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  • 25yr old with tachycardia out of the blue!

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    Old 03-06-2004, 04:52 PM   #1
    AmyRS
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    25yr old with tachycardia out of the blue!

    This could get long but I'll do my best to keep it short as possible!

    Two weeks ago while sitting in a movie theatre I noticed my heart was beating really fast. When my husband and I came home I mentioned it to him and he listened and thought it was going twice as fast as his. We laughed, thinking it was nothing and decided to time it to see if he was right. His was 70 and mine was 130.

    After realising the "normal" resting rate is anywhere between 70-90 I started to realise something was not right!! We monitored it for a while and finally headed to emergency just in case. I spent the day there while they watched me go from 115 to 160 by simply lifting my arm to scratch my face. At this point I had no other symptoms besides my heart beating out of my chest. They released me that same night, under the impression that the medication I've been on due to some neurological problems (Nortriptyline) was causing my heart rate to be elevated. They made me stop cold turkey that night until I could talk to my neurologist.

    When I spoke to him, he said he has never had this happen before, only in elderly patients who had prior cardiac problems before taking the meds. Now we were getting a little worried, condsidering nobody knew why my heart was going crazy and it still hadn't slowed down.

    About 2 days later I was having trouble breathing and quite a bit of chest pain. Back to the hospital, where they admitted me for 8 days to run a bunch of tests. Lung scan to make sure no embollism which was clear, blood work for magnesium, thyroid, blood surgar all clear, echo showed no signs, and holter monitor that recorded beats up to 188. This is all laying in a hospital bed!!! They also had me do a 24 hour urine test which won't be back for 4-5 weeks.

    Because of the previous neuro problems I have a brain MRI coming up in 2 weeks to rule out MS. They released me thinking they'll know more when the urine test comes back and once we have the MRI as well.

    I visited my family dr yesterday and she is trying to convince me that this is generalized anxiety disorder and chronic panic attacks. I've only had difficulty breathing once, and I certainly haven't been anxious while watching a funny movie I'm starting to feel like they're putting me off because they can't figure out what it is and they don't want to take the time to.

    Should I just wait for the MRI and other results or should I be getting a referral to someone else? Should I just let this go? My heart is still pounding and my family isn't comfortable with me only being able to sit on the couch for fear of my heart going through the roof. Here is my big shopping list of symptoms:

    - Blue feet and toenails when sitting
    - Extreme fatigue - too tired to laugh or move at all
    - Irregular periods
    - Hair loss
    - Night sweats
    - Tingling in face, hands and arms
    - Headaches
    - Stiff feeling in eyes and vision problems - dyslexia with numbers and words
    - Out of body feeling - brain shutting off for a few seconds at a time - vision is shifty instead of smooth
    - Nauseous/no appetite
    - Vertigo
    - Sweating
    - Pounding head when first standing up
    - Chest pain
    - Pink rash on feet when in hot shower

    They tried me on 2 beta-blockers in the hospital and they made me feel worse - sick to my stomach and no energy, and they didn't do much to bring my heart rate down either!

    My blood pressure was all over the place as well - 165 over something - that one set off an alarm and they came running into my room, and as low as 80 over something and the nurse asked me if I felt like I could pass out! I haven't fainted (yet)!

    Another thing that was weird was they gave me Ativan and it didn't make me sleepy or make a difference with rate/pressure either.

    Maybe at least the tachycardia will leave as fast as it came on?

    Any opinions or advice are greatly appreciated!

    Amy

     
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    Old 03-07-2004, 03:20 PM   #2
    zuzu8
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    Re: 25yr old with tachycardia out of the blue!

    Amy-
    Goodness...You have so much going on here all at once.
    I will hazard a guess, that the 24-hour urine test was done to ascertain whether or not you may have something called a pheochromocytoma.



    A pheochromocytoma is a tumor (don't panic... over 95% of these are totally benign) that usually originates from the adrenal glands' chromaffin cells, causing overproduction of catecholamines, powerful hormones that cause tachycardia, high blood pressure and other symptoms.

    They are usually very small and may grow within the adrenal glands or in chromaffin cells outside the adrenal glands. They can occur in men or women at any age, but they are most common in people between the ages of 30 and 60.

    Even a small pheochromocytoma can produce large amounts of those potent catecholamines and extreme symptoms.

    The most prominent symptom of a pheo (as it is affectionately called (ha ha)) is high blood pressure, which may be very severe. Other symptoms can include what you experienced which is a VERY fast and pounding heart rate. Also, excessive sweating, light-headedness when standing, rapid breathing, cold and clammy skin, severe headaches, weight loss, chest and stomach pain, nausea, vomiting, visual disturbances, tingling fingers, constipation, and an odd sense of impending doom. When these symptoms appear suddenly and forcefully, they can feel like a panic attack. Not everyone experiences all these symptoms. (You definitely have some of them.) Sometimes sudden unexplained episodes of hypertension might be the only tip-off. In half of the people, symptoms come and go, sometimes triggered by pressure on the tumor, massage, drugs (especially anesthesia and beta-blocking drugs), emotional stress and even during the simple act of peeing!

    Let's see what the urinalysis shows. In the meantime, try to ride with all this as much as possible. After that 8 day stay at the hospital, presumably the doctors have ruled out the most serious stuff by now.

    An interesting thing about beta blockers: Because of high blood pressure and other symptoms, a doctor may prescribe a beta-blocker before knowing that the cause is a pheochromocytoma. BUT Beta-blockers can make high blood pressure worse in people with pheochromocytoma. This "paradoxical" reaction often makes a diagnosis of pheochromocytoma even more of a possibility.

    Pheos are treatable, in case all this info has panicked (not my intention!) rather than reassured you.
    Usually the best treatment is to remove the pheochromocytoma. Often they delay surgery until a doctor can bring the tumor's secretion of catecholamines under control with drugs, because having high levels of catecholamines can be dangerous during surgery. Once the tumor is removed, you're done! And A-okay again!

    zuzu xxx

     
    Old 03-07-2004, 03:32 PM   #3
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    Re: 25yr old with tachycardia out of the blue!

    AMY-
    P.S.-
    As hard as it may be to believe, your family doctor may be right. Many people may have these symptoms as manifestations of an extreme anxiety disorder not a glandular problem. Still, again, let's see what the urine test shows.

    zuzu xx

     
    Old 03-10-2004, 03:44 PM   #4
    AmyRS
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    Re: 25yr old with tachycardia out of the blue!

    Well, my MRI is next Wednesday, so the plan is that no matter what the results are we're going to head to the teaching hospital about an hour away to get a second opinion on everything.

    The cardiologist explained to me about the whole tumour thing, I had never heard of that before. I agree that I have lots of those symptoms though, so it should be interesting if that's what it is!

    I've recently been researching a condition called Postural Orthostatic Tachycardia Syndrome (POTS) that I have just about every symptom of. It's given me some hope that I might have a defense against the panic attack diagnosis. In everything I've read about panic/anxiety attacks the patient has something they are anxious about that they are aware of, even if the attack happens when they aren't expecting it. I don't have anything I am worried about - everybody gets stressed out and I KNOW that what has happened to me for over 2 weeks now is not due to stress. That's another thing - I haven't heard of panic attacks lasting over 2 weeks.

    I guess we'll see what happens with the MRI and then off I'll go for the 2nd opinion!

    Amy

     
    Old 04-27-2004, 07:06 AM   #5
    Mishmosh
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    Re: 25yr old with tachycardia out of the blue!

    Amy, did you ever figure out what it is? I have very very similar symptoms and just on atenolol which is working, but still a band-aid for the real issue.

    Michelle

    Last edited by moderator2; 04-27-2004 at 02:00 PM. Reason: Please carefully read, know and follow the Healthboards.com Policies and Guidelines. Click on FAQ at the top left of this page. Thank you!

     
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