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Dr. Andrew Rynne

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What causes tachycardia like heart palpitations after working out?

Answered by
Dr. Lilit Baghdasaryan


Practicing since :2007

Answered : 1509 Questions

Posted on Tue, 20 Oct 2015 in Hypertension and Heart Disease
Question: Hello, I am a highly active 37 year old female in good physical health. I have been a runner for years and have noticed in the past extremely high heart rates when "pushing" myself on runs but this only happened rarely (~223 BPM). No other symptoms except I will sometimes have the desire to slow down as I feel a little tired (then I notice the rate by taking pulse manually). Went to cardiologist and did a treadmill test and did well (17 mets), no abnormal rates detected. Told to continue with my running unless I notice the high rate more frequently. Anyways (here we are) about a year later and it seems to have kicked into full gear. Noticing high rate on last 2 runs. Then also noticed that while my heart rate comes fairly quickly it remains high (about 120 bpm or so) for 1-2 hours after rest. My normal resting heart rate is "typically" 68 bpm. Other fact: when I experience this tachycardia my rate is normal (does not skip, flutter, it is just fast).
Questions: does the high resting heart rate after exercise seem to mean that by body is staying in tachycardia but just coming down to a lower 'rate' because I am no longer exercising? does this "sound" like A-flutter, or just SVT? what sort of additional tests should I have done?
Answered by Dr. Lilit Baghdasaryan 48 minutes later
Brief Answer:
Holter monitoring is needed

Detailed Answer:
Dear Mrs,

Heart rate of 223 bpm is not normal even for exercise. It is difficult to say what is it only based on description.
I would advise you to wear a holter monitor for 24 or 48 hours. It is a device which register your ECG during the period you wear it. If you run and have those high rates during the period you wear it, then the cause can be found out.
In case you don't have high heart rate during that period, another option is loop monitor. It is a small device, which is placed under the skin, and can record ECG for months until you have tachycardia.
It is better to see an arrhythmologist and discuss all these possibilities with him/her.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Lilit Baghdasaryan 39 minutes later
Dr. Baghdasaryan,

Thank you very much for the response. Greatly appreciate it.

In terms of the resting heart rate staying at 120 (more like 120-130) for 1 to 2 hours following exercise- is that 'abnormal' as well? (I am very calm, and rested at this point). If so, does it sound like a continuation of the arrhythmia?..I am just wondering the significance of this as I never shared this with my cardiologist because I did not recognize that I was hitting the very high rate (223) AND subsequently staying elevated for hours.

Answered by Dr. Lilit Baghdasaryan 30 minutes later
Brief Answer:
Welcome back

Detailed Answer:

Usually heart rate returns to normal during 30 minutes after discontinuation of exercise.
I think ECG monitoring will give answers what's going on during your fast rates.

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

The User accepted the expert's answer

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