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What Causes Increased Heart Rate At Night?

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Posted on Mon, 6 Apr 2015
Question: why does my heart rate go up at night? Wakes me up, eating helps but feel faint when I get up
doctor
Answered by Dr. Ilir Sharka (45 minutes later)
Brief Answer:
A better follow up is needed in your case.

Detailed Answer:
Hello! Thank you for asking on HCM! I passed carefully through your medical history, and I would explain that regarding your complains: racing heart rate: in your case there are two reasons why it may be caused: (1) Thyroid hyperfunction; you should check frequently your thyroid hormone blood levels and also consult your thyroid medication doses in order to avoid hyperthyroidism (even that caused by overmedication); (2) Because of the abrupt interruption of the beta-blocker (Atenolol, because of allergy), a rebound phenomenon expressed with apparent tachycardia (palpitations) may be triggered. Usually beta-blockers are recommended to be tappered off by lowering gradually daily doses. You should consult with your doctor to take an alternative beta-blocker that is safe, or to try a calcium channel blocker (such as Diltiazem, etc.) for controlling tachycardia.
Regarding your weakness and light headed upon standing I recommend you to monitor frequently your blood pressure, as probably we have to do with an orthostatic hypotension. In that case, I recommend you to perform a Head Up Tilt Table testing (to judge about its gravity and management strategy).
Hope to have been helpful to you! Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (46 minutes later)
Have not been on any thyroid meds since January. As of 2 weeks ago, thyroid numbers had finally leveled out. Tapered off of atenolol for a week before stopping due to allergy(was taking only 12.5mg/12 hours).
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
After ruling out thyroid dysfunction, some tests are needed.

Detailed Answer:
Hello again! Could you please upload me any existing data about the primary thyroid disorder and medications prescribed! After assuring that your thyroid function is really normal (testing hormone levels and other immagine studies), then I would recommend as follows:
As your disturbing racing heart rate appears during sleeping I recommend you to perform an ambulatory 24 to 48 hours ECG monitoring (Holter) to have a more objective data of your complain (heart rate trend and day-night variations, etc), coupled with a cardiac ultrasound.
A complete blood count (lab test) to exclude a possible anemia, which may trigger palpitations.
A heart rate lowering drug (may be an alternative of beta-blocker or calcium channel blocker) may be discussed with your doctor for controlling your symptoms.
At the end after checking for all the above, a medication aiding sleeping process (like zolpidem) would be of some help.
My Best Regards!
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9535 Questions

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What Causes Increased Heart Rate At Night?

Brief Answer: A better follow up is needed in your case. Detailed Answer: Hello! Thank you for asking on HCM! I passed carefully through your medical history, and I would explain that regarding your complains: racing heart rate: in your case there are two reasons why it may be caused: (1) Thyroid hyperfunction; you should check frequently your thyroid hormone blood levels and also consult your thyroid medication doses in order to avoid hyperthyroidism (even that caused by overmedication); (2) Because of the abrupt interruption of the beta-blocker (Atenolol, because of allergy), a rebound phenomenon expressed with apparent tachycardia (palpitations) may be triggered. Usually beta-blockers are recommended to be tappered off by lowering gradually daily doses. You should consult with your doctor to take an alternative beta-blocker that is safe, or to try a calcium channel blocker (such as Diltiazem, etc.) for controlling tachycardia. Regarding your weakness and light headed upon standing I recommend you to monitor frequently your blood pressure, as probably we have to do with an orthostatic hypotension. In that case, I recommend you to perform a Head Up Tilt Table testing (to judge about its gravity and management strategy). Hope to have been helpful to you! Greetings! Dr. Iliri