Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

159 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Chest pain, back pain and feeling dizzy with increased heart rate. Should I consult electrophysiologist?

Answered by
Dr. Prabhakar C Koregol

Cardiologist, Interventional

Practicing since :1998

Answered : 424 Questions

Posted on Wed, 23 Jan 2013 in Hypertension and Heart Disease
Question: Hi,

I have question around my fast heart beat.
Today I had a heartbeat of 115-138 when I was just sitting or laying down and had chest pain, upper left back-shoulder pain and I feel dizzy. I feel dizzy most of the time and feel like can faint any moment.
I see many of the symptoms described here wish is ventricular tachycardia:

My background:
Im 32 years old from Belgium and I have a Asymmetrical chest, my left chest is smaller and my right chest bone is bigger. I eat very healthy, fish, vegetables, nutrition and exercise every day.

I exercise 3 times a week for 1 hour intensive weightlifting interval training, all the other days of the week I swim 1km every day.

My average heart rates:
When I exercise my heartbeat is between 120-165…
When I sleep 60-75/ when I lay down 78-95/
when I sit down 95-115 and when I stand without moving around allot 98-125
When I feel stress 128-139
Im concerned about the fast heartbeat, my whole family has a very low heartbeat everybody in my family.

Sometimes I have very slight chest pain and un comfort, like a stinging feeling on my left chest and a bit pressure and pain on my chest and my left upper back shoulder. Every once in 2 weeks I get a nerve cramp in my chest…

1-2 months ago I had severe chest pain and high heart rate,
I went to do full checkup at 3 different specialist center and did all following test:
- full blood test (all perfect, can send you copy to check)
- stress test (very good, achieve level 7)
- x-ray (all good)
- Echocardiogram (all good, I can send you copy to double check)
- bloodpressure (all good)
- ECG ( all good, can send you copy to check)

All the 3 specialist told me everything is good can not find anything…
Then I have done a spine adjustment for a few times at Chiropractor see if that helped but very little change average it went down 5-10 beats…so it helped very slightly…

But still my heart rate is fast 95-110 when I sit down average over the week,

But today it was 115-138 and chest, back uncomfort stays…my partner helped me to massage my back where it hurts and my heart rate dropped to 95, 30 min afther massage back to 130

One of the specialist told me I can best visit a ELECTRO-PHYSIOLOGIST

What can you advice me? Will this be something you can help me with?
What can I do to reduce my heart rate? Will this bring me any complications or danger if I keep walking with this fast heart rate?

Can I still exercise? Is this to do with my spine, nerve system or has it to do with my slightly different chest? Or any other reasons?

Thank you!!
Answered by Dr. Prabhakar C Koregol 7 hours later
Thanks for the query.

I understand your concerns. At the outset, you look like a case of inappropriate sinus tachycardia. Does not look like ventricular tachycardia. However considering the variability in your heart rate, we need to make sure that its not atrial fibrillation.

To confirm or rule it out you should under go holter recording. If it is abnormal, you need to undergo treatment. If not, it is normal. You can still be put on low dose beta blockers to help you with symptoms. Apart from these, some yoga and specific exercise training can help you to reduce your heart rate.

Considering your exercise tolerance, there is unlikely to be any underlying serious cardiac ailment.
As long as you don't feel unusually uncomfortable or fatigued, there is nothing wrong in continuing your exercise. But if it increases your symptoms, then you should better reduce the intensity of exercise.

Hope I had been able to clear your concerns. Please ask if you have any further queries.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Prabhakar C Koregol 9 hours later

Thank you so much for taking your time to find the cause of this Im really grateful for that. After seing many doctors I belief you are the first one knowing the reason inappropriate sinus tachycardia.

5 years ago I already went for full checkup and I had the high Heartbeat, but it seems the fainting feeling, chest pain get worse. After reading about inappropriate sinus tachycardia its exactly what I have. Im very happy already if its not Aortic dissection. Can it be Aortic dissection?
As I also have the pain in my top left back shoulder.

Just to make sure I have uploaded all my documents. You can find all my results of bloodtest, stress test and ECG here:
Next week on tuesday I will go for 24 hours monitoring in Cardiology Medical Center and they will do the holter monitering, urine test and other test to find out source of high heartbeat.
Anything you would advice me to ask them to look or test for?
How to see if its atrial fibrillation?

Any successful treatment for inappropriate sinus tachycardia?

Doing a test with      SOMATOM Definition Flash CT scanner will this be good to do for me?

Im a health and exercise freak ;-)
Lately my heartbeat stays very high after my excercise, 130-140 for hours...and I feel very dizzy the first 30 min after.
I do not have this when I swim or do yoga I will do more of that for the moment..
Does that mean I can not do any high intensity exercise for my life?

I really appreciate all you do and I can see you really taking your time to look in to this, thank you, thank you, thank you
Answered by Dr. Prabhakar C Koregol 1 hour later
Thanks for detailed reply.
First lets wait for your Holter Report before embarking on treatment discussion.
It can not be aortic dissection from what you describe.
Next coming to how to diagnose AF its very easy on the ECG and cardiologist reading it will be able to give you that information.
You just have tell them your symptoms and nothing else. They would know what to look for.
Yes there is treatment for inappropriate sinus tachycardia which depends on your holter findings.
Please get back to me details and shall advice you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,  
Lab Tests ,  

Recent questions on  Cardiac arrhythmia

doctor1 MD

the other day when driving i skidded out on the ice and almost slammed into a truck coming the opposite direction. i was fine but my heart began beating slowly and pounding with the fear rather than faster. it took almost a minute for it to go back to normal and i was terrified.
is this normal? or is this something i should be worried about. i have heard about something called long QT syndrome, but do not know if this is a normal human reaction under intense sudden startled such as that, thanks

27 yr old male, former smoker. no other heart problems

doctor1 MD

I am a 23 year old female, studying medicine. For past 8 months, i have been having some episodes of heart 'dysfunctions' that now have turned constant. I need help in knowing what is the condition.
It started last may when one day i started feeling so weak that i just could not get up and was having a splitting headache, when i measured my BP was 90/55mmHg ( before it was always 120/80mmHg). I was having palpitations, bradycardia at times, tachycardia at times, extreme weakness, sweating ( especially on scalp) after sleeping after headache. I was also having light sleep.
Slowly, these episodes became constant. Now I am feeling weak all times, light headed if sitting or standing for long, headache (thumping with constant heaviness), inability to sleep, tightness in chest, chest pain sometimes, tachycardia at any normal activity (walking, doing some tidy up), BP is still low. I also get dry cough on breathing sometimes.
So i got a holter done for 24 hours, got following:
- sinus tachycardia( 110- 120) almost all day with some normal rate in between, my heart rate dropped to 50 in middle of night ( reason causing me to wake up from sleep and not to sleep again) and it remained like that for 3 hours
- average pulse -81
- my heart rate jumped to 179 per min when i climbed stairs ( 9 floors, easily climbed by others), breathing became laboured, headache with blacking out sensations ( i did not faint though)
- I have some abnormalities in lead I, II and III ( looks like left axis deviation as lead I is showing highest peaks and is moving away from III ) even the avL and avF looks weird, QTc>450ms is 47%, no ST deviation, no T wave abnormalities
I also have tachypnea (26-28 per min) and accentuation of Pulmonary part of second heart sound. I also have slight edema on my feet ( bluish tinge)
I also did a blood work up, I do not have thyroid problems or anemia
I need some advice on what i might be having, so as to proceed further on treatment.

doctor1 MD

About four years ago, I was diagnosed with ventricular tachicardia. I was given a catheter ablation to treat it, and it corrected an irregular heart beat that I've had since I can remember, but I still experience the rapid heart beats every now and again when Im out running or doing some other strenuous activity. Another thing that I've had since I can remember is excessive sweating, and I mean very excessive. What it takes for a normal person to sweat, it would take A LOT LESS for me. My question is, is the excessive sweating linked to the tachycardia? Of course, tachycardia causes the fast heart beat which in turn causes the sweating, but even when Im not experiencing the rapid irregular heart beats, I still manage to completely soak a t shirt when the guy next to me whose done the same amount of work is completely dry, aside from a few sweat beads on the forehead.

doctor1 MD

my blood pressure is 138 over 82 and my heart rate is 56 - my heart rate hardly ever reaches 60 beats when resting and bp is normally 116 over 72 - should i be worried about slow heart rate i am not at all fit athletic - i am a 55 year old woman with a history of sarcoidosis

doctor1 MD

I have high blood pressure(165/110) and was put on Lisinoprin 3 weeks ago and it has come down about 30 points...however i have head aches and have shortness of breath . I wake up at night and feel like i'm not getting enough oxygen . I weigh 260...

doctor1 MD

I was diagnosed with attrial flutters ( arrhythmia ) and the cardiologist did a cardio version and a subsequent EKG showed the condition was corrected. The doctor has me on Xarelto and a beta blocker . I feel fine and I am wondering if I can drink...

doctor1 MD

My husband is 80 years old and has been diagnosed with congenial heart dease. His heart is only pumping half the speed of a normal heart beat. And now his lungs are filling with fluid. He also has Alzheimer's.