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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes fluctuating heart rate?

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5994 Questions

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Posted on Wed, 7 Jun 2017 in Hypertension and Heart Disease
Question: I went running and my pulse got to 145 and after two mins of resting it was down to 99.... and has returned to 78 after 9 mins.... is this good?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows :

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would like to explain that an increased heart rate similar to your levels is quite a normal physiological reaction to physical exertion.

Even if heart rate were higher (180-190 bpm), it would be considered again normal.

In addition, your heart rate decreasing at recovery shows a normal pattern.

So nothing to worry about!

Just keep following a healthy lifestyle with lots of frequent physical activity.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Kind regatds,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 3 minutes later
Thank you for the response .... Would you think it would be pretty unlikely that all the arteries in my heart are clogged up? I just turned 30
doctor
Answered by Dr. Ilir Sharka 9 hours later
Brief Answer:
No reasons to suspect any coronary arteries issues!

Detailed Answer:
Hello again, dear Ashton!

I would say that as far as you don’t have known coronary risk factors (history of hypertension, dyslipidemia, diabetes, you don’t smoke cigarettes, any known family history of premature coronary disease, etc.) and what is more important you don’t have the minimal clinical symptomatology of acute cardiac ischemia; there are no reasons to suspect in such direction.

Considering your age, your increased heart rate during exertion is completely a normal physiological reaction and you shouldn’t worry about that.

All that is needed in your case is to avoid unhealthy lifestyle I mentioned at the beginning of our thread and enjoy your life.

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 hours later
Ok thank you so much? What are tge signs of cardiac ischemia...... my shoulders hurts alot but i can feel tge pressure point when i move my neck where it hurts the worst..... is that a symptom?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
It seems to be a musculoskeletal disorder.

Detailed Answer:
Hi Ashton!

A chest pain or discomfort (including also neck pressure) would not be considered related to any cardiac ischemia if the pain is well localized and modulated by posture change or neck movement ("the pressure point when I move my neck where it hurts the worst...").

It sounds most likely to be of musculoskeletal origin (my be any muscle tension, backbone or articular injuries).

Coming to this point, I would recommend performing some lab tests:

- CPK,
- PCR,
- AST & ALT
- LDH

Any anti-inflammatory drugs like Ibuprofen, Naproxen, etc. could be helpful at relieving your discomfort.

You should discuss with your attending doctor on the above mentioned issues.

Best wishes,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 16 minutes later
I just looked up these test and i was in the er about a month and half ago bc i was having anxiety and full blown melt down when i went in and i know they checked all my heart enzymes, electrolytes , kidney and liver functions.... they took like 8 tubes of blood out of me, he did urine test , listened to my heart real good , ekg and they said everything came back normal.... i have bad anxiety about my health .... but i still have myself convinced ill drop over dead any time..... would you say after all those tests theu ran that my fears are pretty irrational
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

As they took so many tubes of blood, I think they have checked all the above tests, including the cardiac enzymes.

So, there is no reason to think that you are going to die from acute sudden cardiac death.

You are a healthy person.

Maybe anxiety is playing a scary game. You should know that anxiety can mimic a lot of symptoms (including the heart, stomach, brain, muscles, lungs, etc.).

You should know that anxiety activates the sympathetic nervous system, causing increased levels of adrenaline and noradrenaline, which can cause an increased heart rate and blood pressure, difficulty breathing, stomach ache, etc... It can also trigger the feeling of pain in different organs.

But, as all tests result normal, there is nothing to be concerned of.

I would just recommend trying taking Ativan or alprazolam 0.25mg. If it helps improve your situation, it would be another argument in favor of anxiety as the main cause underlying your symptoms.

Hope you will find this answer helpful!

Let me know about everything!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 17 minutes later
Ok thank you ill try to keep all that in mind when i get freaked out, when first went in my heart rate was at like 140 and my blood pressure was like 150/95 bc i was having a full out panic attack.... shaking, breathing crazy, mouth drying out very scary and they got me back in like 5 mins and the min they laid me down and started xanax and talking about something kinda funny my heart rate dropped to like 80 and they did test and all was good and they retook blood pressure and it fell to like 125/81 after like 2 mins of calming me down and then went back to normal after all the negative results came back.i mentioned to ER doctor before ekg that occasionally throughout my life , mostly during stress, that it will feel like my heart misses a beat and he wasnt concerned and told that everyones heart has skipped beats sometimes .... he did ekg and everything was normal there ..... would you agree with him there? Also my normal resting heart rate upon rising is usually around 58-62. They gave me a small prescription of xanax and it works but makes me feel really dopey
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
My advice as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

Yes, I agree with your doctor that anxiety has played an important role in all this clinical scenario.

Besides, all your performed tests have shown nothing abnormal.

You should know that anxiety, as well as physical activity, both activate the sympathetic nervous system and cause increased heart rate, blood pressure and also ectopic heart beats.

But, this happens in every normal person.

In some sensitive persons like you, this reaction may be a little more exaggerated.

But, this is not indicative of any serious medical disorder. It just indicates that you are a sensitive person.

Regarding Xanax, I would recommend reducing the dose to half a tablet, in order to avoid feeling dopey.

Anyway, you should know that this is not a good therapy for long term treatment of anxiety. I would recommend using Xanax only during panic attacks.

If these episodes are repeated frequently and interfere with your daily activity, I would recommend consulting with a psychotherapist or psychiatrist to help you manage anxiety better.

I would also advice checking your thyroid hormone levels, because thyroid dysfunction can trigger this symptomatology.

And here are some natural ways to control anxiety:

-avoid coffee and energy drinks
- eat a balanced diet
- perform a lot of physical activity (aerobics, yoga, recreational sports, walking, etc.).

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 16 hours later
Ok thank you! I think ive figured out my shoulder pain.... i sleep directly on it and my arm and i bend my arm up in a funny position and sleep over on it.... arm and shoulder feel stiff when i wake up off of it but don't know how to not sleep like that
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Yes, this would explain the shoulder and arm pain.

From the other hand some nerves may be compressed from this wrong position during sleeping, causing numbness in the hand and fingers.

I would recommend trying to put a pillow in this shoulder, so you will have to change your position during sleep.

Hope you will find this answer helpful!

Let me know about everything!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 55 minutes later
Ok thank you i will try to do that! One more question .... i want your advice on if you think my diet is pretty healthy...... ill usually eat a cup of strawberries with 2 tablespoons of organic almond butter (just pureed almonds and no additives) and then like 3oz of sauteed wild caught shrimp in olive oil and some salt and pepper and dark leafy greens with a little olive oil and balsamic and carrots and then dinner usually a grilled chicken breast with broccoli with maybe a teaspoon of butter and the same salad from lunch...
doctor
Answered by Dr. Ilir Sharka 5 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello!

I think that your diet is really healthy!

But, there is no need to eat the same things every day.

It is important take a balanced diet in vitamins, carbohydrates, proteins and lipids and plenty of fibers (cereals, vegetables, etc.).

Food reach in omega 3 (nuts, olive oil, fish, fish oil) is really healthy too.

Hope to have clarified some of your uncertainties!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 17 hours later
Ok will do! Do you think eggs are ok in the morning.... ive heard mixed things about them being healthly.... but when i do eat them with some fruit they tend to give me alot of energy and i feel great!
doctor
Answered by Dr. Ilir Sharka 20 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Yes, it is true that there are a lot of controversial studies about eggs.

But, you should know that they contain a lot of vitamins, omega 3 fatty acids as well as proteins and cholesterol.

That is why they provide you with a lot of energy.

I think that there is nothing wrong in eating eggs, but up to 5-6 eggs in a week, because they can also raise your cholesterol levels. You can also check your blood lipid profile, to be sure that your diet is balanced.

Hope you will find this answer helpful!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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