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Dr. David
Dr. David, Doctor
Category: Cardiology
Satisfied Customers: 45997
Experience:  Experienced physician with cardiology experience
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Almost 2 weeks ago, my heart rate got up to 180 when I had

Customer Question

Almost 2 weeks ago, my heart rate got up to 180 when I had exercised by walking at a fast pace. I went to yoga 2 hrs later and my heart stayed in FIT band fat burning and cardio range. This continued until I went in to urgent care 3 hours after yoga to be checked out. Only slightly abnormal EKG. Referred to my PCP with whom I had previously scheduled a visit the next day for further guidance. My PCP referred me to a cardiologist and prescribed pranralol and an order for a radioactive cardiac stress test. My appt w/ cardiologist isn't . 15th. The stress test was Thursday 3 days ago. I had stopped the pranralol 24 hrs previous to stress test and resumed only 1 after the stress test. My heart rate has not stabilized since the initial past peak heart rate. It quickly climbs to 120, I slow way down when it climbs quickly - within a minute or 2 when walking.... and drops to between 50 and 52, Thurs and Fri night and was around 51 to 53 a nd then up to 60 last night at night sitting up, and staying awake. Last night I sat up and ate a chocolate bar with espresso beans in it to increase my heart rate. My oxygen has been around 90 and 91, higher after the espresso and then back down after awhile. So, the heart rate and oxygen are varying widely with rest and exercise. I can't even get into see my PCP until Tuesday. I can't sleep. I have stayed awake most of the last 2 nights to keep my heart rate above 50 and my oxygen above 90. The oncall cardiologist I talked to Thursday night told me not to discontinue the pranrolol because I cannot tolerate it as it was dropping my heart rate . I did. And when I asked him what to do if my heart rate is 50 or lower again at night if I should come in, he said no, only if I am fainting. Please help
Submitted: 9 months ago.
Category: Cardiology
Expert:  dr abid replied 9 months ago.

Hi. I am Dr Abid.Welcome to Just Answer and thank you for the question.
I'm reviewing your question now and will post back with your reply.

Expert:  dr abid replied 9 months ago.

Thank you for asking about your concerns ...

First of all as you have had increase in heart rate with exercise in the absence of chest pain , sweating , nausea or vomiting which is against angina .

So marked fluctuations in heart rate such that abrupt fall from 120 to 60 is usually not seen if pulse is checked manually .

Propranolol reduce heart rate , and while sleeping heart rate normally drops because of loss of Symphathetic tone over heart.

At this stage it would be ideal for you to have low dose of Propranolol 10 mg once a day , meanwhile you shouldnot worry about drop of heart rate while sleeping as I mentioned this is normal .

You will not faint , please donot be anxious , nothing will happen , Propranolol will stabilize your heart rate .

So relax , and wait for stress test . PCP advise to continue Propranolol is reasonable but use low dose 10 mg once a day .

Regards ***** ***** luck .

Let me know if you have further quires .

Please click on good rating .

Thanks.

Expert:  dr abid replied 9 months ago.

Please let me know if you have further quires ...

Customer: replied 9 months ago.
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Expert:  Dr. David replied 9 months ago.

have you had your thyroid hormone levels checked? hyperthyroidism can cause fast heart rate and inability to sleep.

I'm glad you had an EKG. that would have picked up things like atrial fibrillation which can also cause fast heart rate in your age group.

Expert:  Dr. David replied 9 months ago.

you don't have to start a new question here.

I would get copies of your blood testing and EKG testing

I would avoid caffeine for now.

do you have excessive anxiety symptoms? excessive anxiety symptoms can cause fast heart rate as well.