diagnosis or treatment for my 15 year old with tachycardia.

Posted by kdwest422 @kdwest422, Oct 21 5:33pm

My 15 year old has extremely high heart rates regardless of what she is doing. We are under the care of a cardiologist and have had echo and ekg's done. svt & pots ruled out. stress test done in June & found issue but no diagnosis. Her bp dropped to 82/49 her heart rate at 218. Takes salt daily. She was also cleared to participate in color guard/ marching band. As the competition season continues the following is happening,, she will stay between 189 and 220 for the 15 minute program. Then after ward is very dizzy and short of breath and sometimes extremely zoned out or confused. When they have prelims and finals the same day by the end of the finals her blood pressure is low and catching her breath is sometimes impossible. Then for the next 24 to 72 hours she feels like a train has hit her and is dizzy. The newest symptoms: Her legs feel like jelly & chest tightness. She is not critical enough for the cardiologist to give it much attention. ..

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There are two scenarios and time correlations that link tachycardia and low blood pressure. If the blood pressure drops first such as in orthostatic hypotension/POTS ( when you first get up from sitting or lying down) the heart rate increases to compensate for the low blood pressure to prevent passing out. If the heart rate increases first and gets so fast (> 180), the heart cannot fill with blood sufficiently between beats and the blood pressure drops as a result of low cardiac output. In The second situation, keeping the heart rate from escalating so high will prevent the drop in blood pressure and a medication like a beta blocker can be safe and useful. it would be good to know what her resting heart rate is when she is not in tachycardia. If it’s 65 to 70 or above, a dose appropriate beta blocker may be very helpful in controlling her symptoms until the cause of this is determined. Regardless of her cardiologist reputation, I think a second cardiologist’s opinion ASAP is warranted.

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I started having heart rhythm problems at age 14 for 7 years. Never went to doctor but read from a doctor column in news that some people are extremely sensitive to caffeine. Is she drinking colas, Mountain Dew, coffee, energy drinks, eating chocolate?

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@windyshores

What is her heart rate at rest?

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her heart rate at rest varies but is usually in the low 80's
the heart monitor she wore for ten days shows her heart rate slows way down when she sleeps and sometimes drops into the mid 50's. We were told this is normal

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@lindy9

I started having heart rhythm problems at age 14 for 7 years. Never went to doctor but read from a doctor column in news that some people are extremely sensitive to caffeine. Is she drinking colas, Mountain Dew, coffee, energy drinks, eating chocolate?

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she does not drink sodas or energy drinks. She doesn't like anything carbonated so we have not had to worry about the caffeine. She eats chocolate but not excessive. We don't keep a lot of it in the house.

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@slkanowitz

There are two scenarios and time correlations that link tachycardia and low blood pressure. If the blood pressure drops first such as in orthostatic hypotension/POTS ( when you first get up from sitting or lying down) the heart rate increases to compensate for the low blood pressure to prevent passing out. If the heart rate increases first and gets so fast (> 180), the heart cannot fill with blood sufficiently between beats and the blood pressure drops as a result of low cardiac output. In The second situation, keeping the heart rate from escalating so high will prevent the drop in blood pressure and a medication like a beta blocker can be safe and useful. it would be good to know what her resting heart rate is when she is not in tachycardia. If it’s 65 to 70 or above, a dose appropriate beta blocker may be very helpful in controlling her symptoms until the cause of this is determined. Regardless of her cardiologist reputation, I think a second cardiologist’s opinion ASAP is warranted.

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From what we have seen her heart rate gets high and then the blood pressure drops. They ruled out POTS due to this not occurring when there is a sudden change in movement. The heart rate rises simply with any physical activity, regardless of how extensive it is.

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IT might be Vagus nerve intonality. The Vagus nerve is part of the parasympathetic nervous system, the 'side' of the body's nerve supply that is meant to regulate and to calm. The sympathetic nervous system is the 'arousal' mechanism that is part of the 'fight or flight' response to stress. The Vagus nerve runs from the brain all the way down to the lower gut with at least 50 branches off it, running to most organs and into tissue. You might wish to research 'Vagus nerve tone' and cardiac reactivity and arrhythmias. Here's a fr'instance:
https://www.nature.com/articles/s41569-019-0221-2
The medical community feels that any HR between 60 and 99, inclusive, is 'normal sinus rhythm'. Some cardiologists have begun to question those range limits, especially the lower one, and think that 50 is more reasonable. The upper one, believe it or not, is pretty robustly supported. It seems high to me, but...your daughter's resting rate is well below that threshold.

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@gloaming

IT might be Vagus nerve intonality. The Vagus nerve is part of the parasympathetic nervous system, the 'side' of the body's nerve supply that is meant to regulate and to calm. The sympathetic nervous system is the 'arousal' mechanism that is part of the 'fight or flight' response to stress. The Vagus nerve runs from the brain all the way down to the lower gut with at least 50 branches off it, running to most organs and into tissue. You might wish to research 'Vagus nerve tone' and cardiac reactivity and arrhythmias. Here's a fr'instance:
https://www.nature.com/articles/s41569-019-0221-2
The medical community feels that any HR between 60 and 99, inclusive, is 'normal sinus rhythm'. Some cardiologists have begun to question those range limits, especially the lower one, and think that 50 is more reasonable. The upper one, believe it or not, is pretty robustly supported. It seems high to me, but...your daughter's resting rate is well below that threshold.

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I wonder if any of the knowledgeable people here know whether avoiding activities that raise the heart rate for some period of time could somehow heal whatever is going on. I know this is vague!

Does walking raise the heart rate? Are there certain activities that don't, like, say, swimming? Can the heart be retrained?

My kid has a resting heart rate of 140 at one point, as I wrote, and my son's heart rate went really high after any exercise- at age 10 or so. Somehow both resolved and I have no idea why. Kid with high resting heart rate had a positive Lyme test and was eventually diagnosed with lupus, has type 1 diabetes. Co-morbidities can be important but so far your daughter doesn't have any!

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@ruby2020

Please. Today. Find a different Cardiologist. It could very well be only a matter of time before a heart rate like that churns up a clot. As a School Nurse- I would have a hard time allowing a student with these symptoms to participate. Was she cleared during the time that she was having this many symptoms?
This sounds very scary. Maybe even ask for a Loop Recorder to be implanted to monitor continuously.
I'm sure you've been asked this a gzillion times- but seriously, does she consume very much caffeine? I am the biggest critic of Energy Drinks in all ages. But, I have the loudest voice to teach kids/adolescents about the dangers of them.
Many blessings and hopefully you can find the right Cardiologist to help get to the bottom of what is going on.

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Did your cardiologist suggest techniques to helplower your daughter’s rapid heart beats? I occasionally have intermittent tachycardia which can be helped with slow, deep measured breathing. Here is a Mayo Clinic article about Tachycardia:
https://www.mayoclinic.org/diseases-conditions/tachycardia/diagnosis-treatment/drc-20355133

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Here is an article by Mayo Clinic about lowering your rapid heart beat with measured breathing:
https://www.mayoclinic.org/diseases-conditions/tachycardia/diagnosis-treatment/drc-20355133

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I wonder if this is some form of dysautonomia. There are dysautonomia clinics in some hospital systems. I just randomly ran into this on Facebook https://www.facebook.com/groups/1016433459359125/?hoisted_section_header_type=recently_seen&multi_permalinks=1285375155798286

Apparently people are using a vagus nerve stimulator. I know nothing about this and did not investigate so just passing it along. Functional medicine might be helpful alongside cardiology.

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