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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 56181
Experience:  Cardiology Expert
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I am 45, female, have been active, don't smoke or drink, no

Customer Question

Hello, I am 45, female, have been active, don't smoke or drink, no drugs or caffeine, cook most meals from scratch, vegetarian and drink at least 2L water daily. I caught a cold three weeks ago and then felt strong heart palpitations and chest pain after that kept worsening. On Dec 22 I was in emergency, they did chest x-ray, several ECG, a thorough blood test incl. thyroid, and all came back good. I was relieved but the symptoms kept coming back. I could not exercise or feel back to normal. I monitored my heart and found that my heartbeats increase more than 30bpm when I stand, I thought it might be POTs, and so I increased salt in my diet and I also eliminated wheat, soy and processed food that might have msg, just in case. I also started a mild exercise routine. Two days and I improved, only 10bpm increase when I stand, the pounding or palpitation feeling subsided and chest pain was gone. I was almost back to normal. Then last night, the pounding sensation was so strong it kept me awake all night, checking my bp it was 70/40 (I've always had a bit low bp but never that low), but after moving and getting up it was good quickly. The minute I close my eyes, it pounds so strong (not fast) it's burning in my chest and scary. I also started urinating to frequently, I cannot remember laying in bed longer than two minutes at a time. Today all day the pounding was there, just tolerable because I'm busy but I feel it, now my chest is burning. My bp was good all day long. And increase between sit and stand is between 10 to 20 bpm. No swelling anywhere. Please help. Thank you.
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.

Thanks for this question

Are you taking any cold medicine or OTC?

Customer: replied 1 year ago.
No. Not taking any drugs at all. No supplements. No birth control. Nothing at all.
Expert:  Dr. Phil, MD replied 1 year ago.

It sounds like possible severe dehydration.

what are your thoughts on that?

Customer: replied 1 year ago.
It sounds like you did not read my question. At the very beginning of the question I said I drink at least 2L water daily. Thanks. That would be enough for now. I don't want the service.
Expert:  Dr. Phil, MD replied 1 year ago.

I understand and I read your question

However, as you may know, an acute severe illness can increase your water demands tremendously

It is not common to develop POTS from an acute illness

That is why I was wondering what your hydration status was at this point in time

Customer: replied 1 year ago.
I'm sceptic. I never used this service before. You asked while it is mentioned right there. 2 Liters water (that's water only) is a lot, because I drink fruit smoothies too, coconut water and other fluid from food, my urine is always light yellow and almost clear. No signs of dehydration. The cold could be not related, just happened at the same time. I did not sleep since yesterday and am concerned about the situation of this night, added to the palpitation is the night urination too...If it is not POTs, my symptoms were similar to it. But the 30bpm increase has improved, now it increases less between 10 to 20. Right now my bp is 120/84 and 70 bpm sitting, stand:129/84 and 74 so those symptoms are gone. Last night, my bp was 70/40 in bed with painful pounding of heart in chest. The last couple of days I was getting better. I can't find anything new that I might have consumed the night before other than a processed soup for dinner. The palpitation/pounding isn't gone yet, so chances of good night sleep are slim. Thank you.
Expert:  Dr. Phil, MD replied 1 year ago.

Thanks for this reply and trusting me to help you on this.

I can assure this site is legit.

As for your symptoms, that low blood pressure is highly concerning.

Generally when the blood pressure goes very low the heart tries to compensate by speeding up or increasing the forcefulness of contractions. It is the heart trying to maintain stroke volume.

That being said, so what is causing the low blood pressure.

Things that can do it



3)blood loss

4)other bizarre things like adrenal insufficiency

At this point, I really think you need to see a doctor and have some blood work tested. That is the only way to be sure

Customer: replied 1 year ago.
I did full blood work, also mentioned in my original question. They took three full tubes. All came back good. Ok, then. Thanks for trying to help.
Customer: replied 1 year ago.
Also, my blood pressure is good right now as mentioned, but I still have the pounding/palpitations.
Expert:  Dr. Phil, MD replied 1 year ago.

I know that. But I highly doubt they checked things like cortisol level.

This is the "bizarre" thing I mentioned.

Customer: replied 1 year ago.
Sir, they did the cortisol level check. And when you explained the palpitations to me you again missed the point mentioned in my original question that these pounding/palpitation were there the entire night and today without having a low blood pressure. I'm sorry, I thank you for trying to help, but I can't pay for this.
Expert:  Dr. Phil, MD replied 1 year ago.

no problem

good luck to you :)