My trip to the ER / high heart-rate

[I was going to post this a reply to "heart rate really high on waking in morning?" (viewtopic/t89376/viewtopic.php?f=1&t=89376) but didn't want to hijack it..]

My chest pain has been getting worse and I figured it was about time to see the GI guy to make sure this really is gerd/esophogeal spasms. If it's actually my heart instead things may get ugly..

Well low and behold that night after masking up I did a spot check with my pulse-ox and watched my heart rate -- 105, 107, 114, 118, 122, 128 for a bit and then jumped down in the 90's to start all over. I figured maybe the tums, gaviscon, and xanax had something to do with it so I went to sleep.

The next morning I was running errands getting ready for Mother's Day (company coming). I bought two pork butts (pulled pork) and 8 racks of baby back ribs for the smoker. Drove home from the pork store, put the meat in the fridge and wasn't feeling right so I took my BP. BP was a bit high - but certainly not terrible for me. Pulse was 130+. hmmm.. Sat down for a while and rechecked. Same. 30-60 minutes later I checked my elliptical HR monitor and my pulse-ox. All agreed it was still very high. Figured now was a good a time as any to get this checked so off to the ER I went.

(I didn't think that I was dying then and there and really didn't want the spectacle of an ambulance and police so we drove.. This was also a time I didn't think the ER would be very busy.. But generally if you need quick attention ALWAYS call an ambulance as you will bypass triage and the waiting room.)

Triage didn't like what they heard so off to a room. Had the usual EKG, blood tests, xray, etc. Even had a cat-scan of my lungs with dye to check for clots.. No cardiac events - ekg was fine, just quite fast.. Lungs need to get checked in a few months -- found a nodule (whatever that means)..

My wife noticed the monitor doing the same thing my pulse-ox did every now and again -- 100, 102, 105, 108, 110.. 86, 89, 95, 105... We told the ER doc but he didn't seem to care. Later he happened to be in front of the monitor when it happened and he said "Well I'll be damned! I can't believe that just happened!!" I'm thinking "oh crap, that can't be good.."

I asked if that was a good thing. His reply, "It was a very good thing that he saw it." ..double crap..

They later concluded it was "just sinus" and said I was fine - although I'm really not sure what that even means..

After a few hours and fluids my heart-rate dropped into the 90's and my official diagnosis was tachycardia due to dehydration. They said my kidney function wasn't great and the fluids seem to have helped regulate my heart-rate. I *was* running around that morning and not eating or drinking so I guess it's plausible?

Holidays are always interesting

I have had esophagus spasms for years. I was always told my heart was fine but given nitroglycerine tablets for the pain. I was undiagnosed until I met my new doctor this year. I was so glad to finally find out the cause of the pain instead of just taking heart medication and not knowing why. I hope you get your problems sorted out faster than I did.

Dehydration can cause tachycardia, yes.

Sinus ones are considered not as bad, in general, and they would see that while you were there.

Did you feel better when you got hydrated?

Hi!

Late 2005 I was robbed, stabbed and beaten. Near the anniversary of that attack in 2006 I was at the emergency room – pulse 140 (I had been sitting quietly for several minutes) BP 200/120. They took me right in.

Visit to ER same time of year 2007.

2008-10 made a plan which avoided the ER.

On October 12 2011 listened to a Dr. Park interview which explained good portions of the physiology of hyperventilation (see: http://doctorstevenpark.com/expert-inte ... ck-mckeown ). As I listened to the interview I tried the breath control portion of the nose clearing exercise. My nose did clear (in spite of not holding it or bobbing my head up and down) and my heart rate reduced notably!! I could feel the blood rush back into my feet. I felt warm. I relaxed!!!

In thinking about what was going on it occurred to me that hyperventilation was a key part of what my doctors had been calling anxiety attacks.

The thing that bothered me about any of the eucapnic breathing techniques that I found is the lack of feedback to know when you go through eucapnia into hypercapnia. As I thought about this it occurred to me that the heart rate would be lowest in the eucapnic state. So I dawned my pulse oximeter (it was on my desk as I was listening to the interview) and started a several hour process of finding the lowest heart rate controlling breathing while keeping exertion constant.
I also later did this on my treadmill at a moderate rate.

While doing all of this, several times, I noted that the lowest heart rate occurred when the SpO2 was at a certain reading. At my computer an SpO2 of 96% yielded the lowest heart rates on the treadmill an SpO2 of 97% yielded the lowest heart rates. So the SpO2 reading became my guide.
Now living at 2500' rather than near sea level, and/or perhaps because I am in much better shape it is now an SpO2 of 95% at my computer and 96% doing moderate exercise that yields the lowest heart rates.

It is harder to control breathing near the anniversary times but it works – no anxiety attacks since I learned to do this.

To control the tendency to do this at night with CPAP I use EERS[1] during those times. There may be better therapies in the future[2].

Have a great week!

Todzo

[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741

[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link: http://www.ncbi.nlm.nih.gov/pubmed/19628721

In addition to making sure you have adequate hydration you may want to read the book "The Magnesium Miracle" by Dr. Carolyn Dean.

jdr999 wrote:[I was going to post this a reply to "heart rate really high on waking in morning?" (viewtopic/t89376/viewtopic.php?f=1&t=89376) but didn't want to hijack it..]

My chest pain has been getting worse and I figured it was about time to see the GI guy to make sure this really is gerd/esophogeal spasms. If it's actually my heart instead things may get ugly..

Well low and behold that night after masking up I did a spot check with my pulse-ox and watched my heart rate -- 105, 107, 114, 118, 122, 128 for a bit and then jumped down in the 90's to start all over. I figured maybe the tums, gaviscon, and xanax had something to do with it so I went to sleep.

The next morning I was running errands getting ready for Mother's Day (company coming). I bought two pork butts (pulled pork) and 8 racks of baby back ribs for the smoker. Drove home from the pork store, put the meat in the fridge and wasn't feeling right so I took my BP. BP was a bit high - but certainly not terrible for me. Pulse was 130+. hmmm.. Sat down for a while and rechecked. Same. 30-60 minutes later I checked my elliptical HR monitor and my pulse-ox. All agreed it was still very high. Figured now was a good a time as any to get this checked so off to the ER I went.

(I didn't think that I was dying then and there and really didn't want the spectacle of an ambulance and police so we drove.. This was also a time I didn't think the ER would be very busy.. But generally if you need quick attention ALWAYS call an ambulance as you will bypass triage and the waiting room.)

Triage didn't like what they heard so off to a room. Had the usual EKG, blood tests, xray, etc. Even had a cat-scan of my lungs with dye to check for clots.. No cardiac events - ekg was fine, just quite fast.. Lungs need to get checked in a few months -- found a nodule (whatever that means)..

My wife noticed the monitor doing the same thing my pulse-ox did every now and again -- 100, 102, 105, 108, 110.. 86, 89, 95, 105... We told the ER doc but he didn't seem to care. Later he happened to be in front of the monitor when it happened and he said "Well I'll be damned! I can't believe that just happened!!" I'm thinking "oh crap, that can't be good.."

I asked if that was a good thing. His reply, "It was a very good thing that he saw it." ..double crap..

They later concluded it was "just sinus" and said I was fine - although I'm really not sure what that even means..

After a few hours and fluids my heart-rate dropped into the 90's and my official diagnosis was tachycardia due to dehydration. They said my kidney function wasn't great and the fluids seem to have helped regulate my heart-rate. I *was* running around that morning and not eating or drinking so I guess it's plausible?

Holidays are always interesting

What they meant by sinus was that the heart rhythm was normal (ie. sinus rhythm). Had it been abnormal, they would have diagnosed you with atrial fibrillation and they could have made lots of money off you and your insurance .... Hence, dag nabbit! -- It was "just sinus".

Stormynights wrote:I have had esophagus spasms for years. I was always told my heart was fine but given nitroglycerine tablets for the pain. I was undiagnosed until I met my new doctor this year. I was so glad to finally find out the cause of the pain instead of just taking heart medication and not knowing why. I hope you get your problems sorted out faster than I did.

What exactly were your symptoms and how did they treat it?

I'm one that can't really zero in on my own heart beating. Might be the years of weightlifting, or just way too much extra fat.. I know it's in there, just can't really feel it. It's also a bit quiet on a stethoscope. The most I can feel is something "odd" at times.. So heart, reflux, esophagus.. Just too difficult for me to zero in on anything in there so I'm always guessing...

For as long as I can remember (5-10 years+) food has been getting stuck in my throat. Not every time, but at least a few times a week. I thought I was just taking too large of a bite or not chewing my food well enough. It got to the point where I won't even start eating until I've got a large glass of something to force whatever happens to get stuck down. Rice was always a tough one for me. I don't notice it as much anymore so maybe I figured out how to deal with it better...

Xney wrote:Dehydration can cause tachycardia, yes.

Sinus ones are considered not as bad, in general, and they would see that while you were there.

Did you feel better when you got hydrated?

I did, but I was also in bed for several hours.. They didn't check my vitals while standing or ambulating though. When I got home my heart rate wasn't as good as in the hospital, but better than when I arrived. It was probably 100 or so at rest, and 110-120 at exertion. They claimed my heart was fine and wrote me an RX for beta blockers, but I didn't take any.

My heart rate was better the following day. And to be honest I never really scrutinized my HR at home. It still ping-longs a bit but that may be normal for me. 80-90 at rest during the day, and 100-110 at exertion was typical.. Sometimes the more you dig the less you like what you find

Todzo wrote:Hi!

Late 2005 I was robbed, stabbed and beaten. Near the anniversary of that attack in 2006 I was at the emergency room – pulse 140 (I had been sitting quietly for several minutes) BP 200/120. They took me right in.

Visit to ER same time of year 2007.

2008-10 made a plan which avoided the ER.

Honestly I can't rule out stress -- especially around the holidays. It seems that with everything that happened this year I can't deal with stress as well as I could in the past. I'm still just getting by.. Once I feel well enough to exercise regularly again and figure out how to loose some weight I'm sure I'll feel better.

I'll look into those breathing exercises. Thanks.

HoseCrusher wrote:In addition to making sure you have adequate hydration you may want to read the book "The Magnesium Miracle" by Dr. Carolyn Dean.

I've have heard magnesium mentioned on the forum before. I'm not sure if I've had that checked yet but I'll definitely look into it. Thanks.

DreamStalker wrote:What they meant by sinus was that the heart rhythm was normal (ie. sinus rhythm). Had it been abnormal, they would have diagnosed you with atrial fibrillation and they could have made lots of money off you and your insurance .... Hence, dag nabbit! -- It was "just sinus".

They did make it sound like it was normal and nothing to worry about.

I researched tachycardia on the web it was listed under SSR or sick sinus rhythm. That doesn't sound all that wonderful to me.

Irregular heart rhythms are certainly not uncommon for people with severe sleep apnea. But I'm not sure that they are dangerous either..

When using a pulse-ox while walking, I discovered my heart rate changes inverse to O2 levels.
I tried pursing my lips while exhaling, and as my oxygen rose, my pulse came down to a more comfortable level.
In this way I was able to quickly ascend a deeper grade without nearly as much stress.
I'm not sure how this would work while resting, but it's nice to help with exercise.

jdr999 wrote:[I was going to post this a reply to "heart rate really high on waking in morning?" (viewtopic/t89376/viewtopic.php?f=1&t=89376) but didn't want to hijack it..]Later he happened to be in front of the monitor when it happened and he said "Well I'll be damned! I can't believe that just happened!!" I'm thinking "oh crap, that can't be good.."

The Doc shouldn't have said that. We were always told NOT to say: "Jeez... hey Bill, come over here and look at this guy!"...

Sheriff

jdr999 wrote:

Stormynights wrote:I have had esophagus spasms for years. I was always told my heart was fine but given nitroglycerin tablets for the pain. I was undiagnosed until I met my new doctor this year. I was so glad to finally find out the cause of the pain instead of just taking heart medication and not knowing why. I hope you get your problems sorted out faster than I did.

What exactly were your symptoms and how did they treat it?

I'm one that can't really zero in on my own heart beating. Might be the years of weightlifting, or just way too much extra fat.. I know it's in there, just can't really feel it. It's also a bit quiet on a stethoscope. The most I can feel is something "odd" at times.. So heart, reflux, esophagus.. Just too difficult for me to zero in on anything in there so I'm always guessing...

For as long as I can remember (5-10 years+) food has been getting stuck in my throat. Not every time, but at least a few times a week. I thought I was just taking too large of a bite or not chewing my food well enough. It got to the point where I won't even start eating until I've got a large glass of something to force whatever happens to get stuck down. Rice was always a tough one for me. I don't notice it as much anymore so maybe I figured out how to deal with it better...

You might do a search for nutcracker esophagus. It started when I was in my late twenties and I was not overweight. I have been told that it is a classic heart attack symptoms. The pain is so unbearable I can't get off the floor. There are other symptoms that are associated with this that I never had. I think your symptoms sound like the ones I missed out on. It is supposed to be rare but it is miserable. Let me know what you think after you google Nutcracker Esophagus.