Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes A Higher Resting Heart Rate?
Question: I have a complex question for the last couple of years I have experience in this message a weird experience. .. while at rest my heart will start to beat over 100 beats per minute followed by mild to sometimes sharp chest pain in my sternum. I have had a recent heart catherization 1 year ago that turned out clean... no cardiologist can find out what is wrong with me the only thing that I can piece together is that when I start to exercise heavily it always occurs within a short amount of time after a long run am I crazy or is there really something to be worried about
Brief Answer:
Relax / More tests may help
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
Doctors’ job is often like the detectives! …
We are called in and enter the scene after the thing has happened...!
With limitations of man and machine, if we could not conclude, we postulate as psychiatric! Of course, Psychiatrists are taught / trained to make presumptive and proactive diagnosis, but for rest of the physicians, it is an exclusion diagnosis…
A trial of anxiolytics may be helpful
A higher resting heart rate could be from Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Infection / Pain / Stress / Thyroid / medicines like Phenylephrine used for ‘cold’ and so on.
Cut your caffeine; check your thyroid; No tobacco or alcohol…
At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible! The heartbeats need to be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly - one needs Holter or event monitor.
If there are no clues and if the rate bothering to the extent of interfering with life style, Electro Physiological Studies (EPS) may help > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
“Clean catheterisation” as you say is very reassuring indeed.
It excludes organic obstruction – which however causes symptoms on effort.
Rare possibility of spasm can cause rest pain; provocative tests may reveal, but it could be hazardous… An option will be to try calcium Channel Blockers (CCB) like Diltiazem – this could help spasm AND the rate too!
The long duration / young age / negative investigations – all augur an excellent prognosis!
The treating doctor may suggest further depending on need, based on his assessment of the situation.
Take care
Good luck
Relax / More tests may help
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
Doctors’ job is often like the detectives! …
We are called in and enter the scene after the thing has happened...!
With limitations of man and machine, if we could not conclude, we postulate as psychiatric! Of course, Psychiatrists are taught / trained to make presumptive and proactive diagnosis, but for rest of the physicians, it is an exclusion diagnosis…
A trial of anxiolytics may be helpful
A higher resting heart rate could be from Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Infection / Pain / Stress / Thyroid / medicines like Phenylephrine used for ‘cold’ and so on.
Cut your caffeine; check your thyroid; No tobacco or alcohol…
At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible! The heartbeats need to be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly - one needs Holter or event monitor.
If there are no clues and if the rate bothering to the extent of interfering with life style, Electro Physiological Studies (EPS) may help > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
“Clean catheterisation” as you say is very reassuring indeed.
It excludes organic obstruction – which however causes symptoms on effort.
Rare possibility of spasm can cause rest pain; provocative tests may reveal, but it could be hazardous… An option will be to try calcium Channel Blockers (CCB) like Diltiazem – this could help spasm AND the rate too!
The long duration / young age / negative investigations – all augur an excellent prognosis!
The treating doctor may suggest further depending on need, based on his assessment of the situation.
Take care
Good luck
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
by the way when im not going through one of these episodes my resting heat rate is 56, thank you for your detailed response.......I forgot to mention that a nurse at the hospital when I had my XXXXXXX done told me that she had the exact same thing happen to her and no one could find out the cause.....she wore a Holter monitor and couldn't find anything.....turns out her cardiologist thought it always a condition called prinzmetals angina and put on calcuim channel blockers like you mentioned and she hasn't had an episode in 25 years she said. she was very adimate about me mentioning that to the doctor what are your thoughts on that ?
Brief Answer:
Agree
Detailed Answer:
Hi
You are right… When the pain is typical, but not related to effort, this diagnosis comes for consideration. That was exactly what I had already suggested. I did not mention the medical jargon! Prinzmetal or variant angina is from spasm (not mechanical blockage) and is benefitted by CCB... if the resting heart rate is on the lower side, we prefer CCB like amlodipine [if high, we go for Diltiazem or verapamil / these are 3 different classes of CCB]
Regards
Agree
Detailed Answer:
Hi
You are right… When the pain is typical, but not related to effort, this diagnosis comes for consideration. That was exactly what I had already suggested. I did not mention the medical jargon! Prinzmetal or variant angina is from spasm (not mechanical blockage) and is benefitted by CCB... if the resting heart rate is on the lower side, we prefer CCB like amlodipine [if high, we go for Diltiazem or verapamil / these are 3 different classes of CCB]
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
you are the best :) thank you doctor
Brief Answer:
Thanks
Detailed Answer:
Happy to note that you are happy!
50 years of on the job - seeing satisfied faces is the best gift
You will be alright - in spite of us doctors, if not because of the doctors
God bless you
Thanks
Detailed Answer:
Happy to note that you are happy!
50 years of on the job - seeing satisfied faces is the best gift
You will be alright - in spite of us doctors, if not because of the doctors
God bless you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
God Bless you too :)
Brief Answer:
Thank you
Detailed Answer:
Keep following up with doctor
If in doubt, have a second opinion
Regards
Thank you
Detailed Answer:
Keep following up with doctor
If in doubt, have a second opinion
Regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
