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Irregular heart rate. Done Echo, Ekgs, Holter, Stress test done. What could be the reason?

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Practicing since : 1981
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I HAD my son 5 weeks ago. Starting this weeks overtime i stand up my heart rate jumps. My resting rate varies depending on how anxious i am. Anywhere front 60-100. As soon as i stand up though my heart rate say rockets. It goes anywhere from 130-180 and slowly cones down. Anywhere from minutes to hours. Comes down faster if i sit. Also the slightest give during sitting or laying causes my heart rate to jump. I've seen two cardioligist who say it is still hormonal and will clear up in a couple months. Have you seen this before? What was the outcome? I i am flying around if i do the slightest thing like cleaning. My heart rate is 160. I've has echo, stress test, ekgs, holter monitor. Allocate back normal beside tachycardia. No skipping beats. Holter showed sleeping heart rate in 50s and during standing up to 178. I am so scared I am going to die. What could this be?
Posted Sun, 1 Jul 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Anil Grover 3 hours later

Thank you for writing in.

I am a cardiologist and read your well written description with diligence.

There are hardly any better things in life than seeing your child grow. Congratulations. Yes, there are associated anxieties too.

To answer one of your questions whether I have seen any such thing I can honestly say yes, about a dozen in my career of 25 years.

As per the details provided, I want you to remember these facts:
1. As 26 year old lady, heart rate generated on its own (also called target heart rate) while doing stress test is 194. It is calculated as 220 minus age in Years.
2. Going through your normal echocardiography Doppler, Holter and stress test; all is been normal. It is seems that you have "Sinus Tachycardia".
3. This is further supported by fact that though the onset of rapid heart rate is 'rapid in minutes' before it slows down. That is opposed to a similar condition which can be possibly disease that is Paroxysmal Supraventricular Ventricular Tachycardia (PSVT). Typically, here the heart rate jumps like a bolt from blue and after a short duration it settles down to normal heart rate as abruptly as it started. It does not slowly come down.
PSVT is also relatively benign condition, but may need treatment. At times the later is associated with urge to urinate after tachycardia settles down.
4. Structurally normal heart - as revealed by echocardiogram, no irregular heart beat, normal sleeping heart rate around 50 and normal rise of rate with exertion - as revealed by stress test, no significant abnormality - as revealed by Holter are further reassuring signs of investigations. These prove the benign and temporary nature of the phenomenon.

Yes, there was cause for concern before you were investigated; But never a cause of panic especially now.

Hope I was able to address your concern and reassure you. If you have any follow-up query I shall be pleased to answer.

With Best Wishes
Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Irregular heart rate. Done Echo, Ekgs, Holter, Stress test done. What could be the reason? 9 hours later
What could cause this? Every time I stand my heart rate increases by 30-60 beats or more.
Answered by Dr. Anil Grover 11 hours later

Thanks for your pertinent question.

When one stands the blood supply to upper part of body, decreases. It includes blood supply to carotid receptors to sense your blood pressure. It is sensed as if your heart output has gone down and by a natural reflex these receptors send signals to brain which in turn increases your heart rate. As we grow, in most of us this phenomenon is stabalized and one does no longer feel it happen. In your case, your pulse generating center of heart that is sinus node is a little more sensitive than others this produces not only aggravated response but you perceive it as palpitation. That is perfectly normal and happens in some.

With best wishes,

Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Irregular heart rate. Done Echo, Ekgs, Holter, Stress test done. What could be the reason? 2 hours later
Thank you for thatbanswer. One doctor today suggested POTs. Abduction another would like to do an eblation of thesis node. Im not sure butbI thought I read ablation could make POTs worse. Could this whole situation have anything tobdo with me being 5 weeks postpartum. Would you suggest me getting the ablation?
Answered by Dr. Anil Grover 13 minutes later

Let us review the procedure (RF ablation) and side effects. It is painless, more than needle prick and momentary heavy sensation in chest, there is nothing more as far as patient's discomfort is concerned.

A finite percentage of patients land up with need for a permanent pacemaker post procedure for some time if there is a complication...that is the only serious complication

I have come across in one patient apart from in two patients my failure to abolish arrhythmia. The patient needed pacemaker support for few weeks fortunately.

You can specifically discuss complications with your doctor. In my view, it is perfectly safe and benefits outweigh the risk of complications and long term medical treatment. Of course, final decision is always that of the patient. Therefore, my suggestion is take your time, discuss, and finally decide. Your being 5 months post partum should not come in a way it is an outpatient procedure and you will be away for few hours from your child.

With Best Wishes.

Dr Anil Grover
Above answer was peer-reviewed by
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