Night Heart Racing

[nancyannehanson]

I have been reducing my prednisone was at 30mg down to 27mg in 3 weeks. About 10%. While documenting my reduction I notice at about 3:00 am I wake up with my heart racing. I try deep breathing, even hear the beating in my ears. Anyone ever experienced this?? Has anyone ever used acupuncture for PMR??

[Brixhamhampster]

Nancy Anne Hanson I have had heart racing all the way through having PMR. I am now down to 7/6mg per day and it has lessened lately. It really feels like a heart attack but deep breathing does seem to help. Mine seems to be worse when I first lie down which isn't quite the same as you. I have assumed it is just another side effect of prednisolone. Never had acupuncture so can't help on that one. What a contrary condition this is. Hope you get some better suggestions later in the day. It is currently 4.20am!!!

[nancyannehanson in reply to Brixhamhampster]

Ok, good to know. Yes, it's when I first lay down at night. Do you get some shortness of breath later in the day??

[zarzis in reply to nancyannehanson]

Hi Nancy Anne I am the same as you, I get short of breath even on the most trivial task, also my heart has started beating irregular, more or less since I started taking prednisone last April now down to 12.5mg, so getting there slow but sure.

Wish I could suggest a solution, but it's getting better, wish you good luck.

Peter

[Brixhamhampster in reply to nancyannehanson]

Nancyannehanson. No I don't suffer with shortness of breath unless I get stressed. I live in Devon with hills everywhere so maybe that makes a difference!

[Admiral06]

nancyannehanson and Brixhamhampster, I too have experienced tachycardia which was often accompanied by ectopic heartbeats. Changing my blood pressure meds from an ACE inhibitor to a beta blocker helped for several months, then the symptoms occurred again. This time I discovered I had low potassium levels and when I added potassium rich foods to my diet, the symptoms went away almost immediately.

Potassium deficiency is common among steroid users, and I had to add 4000 mg (or more) to my diet daily to stop the symptoms. Interestingly, I also experienced elevated blood sugar, and muscle fatigue, (especially in my legs) and by increasing my potassium intake, both of these problem went away as well.

The minimum daily requirement for potassium is 4700 mg per day and I now carry a card in my pocket so I can keep track of my daily intake. When I fall short of my goal, both the muscle fatigue and blood sugar problems return.

A word of caution, however, is that too much potassium (especially from supplements) can be toxic. For this reason I get as much as I can from potassium rich foods and supplement only when necessary. The relationship between potassium and the aforementioned symptoms is well known, but please read what you can before starting to supplement.

If you are not diabetic, 1 Tbsp of Plantation brand organic blackstrap molasses contains 630 mg of potassium and when added to one cup of milk, you get a delicious 1000 mg cocktail. Take this 3 times per day and add a baked potato with skin (800 mg) and some acorn or butternut squash 500 mg per cup and you are there.

I hope this helps.

[Megams in reply to Admiral06]

~Your post re potassium most interesting - thank you.

Merry Christmas to you and yours ~

[HeronNS in reply to Admiral06]

Thank you. This may help with a couple of problems I've experienced the past six months or so. Merry Christmas! 🎄

[Megams]

~Yes Nancyannehanson I have had the odd episode of racing heart. On several occasions it did accompany breathlessness.

Not sure which came first, the racing heart as a result of the breathlessness or other way round. I did end up spending several nights in hospital with suspected heart attack + myocarditis & in final analysis a coronary angiogram ruled out heart attack which I am grateful to say. Now have valve changes/medium atrium enlargement which never had before. My b/p is within range (give or take) & I am not overweight however have collected a mild tum since a recent PMR flare with increased dose of my meds. I do think there is a connection with the increased dose of meds as noticed a slightly racy heart at days end of late.

Not one medical person could comment if my problem (racing heart/breathlessness) may have been side affects of my steroids.

Yes, I have western acupuncture on a weekly basis by my physio (at least 8 weeks now) & believe it is really helping my tendonitis (elbow & hip). Also a few extra needles to support spleen, liver & gut. Would not be without it.

Merry Christmas

[nancyannehanson in reply to Megams]

Can you provide me some insight about choosing a quality acupuncturist??

[Megams in reply to nancyannehanson]

~Not sure where you live but I am in Auckland NZ. I purposely hunted around for a Physiotherapist who is trained in acupuncture - I didn't mind which sort of acupuncture (i.e. Chinese or Western). Fortunately for me he is very dedicated & goes above & beyond to help me.

The post to you by Admiral06 is very relevant too when looking at the overall picture ~

[withington1961]

Hi I was diagnosed with Pmr last August after a year of pain.I never had any problems with my heart. I now have been diagnosed with Atrial Fibrillation and take a beta blockers in the morning and fleccanide at night.it started with palpitations and then very fast beating for over 2 hours so went to hospital and had a heart rate of 250 bpm. None of the doctors will admit any connection with Pred but I think it is too much of a coincidence. I am now down to 5 mgs per day and the occurrence is less.Good luck .Best regards.

[PMRpro Ambassador in reply to withington1961]

It can be from pred - but it can also be from the autoimmune part of PMR itself. See my longer post.

[nancyannehanson in reply to withington1961]

Thank you, validation feels warm and safe.

[SheffieldJane]

Thank you for this post nancyannehanson, I am sure you find the advice useful as I do. The potassium was a revelation. I do have this alarming symptom and have been to hospital and had tests, before PMR diagnosis. Nothing was found. I do take Propranolol as and when required (40 mgs). It does the trick but I am doing this, perhaps stupidly, without advice, from an old supply. I am also on 25 mgs of Atenolol for slightly raised blood pressure. It happens to me for no apparent reason when I am resting in the evening most often but I have noticed it when something stressful happens too, but more often the former.

Best wishes to you!

[PMRpro Ambassador]

Really don't get why loads of GPs will insist tachycardia/palpitations are due to pred and other doctors then say "couldn't possibly comment"!!

A listed side effect of pred is tachycardia/palpitations. However - it can also happen with PMR, caused by the autoimmune part of PMR damaging the electrical cells in the heart that trigger the heart beat. In addition, atrial fibrillation, which causes palpitations and tachycardia as a symptoms, becomes increasingly common as we age.

"There are an estimated 2.2 million people in the United States with AF, with a median age of about 75 years. The prevalence of AF is 2.3% in people older than 40 years and 5.9% in those older than 65 years. Approximately 70% of individuals with AF are between 65 and 85 years of age."

The figures aren't much different elsewhere.

I had mild "episodes" of palpitations right from the early days of PMR - they definitely weren't pred, I wasn't taking it for the first 5 years. Eventually I had a massive episode while in hospital (due to a drug reaction) - it was investigated, the cardiologist was confident it was due to PMR anyway. And it seems he was probably right as since I've been taking the tablets those earlier episodes have disappeared.

There are several other ladies on the forums who have developed atrial fibrillation. It is more common in people with RA than in the general population - I asked rheumatologists about PMR and got the get-out waffle of "it's more common in the age group anyway". Not the answer to the question I asked though.

IF you have episodes of palpitations then you need to get your GP to arrange a longterm monitor (at least 24 hours, possibly longer) and there must be an episode while you are wearing it. Otherwise they can say nothing at all on the basis of an ECG or a just checking you over. If it happens and you are worried - dial 999. Paramedics carry ECG machines. In fact, if it happens at all, dial 999. One lady suddenly found herself bundled into the car by her friend, a retired GP who'd just checked her pulse while she was visiting his wife! A/F duly diagnosed at the hospital and corrected.

Atrial fibrillation is a major cause of stroke - it isn't just episodes of feeling funny! It needs to be diagnosed and managed - at the very least by you being on warfarin or the like to prevent clots forming.

[nancyannehanson]

I have noticed as I decrease the prednisone it's not as frequent.....but when it does It feels like my heart is turning over very odd sensation. I need to have this checked out.

[Avantidave1988]

Yes it becz of predisolone. .mine got reduced wen I was on 5mg alternate day dose

[piglette]

Thankfully I have not had tachycardia although my rheumie said it quite often happens with PMR.

I have had acupuncture twice and in my case it was a complete waste of time. In fact worse than that as I managed to damage my leg on the folding bench and had the most unbelievable bruise from it. Some people say it helps though.

[nancyannehanson]

Well that stinks......I am learning it's different for each of us.

[Hidden in reply to nancyannehanson]

I use Chinese acupuncture and do find it helps me, though she mostly uses her hands on most points depending on how I am.

I also suffered tachycardia a couple of times. Both times on sudden reductions in dose although an underlying heart problem was found and is now fixed. You should have it checked if you haven't already.