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Heart & Cardiology/Heart racing upon waking up

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Question
Hi there,

I have a question. I previously asked you one recently and you answered with the possibility of POTS. I'm trying to get in with a POTS specialist, but it takes awhile to see one around my home. Does this still sound like POTS? I have mitral valve prolapse (mild regurgitation), Crohn's disease, and anxiety. I started Zoloft for my anxiety about 2 weeks ago. I also take Bystolic (bet blocker) 2.5 mg, and Xanax as needed for the anxiety I have. The past 2 and a half weeks or so, I have been waking with my heart racing- probably around 120 bpm every morning. If I move my arm, leg or whatever, it races a little bit faster than that. I also have a weak feeling all throughout my body along with nausea. It takes me about an hour to have it return to normal (80's) and when I stand to use the restroom or get out of bed (which I do slowly) it also speeds up and pounds. I'm mainly concerned by the fact that it is already racing when I wake up. It's a horrible way to start my day and it is really bringing me down! My echo showed mild MVP, all ekgs normal except I get sinus tach sometimes, had an EP study that was normal...etc. Idk what to do anymore! ER just sends me home and my current cardiologist brushes me off. Thanks so much for your help/insight!!!

Answer
Hi Sara,

The constellation of symptoms you describe may well be related to dysautonomia and i think you are doing the right thing by checking in with a POTS specialist. It sounds like you have seen a cardiologist including an EP already and they were not able to shed further light on the diagnosis. I realize it feels the cardiologist you saw is brushing you off however this is likely because they don't know whats causing the symptoms or how to address them. The majority of heart specialists are simply not familiar with the evaluation and treatment of dysautonomia. For me to be able to give you meaningful advice over the internet in this complex setting is almost impossible and would be doing you a disservice, in fact even a face to face clinic visit for the same may last 30 minutes to an hour. I realize this is a frustrating time and i would advise maintaining as much patience as possible while a dedicated specialist sees you and formulates a treatment plan. The good news is that the tests you have had so far and the description of the symptoms mean that this is more quality of life affecting rather than life threatening. I know thats still not a solution, but it should be somewhat reassuring.

Hang in there,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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