Heart & Cardiology/Racing heart upon standing and moving
Hi, I have a couple questions for you if you don't mind!
First of all, I am a 21 year old female and I was diagnosed with MVP with mild regurgitation and also SVT in the ER when my heart rate went to 180. Well I went for an EP study/ablation this past week, and they said I don't have SVT and never did. It was just sinus tachycardia...I've had all the event monitors and 24 hour holters and when I thought I was in an SVT episode- they come back as sinus tach. But my heart rate will go up to 140-170. I was recently taken off my beta blocker (5 days ago or so) due to me not having the SVT. Since then I've had pretty bad episodes where my heart rate positively races when I stand. I've been pretty much bedridden and even called an ambulance yesterday because at rest I was at 120 and when I stood for more than a minute I would go up to 160ish. The paramedic told me I was at 165 or so with an "almost buried p wave." Does this mean the SVT is really there?
Also- do you know what else could cause your heart rate to race so quickly when standing? It first started in the shower- my heart rate went high and I would get a little faint and have to get out and lie down- 2 days ago. Then yesterday this all happened. The ER told me to follow up with my cardiologist and my neurologist- which I plan on doing. But I'm just trying to get some possibile answers in the meantime! By the time I got to the ER my heart rate was back down to 120's. After about an hour my heart rate went back to normal- 85-95 and was hovering there. They then did a test- lie me down and take bp and heart rate, then sitting up, and then standing. Blood pressure stayed about the same but my heart rate increased about 30 beats upon standing. They gave me fluids and then the doctor came in and did the same thing and it only went from about 90 to 110 and then once up for a minute went back to around 100 standing. I'm so confused about this all and pretty frightened.
Also- I have had an echo- all was normal except for mild MVP. Also have had numerous chest X-rays, ekgs, the 24 hour monitors and a 10 day event monitor. Thanks so much for your time Dr. Ahmed!
It sounds to me that you may have a dysautonomia and possibly something known as POTS syndrome. If your symptoms persist i would go and seek out someone familiar with that, maybe local to you and ask them if you have a dysautonomia. I have linked a detailed resource i have written above. It may also be worth seeking a second EP opinion if you aren't satisfied with the opinion you have been given.
Hope that was helpful.