Increased heart rate from Pred??

[Duffer55]

I am having problems with increased heart rate with any exertion. I did a stress echo test this week and am waiting for results. I reached my target heart rate in 90 seconds so doctor stopped the test. I did not realize how much this has been limiting me. Anyone else have this issue, I just thought it was fatigue with pmr. Heart rate runs about 80 to 100 at rest. Tops out to 110 to 125/135 with activity.

[Blearyeyed]

What cardiovascular issue have they said that you have ?

I am just going through the cardio minefield , but have just received a letter back after the Echo saying it is essentially normal and the ECG has not shown AF or heart arrhythmia.

Hilarious , I was being tested for POTS and dysautonomia not arrhythmia or irregular beat but because of orthostatic sinus tachycardia ( heart rate goes mental from changing position or standing up).

Of course , this means I have to raise my heart rate a bit more as I remind them what my tests were for and firmly request a tilt test which they were meant to be just checking I would survive with the Echo and ECG it wasn't meant to be what was used to confirm my diagnosis . Seriously , some days you just want to give up and just line them up like ducks at a shooting gallery!!

They have said I can't do a stress test at present because of the rapid raise in heart rate just from getting from sitting to standing , in a minute it increases by 30-50 beats a minute and is a minimum of 125 after standing still for a minute !

Even standing in the Kitchen to make a cuppa is accompanied by dizziness and blurred vision , ridiculous!

The Rheumy and nurses all say it's POTS and that the Pred or PMR has increased the resting heart rate to a level that has made it the POTS effect feel unmanageable.

Of course , the Cardio was meant to do the right tests to confirm this , ha!ha!

It is making life pretty unworkable at the moment as I can't go out of the house on my own or exercise in any really helpful way except for flat walking or light swimming.

It would be interesting to hear what they said about you , as we have so many similar symptoms going on , including the uvietis .

What other illness have you been diagnosed with to account for that one , did they ever check you for Behcets like they are with me?

[Duffer55 in reply to Blearyeyed]

I just had the stress echo done and am waiting for report. I have an appt on Thursday morning with family doctor so I hope to find out what is going on. I am not sure if increased heart rate is from Pred or underlying heart problem. I just know that when I try to do a task, it increases to where I need to sit and rest before I can do anything else. I guess I am looking to see how others are doing and what questions I should be asking. FYI. Onset oct with confirmed diagnosis in dec 2018; currently on 12.5 mg prednisone, lisinopril for blood pressure, pantropazole for gastritis.

[PMRpro Ambassador]

Have they done any other monitoring?

My tachycardia/atrial fibrillation is nothing to do with pred - it was caused originally by the autoimmune part of PMR damaging the sinus node, the set of cells in the heart that governs heart rate. I mentioned it to the GP, he couldn't feel anything, ECGs were OK - so obviously there was nothing wrong! I should call 999 when it happened. Of course I never did - but more recently if I have done so it has gone by the time they get here!!

I had a severe back problem and as given iv diazepam as part of the treatment - worked pretty well really except after the 2nd lot I developed atrial fibrillation (a/f) with a HR of 230+ (it's a rare but known adverse effect). Once it was sorted out I realised the previous episodes had gone - it had been paroxysmal a/f . I have since discovered that it is worse when I flare with PMR and so is closely associated with the vasculitis - and have had to increase my pred dose to manage it since the cardiologist couldn't offer anything better especially to deal with the bradycardias I was also having, pred did a good job.

Ten days ago I fell and ended up in hospital - where they gave me iv diazepam again despite it being on my notes I shouldn't get it. And the a/f took off! I was having asystoles (heart rate pauses) of up to 7 seconds - that is a long time believe me - and since we couldn't rule out that wasn't the cause of the fall, I've had a pacemaker put in. No more asystoles ...

It is not unusual that such things are associated with inflammatory arthritides and also with vasculitis - the trouble is too many doctors are in blissful ignorance.

[Duffer55 in reply to PMRpro]

I still don’t have results of stress echo and have appt Thursday with doctor. My concern is how do they distinguish if it is prednisone side effect, heart problems, or damage caused by pmr. Guess I will have to wait and see.

[PMRpro Ambassador in reply to Duffer55]

I couldn't do the ergometer stress test so as sent for the chemical version. Everything was fine with that - doesn't alter the fact I have atrial fibrillation. Mine improves/improved at higher doses of pred - fairly conclusive one might feel. But it needs an experienced cardiologist.

[polymy in reply to PMRpro]

My A/F has also improved with the higher dose of pred for a GCA. Quite odd really.

[PMRpro Ambassador in reply to polymy]

I don't think it is odd!