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Suggest Treatment For Tachycardia And Heart Palpitations

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Posted on Thu, 21 Jan 2016
Question: I'm having problems with a fluctuating heart rate I noticed that right before my menstral cycle and right after it drops really low my normal resting heart rate is around 85 but during these times it drops down to low 60 the other times it runs at 120 I have a lot of palpitations what could cause this
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
various potential causes

Detailed Answer:
Hello,

there are various potential causes of palpitations and tachycardia. I'll mention the most common ones.

- thyroid disease: measuring serum TSH is enough to find out.
- anemia: a complete blood count will detect it.
- various arrhythmias: an electrocardiogram or (if negative) a Holter's 24h study.
- fever: in case of fever the heart rate rises. When the temperature returns to normal the heart rate also gets lower.
- anxiety: this is a diagnosis of exclusion, that is other causes will have to be excluded first.

In a young otherwise healthy woman the most likely cause seems to be anxiety. Arrhythmias will have to be excluded first.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
I have an overactive thyroid that is controlled with methimazole. However the slower heart rate correlates with my cycle. Would the hormone fluctuation cause this
doctor
Answered by Dr. Panagiotis Zografakis (0 minute later)
Brief Answer:
I don't believe so...

Detailed Answer:
I don't believe it does. The "slow" heart rate is not very worrisome. 60 beats per minute is fine. 120 beats per minute are far too many for a healthy individual and no hormonal imbalance is an adequate explanation for it.

I think you should proceed with the investigation I've described in my previous answer.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
okay. my tsh is controlled and currently at 2.08 with normal free t3 and t4. Complete blood count normal. echocardiogram and holter only show tachycardia with normal rythym. No fever and not anxious person. My doctors are having a hard time figuring it out. Was hoping to look outside the box. Is there anything else you can think of that might cause this in an otherwise healthy young person. Thank you.
doctor
Answered by Dr. Panagiotis Zografakis (3 hours later)
Brief Answer:
there are some scarce reports about it but no solid proof it may occur

Detailed Answer:
I see...
If the cardiologist found nothing abnormal then I guess it would be hard to reach a diagnosis. There are some scarce reports about menses associated rhythm disorders but they cannot serve as a proven fact of the effect of hormones on the heart rate. Actually I've read about a patient with the exactly opposite symptoms (tachycardia before and during the menses, which sounds more reasonable as a symptom for various reasons).

Do you also have other symptoms during this 'attack' like postural hypotension, bowel problems (constipation, bouts of diarrhea), burning feet, abnormal sweating (either no sweating or too much sweating) ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (15 minutes later)
I get short spikes in blood pressure, really cold, and general unwell feeling. I have numerous physical symptoms they are having a hard time figuring out. Hard time maintaining weight, new food intolerance (lactose and gluten), hair thinning, very dry skin, worsening dental health, on top of my heart not wanting to cooperate. They find me confusing as do I.
doctor
Answered by Dr. Panagiotis Zografakis (2 minutes later)
Brief Answer:
please provide more details

Detailed Answer:
If you'd like to provide more details about the numerous symptoms you've mentioned perhaps it can bring up some ideas. I was considering autonomic neuropathy which is a syndrome, not a disease. Have you done serum proteins and electrophoresis?

Please describe your other symptoms in detail. It may help.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Suggest Treatment For Tachycardia And Heart Palpitations

Brief Answer: various potential causes Detailed Answer: Hello, there are various potential causes of palpitations and tachycardia. I'll mention the most common ones. - thyroid disease: measuring serum TSH is enough to find out. - anemia: a complete blood count will detect it. - various arrhythmias: an electrocardiogram or (if negative) a Holter's 24h study. - fever: in case of fever the heart rate rises. When the temperature returns to normal the heart rate also gets lower. - anxiety: this is a diagnosis of exclusion, that is other causes will have to be excluded first. In a young otherwise healthy woman the most likely cause seems to be anxiety. Arrhythmias will have to be excluded first. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!