexplained tachycardia for 18 months.

saw a cardiologist last year and he said I had POTs, was on bisoprolol for about a year but came off it as it was making me ill.

After 2 months no medication I woke up to heart rate of 160 and took 1.25 bisoprolol but several hours later it was still 110. Gp told me to go to a and e. A and e said they didn’t know why high heart rate but bisoprolol was regulating.

Went to see cardiologist who said he had a fast paced heart rate and he thought I had atrial tachycardia. I had 24 hour urine test, blood tests and 48 hour ecg monitor but they came back fine so cardiologist said nothing wrong with my heart and that he could refer me for psychological support.

I often have very high heart rate, pains in left side (around heart), sore left arm, sore left armpit, shortness of breath, dizziness, palpitations, tremors, shaking, headaches, red face. Generally feeling unwell.

Can anyone suggest any next steps please?

Thank you.

[Captain_Birdseye]

I've got myocarditis, so I often still have pain in the areas you have, as well as flutters and palpitations. I've been advised to go to a&e if I experience this with nausea or lightheadedness.

We can't diagnose anything here... if I was feeling like that I'd be back to the GP or calling 111.

[Joolebot in reply to Captain_Birdseye]

Thank you Captain_Birdseye

[Jacey15]

Can you ask your GP to refer you to a PoTS specialist? There are other meds available e.g. ivabradine.

[Joolebot in reply to Jacey15]

Thank you Jacey15, I am going to try that but I don’t think there are any in Scotland so it would need to be online appointment.

[Crazyface]

Like you I had regular bouts of racing heartbeats for around 18 months. I was on the 'devil drug' bisoprolol - 1.5, 5 & 10.

Finally diagnosed as SVT and put on waiting list for a catheter ablation.

Got it done in November '21 - fantastic result - I am a new man.

Do whatever it takes to get on the list for an ablation and try not to worry too much - I wish you well.

[Joolebot in reply to Crazyface]

Thank you Crazyface. I will look into this. I am glad you are better.

[Sleepybear987]

I would ask for a MRI because I discovered I had water on my heart. I think it could help find out what's going on. Everything else came back as "normal" for my ECGs and urine tests too but I am still in the process of investigating. You also might need a second opinion because doctors can be quite...lax when it comes to diagnosing heart problems.

I say all of that to say; you might need to start looking at the possibilities of your sickness and where you want to go next. Not say you need to start self-diagnosing if you feel uncomfortable but just start thinking about what it could be and see if you can work with your doctors/GP/specialists to find out where to go next.

[Joolebot in reply to Sleepybear987]

Thank you Sleepybear987. I have a gp appointment next week and have started wiring more thorough notes to try and find patterns. The waiting list for MRI might be long too! I am glad you got a diagnosis finally. The cardiologist I saw on Monday made me feel like I was wasting his time and that my experience was not valid, which is not great on top of every other battle!

[Sleepybear987 in reply to Joolebot]

*my personal opinion* is that cardiologists are the most annoying department. I think in their heads, if they don't obviously "see" a problem, they'll leave it. But make sure you cause a fuss, get in contact with PALS , I even tagged them in a post on Twitter and that seemed to do it 😂

But yeah you'll get there, with illness like this it's an uphill battle. Even if the MRI lists are long, it's still worth a try - there might be a cancellation or extra slots for next year!

[Joolebot in reply to Sleepybear987]

Thank you very much Sleepybear987. I am going to write a letter of complaint but will contact PALS too.

[MartinOG]

My issue with Bisoprilol seems the opposite as it leaves me highly fatigued, even after splitting the dose of 5mg to twice daily

[Joolebot in reply to MartinOG]

sorry to hear that MartinOG, can you try any other meds? I am also fatigued with it but for me worth it to regulate my heart rate.

[Engineer46]

Let's start at the beginning. Do you think that you have POTS? Does your heart rate increase significantly on or shortly after standing up from a sitting or lying position? Were you ever given a "tilt table test"? This NHS web page has information on POTS diagnosis and treatment strategies:

nhs.uk/conditions/postural-...

Assuming that you were originally taking the lowest dose of Bisoprolol (1.25mg once/day) the medical aim was probably to limit your heart rate only a little, since our hearts need to beat faster when we stand up and become active. For many people this small dose of Bisoprolol doesn't affect them adversely, but there are exceptions.

Your description of a high heart rate when you woke up might tend to discount POTS, unless it was taken after you had got out of bed and could therefore be related to posture.

Since your heart appears to be in good shape you certainly don't want to be considering an ablation. However, you still have various unwanted symptoms, so you may need to visit your GP and ask to get POTS clearly diagnosed or discounted. If you do have POTS there are several strategies to alleviate the symptoms, but unfortunately no cure it seems.

I hope that you are able to get some relief from your symptoms soon.

Paul