Why does the heart rate increase in response to pain?
A review of your Holter monitoring is necessary.
Welcome and thank you for asking on HCM!
Regarding you concern, I would like to explain that, facing your actual age, a heart rate of 250+ bpm could not be caused by pain (even a severe one).
For a better judging on your heart rate/rhythm issue it is necessary to review your Holter monitoring recordings.
Please, could you upload your test report here for a direct review?
I remain at your disposal in case of further uncertainties.
Opinion as follows:
Extreme pain may serve as an important trigger for sinus tachycardia and sometimes even for abnormal tachyarrhythmia, but in the latter a per-existing cardiac disorder is not rarely present.
In your case a tachycardia of 250+ bpm, should be investigated about the exact arrhythmia and underlying triggering factors.
A systematic review of your thyroid function, cardiac structure and function, circulating catecholamines (especially during extreme pain), and drugs interaction should be done to conclude on the clinical importance and underlying therapeutic strategy.
Waiting for your medical tests reports.
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