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Suggest Treatment For Elevated Heart Rate When On Treatment For Lymes Disease
Question: Hi I’m wondering when sustained elevated heart rate becomes urgent or emergent. My heart rate is normally 60-70 beats per minute, and some days I can get as many as 15 PAC and/or PVC heart beats when my nervous system is overwhelmed. I am treating Lyme Disease, and today I did a treatment which increased my resting heart rate to 90 beats per minute and gave me a bad headache for most of the day. (When Lyme Disease is treated, the toxin load from dead bacteria etc. can cause die-off symptoms.) At the end of the afternoon, after drinking some water which may have been slightly bad, my heart rate got as high as around 160 beats per minute for a time, and has been in the 110-145 range since. My blood pressure has been 120/70, my pulse is steady, and I do not have an elevated temperature. I do have an incisional umbilical hernia but it is reducible. Given the PAC and PVC beats and other background above, can you tell at what point sustained elevated heart rate becomes urgent or emergent?
Brief Answer:
emergency is unpredictable.
Detailed Answer:
Hello,
Welcome to the HCM.
Since frequent and prolonged PVCs may increase the risk of developing other , more serious cardiac arrythmia's suddenly . So emergency is totally unpredictable. But if you feel PVCs and PACs mostly at rest and associated with alarming symptoms like light headedness, chest pain, sweating, lethargy or loss of consciousness, it could be sign of emergency and may need prompt hospital admission.
As lyme disease can cause carditis and even every tissue of heart including the conduction system can be effected.if someone having prolonged and frequent PVCs and PACs with lyme disease , it is advisable to get prompt hospital admission and continuous monitoring , with heart monitor and EKG , as it may need pacemaker (temporary ) , some antiarrythemic medicines (betablockers) and ablation depends on decision after close and careful evaluation by a cardiologist .
I would highly recommend you to alert your treating doctor promptly , if you feel prolonged and frequent palpitation in a day.
Also if medication you take routinely is causing your symptoms , discuss a possible change in medication with your treating doctor .You can help control your PVC's and PACs by reducing or eliminating your caffeine , stress and anxiety.
Since we can not predict that sustained and increased heart rate is weather benign or a serious arrhythmic attack of heart like (fibrillation or flutter ), so close monitoring by cardiologist is necessary , whenever undergoing these symptoms.
Hopefully I answered your Question, you may ask further , if you have more questions to ask.
Wish you best of health.
Regards,
Dr.Maheshwari
emergency is unpredictable.
Detailed Answer:
Hello,
Welcome to the HCM.
Since frequent and prolonged PVCs may increase the risk of developing other , more serious cardiac arrythmia's suddenly . So emergency is totally unpredictable. But if you feel PVCs and PACs mostly at rest and associated with alarming symptoms like light headedness, chest pain, sweating, lethargy or loss of consciousness, it could be sign of emergency and may need prompt hospital admission.
As lyme disease can cause carditis and even every tissue of heart including the conduction system can be effected.if someone having prolonged and frequent PVCs and PACs with lyme disease , it is advisable to get prompt hospital admission and continuous monitoring , with heart monitor and EKG , as it may need pacemaker (temporary ) , some antiarrythemic medicines (betablockers) and ablation depends on decision after close and careful evaluation by a cardiologist .
I would highly recommend you to alert your treating doctor promptly , if you feel prolonged and frequent palpitation in a day.
Also if medication you take routinely is causing your symptoms , discuss a possible change in medication with your treating doctor .You can help control your PVC's and PACs by reducing or eliminating your caffeine , stress and anxiety.
Since we can not predict that sustained and increased heart rate is weather benign or a serious arrhythmic attack of heart like (fibrillation or flutter ), so close monitoring by cardiologist is necessary , whenever undergoing these symptoms.
Hopefully I answered your Question, you may ask further , if you have more questions to ask.
Wish you best of health.
Regards,
Dr.Maheshwari
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you so much Dr. Maheshwari. :) I am consistently impressed with replies from physicians from XXXXXXX - you guys must have good medical school training there. I am wondering how you would define the "frequent and prolonged PVCs" threshold. One figure I have heard referenced in XXXXXXX by the nationally prominent cardiologist Dr. XXXXXXX Sinatra is that 6+ PVCs per minute or 30+ PVCs per hour exceed the safety threshold and necessitate treatment. Here is a source where he speaks on this:http://www.heartmdinstitute.com/component/content/article?id=494:worried-about-heart-palpitations
Would you concur with this, or would you consider the safety threshold for PVCs lower in the case of Lyme Disease patients because of the carditis issue? I have been treating Lyme Disease for some time, and the physician specialist I've been seeing was saying carditis typically occurs early on in Lyme Disease patients, and that late onset can be rare. I will nonetheless perhaps try and get an echocardiogram to assess the possibility of carditis. I have had historically elevated levels of homocysteine - presently 11.8 umol/L but once as high as 18 umol/L - and I know this can present an increased inflammation risk.
Would you concur with this, or would you consider the safety threshold for PVCs lower in the case of Lyme Disease patients because of the carditis issue? I have been treating Lyme Disease for some time, and the physician specialist I've been seeing was saying carditis typically occurs early on in Lyme Disease patients, and that late onset can be rare. I will nonetheless perhaps try and get an echocardiogram to assess the possibility of carditis. I have had historically elevated levels of homocysteine - presently 11.8 umol/L but once as high as 18 umol/L - and I know this can present an increased inflammation risk.
Brief Answer:
Safety threshold can not be predicted in arrythmias.
Detailed Answer:
Thankyou for your appreciation dear.
Since increased homocysteine level can cause cardiovascular disease ,but it is less likely that it is causing directly PVCs and PACs.
Well anything below 1000PACs and 1000 PVCs a day is ,in a structurally normal heart considered normal. However 2000 or 5000 is not necessarily abnormal. As some people actually have bigeminy (half of all heart beats are PVCs and PACs) as their normal rhythm. It all depends on the cause ,and how bothered you are from them.
Since every one in average 50 to 70 percent have PACs, and 40 to 60 percent have PVCs during a random 24 hour interval. If some one have a day without them ,they are likely to occur the next day.
As safety threshold can not be predicted ,as I have mentioned before that these premature beats some time can cause more and serious other arrhythmic beats.
If you are anxious ,you should see a cardiologist ,and get necessary tests done,just to be completely sure they are benign.
Such tests can be monitoring 24 hrs of ECG to clarify how many you have,and if necessary ,an echocardiogram can be done to rule out any structural heart disease or effect of lyme disease .
Wish you best of health.
You may ask further,I will be happy to help.Else You may close the discussion
and rate the answer.
Regards,
Dr.Maheshwari
Safety threshold can not be predicted in arrythmias.
Detailed Answer:
Thankyou for your appreciation dear.
Since increased homocysteine level can cause cardiovascular disease ,but it is less likely that it is causing directly PVCs and PACs.
Well anything below 1000PACs and 1000 PVCs a day is ,in a structurally normal heart considered normal. However 2000 or 5000 is not necessarily abnormal. As some people actually have bigeminy (half of all heart beats are PVCs and PACs) as their normal rhythm. It all depends on the cause ,and how bothered you are from them.
Since every one in average 50 to 70 percent have PACs, and 40 to 60 percent have PVCs during a random 24 hour interval. If some one have a day without them ,they are likely to occur the next day.
As safety threshold can not be predicted ,as I have mentioned before that these premature beats some time can cause more and serious other arrhythmic beats.
If you are anxious ,you should see a cardiologist ,and get necessary tests done,just to be completely sure they are benign.
Such tests can be monitoring 24 hrs of ECG to clarify how many you have,and if necessary ,an echocardiogram can be done to rule out any structural heart disease or effect of lyme disease .
Wish you best of health.
You may ask further,I will be happy to help.Else You may close the discussion
and rate the answer.
Regards,
Dr.Maheshwari
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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