Heart rate questions: Rate increases when standing or waking up?

Posted by learningstudent @learningstudent, Apr 18, 2020

Well I know it does not seem ok. Last time I went to see the doctor, he said my resting heart rate was high 85 to 90. But I think I do have white coat syndrome cuz when I go to see docs, I will would be very nervous. He prescribed me the antenolol 50mg, for the first three weeks, I was fine but aferwards I started to have side effect - dizziness, one night felt like blacked out and then cold hand and feet, ringing in ear, shortness of breath... So I reduced the dosage to 25mg and took it for about a week and a half and then stopped for 3 days and it was worse, heart palpitation every night so I reduced the dosage to 12.5mg and then took it a couple days and then stopped cold turkey.

I did not tell my primary doctor when I stopped because he said that all these symptoms are due to my anxiety. I said that was a side effect and he did no t believe it and he said he is taking it too but 25mg.

At first I thought it was withdrawal symptom, cuz I had heart palpitations every morning when I woke up and that came with dizziness as well as shortness of breath on exertion and I ignored it but now it has been almost 4 months and it is getting worse.

These are the symptoms I have right now
1) whenever i am moving during sleep such as rolling to another side or about to wake up, my heart rate increases dramatically and if I don't wake up, the heart just keeps increasing, which is scary so I have to wake up and rest and the darn heart rate gets back down to normal 86 to 75. It does not matter whether I have low oxygen saturation or not or any other sleep apnea.

2) I used to sleep with my mouth open, but not anymore. I have developed mild central sleep apnea but the specialist said it was most likely obstructed sleep apnea. But I do not snore. She only had me do the home oxygen saturation test.l due to the pandemic so no sleep study clinics are open. My body has totally changed how it used to behave. I did not have sleep apnea before taking beta blocker.

3) Whenever I talk, no more than a few seconds I have to pause and take deep breath before continuing. The breathlessness on exertion does not go away and still exists.

4) cold hands and feet still persists and now they are sweating all the times and the dizziness sometimes come and go. Whenever I get up, heart rate increases and feel dizzy so I have to wait a bit before standing up and walk.

5) the chest tightness is gone but the breathing problem is getting worse. If I cannot breathe normally, my right shoulder hurts and there is some tightness in the right chest. What is worse is that I somehow seems to develops what is so called empty nose syndrome - no mucus in my nose, no congestion any nothing and my nose feels so empty that I have to put something into my nostrils to partially block the air flow cuz whenever I breathe, there seems to be so much air - esp cold air getting in, which makes me so uncomfortable. I also lose a bit of sensation of breath and smell and this happens sporadically.

I am just wondering if this is still the side effect of withdrawal symptom or it has damaged my autonomous nervous system permanently? In this post I would like to address the first symptom, heart rate increase whenever u wake up? Has anybody have this symptom? If so how do u get rid of it? Thx.

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@learningstudent I hear you. I have a fast heart rate, 145 at rest and higher when moving. I also have the lightheadedness. Here’s what I do. My cardiologist found that the lightheaded was from a blood pressure problem. So, I take fleccainide for the fast heart rate and have recently started lisinopril for blood pressure. I had my vitamin and mineral levels checked and was low on vitamin d. Started taking vitamin d once a day and that is making a difference in my lightheaded and dizziness. I would like to recommend that you ask for a cardiology appointment if you haven’t already. Ask questions about both tachycardia and brachycardia.
All the best to you, I hope you find the answers you need.

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Yup I did but due to this pandemic, he won't schedule anyone for physical visit. He had me wear the holter monitor for a night but since I am having health problem, I sat and on bed most of the time besides the heart palpitation that wakes me up and I did miss the time when fast rate happened and so sure if that affects the result and he said everything was ok and esp the heart rhythm.

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Hello, I am not a doctor but maybe this small bit of information may help. Perhaps your kidneys should be checked because they can increase the heart rate. This is happening to me so perhaps? And good luck and health to you.

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A month ago just got my complete blood panel test, everything was normal with my liver. I am just wondering why my heart beats really as I move or wake up.

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I know it is normal when we rest the heart rate slow down but as soon as we stand up the heart rate increases and goes back down and as I move around the heart rate increases further. However here is what happens to my heart rate. When I lie down my heart is between 75 to 85, and that may be considered normal. When at rest sitting down and heart rate is 77 to 89. But as soon as I stand up it just increases dramatically. Let say from lying down to standing up it increases from 77 to 103 or 105. It depends and when it drops down it would stay at about 90 to 103 or something and it rarely goes back down to 80 to 89. And sometimes for no reason esp in hot weather it increases to 120 and I feel really hot. Also I have shortness of breath during or after taking beta blocker and not sure if that is what causes it.

Going to a short distance can sometimes goes from 80 to 130. I am just wondering what causes it and what happens? I also feel dizzy too.

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@learningstudent

I know it is normal when we rest the heart rate slow down but as soon as we stand up the heart rate increases and goes back down and as I move around the heart rate increases further. However here is what happens to my heart rate. When I lie down my heart is between 75 to 85, and that may be considered normal. When at rest sitting down and heart rate is 77 to 89. But as soon as I stand up it just increases dramatically. Let say from lying down to standing up it increases from 77 to 103 or 105. It depends and when it drops down it would stay at about 90 to 103 or something and it rarely goes back down to 80 to 89. And sometimes for no reason esp in hot weather it increases to 120 and I feel really hot. Also I have shortness of breath during or after taking beta blocker and not sure if that is what causes it.

Going to a short distance can sometimes goes from 80 to 130. I am just wondering what causes it and what happens? I also feel dizzy too.

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@learningstudent, I moved you recent question to this discussion that you started a couple of days ago. I did this as your questions appear to be related and give members more information to share their experiences.

I found this information that, in part, describes some of the symptoms you describe:
- Mayo Clinic Q and A: All about POTS — postural tachycardia syndrome https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-all-about-pots-postural-tachycardia-syndrome/

This excerpt states:
"A person’s heart rate is usually about 70 to 80 beats per minute when resting. Normally, the heart rate increases by 10 to 15 beats per minute when standing up, and then it settles down again. For people with postural tachycardia syndrome, the heart rate goes up considerably higher when they stand, often increasing 30 to 50 beats per minute or more. This can lead to lightheadedness, dizziness and fainting."

I'd also like to bring @predictable @julianned @suzanne2019 into this discussion to share their thoughts.

LearningStudent, you mention that you take beta blockers. Have you already been diagnosed for a heart condition? What medications are you taking?

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Hi, LearningStudent @learningstudent, your description of your concerns makes me think we have a lot in common, especially a tendency to concentrate on my heart rate, perhaps a little too much. I've had hypertension and tachycardia -- especially postural tachycardia -- for a number of years, and a few years ago that advanced into atrial fibrillation -- a heart-rate problem caused by electrical instability in my heart. But I've learned to not be so sensitive. My normal heart rate used to range from 50-60 sitting or even lying down. When I stood up it rose to 85-95, sometimes with a bit of dizziness. When I raised that with my medical team, they put me through the heart-rate testing paces to see what was going on. Turns out I was expecting too much stability in my heart rate and advised that I needed to cool it. Part of the problem was my hypertension medication. Because of the heart rate issue and the start of A-fib, I was put on a beta blocker (Carvedilol 25mg twice daily) and given very pointed advice not to mess with the dosage -- don't try to change it on my own and especially don't reduce it or drop it abruptly, because dosage should only be phased down over a period of weeks in close coordination with my medical team. Others here on Mayo Connect told of violating those rules and suffering disquieting consequences -- sometimes feeling as though their basic circulatory system had gone haywire. Your beta blocker was Atenolol. At 50mg (all at once?) that's pretty hefty dose. My wife has taken it for years at 25mg with breakfast, so we have paid a lot of attention to proper use of beta blockers, without much adversity because we both have followed the rules I mentioned above. I had the good fortune of having an excellent nephrologist treat my hypertension, and after she discovered I lacked enough potassium, she fixed that with potassium-sparing diuretics and a number of other minor adjustments in my 4-component medication regimen. Then she mentioned as I was heading out the door of our 5th meeting that I should be sure to take a Vitamin D supplement of about 1000IU every day -- not a big dose, but just 1000IU. Then after settling on a permanent regimen for me, she urged me to play it cool for three or four weeks until my metabolism settled down and my anxiety did not return. I hope you can steel your emotions and progress smoothly into a permanent status involving heart-rate changes, guided by your doctor(s) all along the way. Hopefully, you won't have to get an appointment to visit them, but communicate information between you by phone or messaging. Martin

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I think I have white coat syndrome. My darn doc said my heart rate was high. Cuz whenever I see doctors I am nervous. My darn doctor did not tell me anything about the beta blocker and asked me to take it. And I did not have health concern at that time just hot flash and dizziness for a few days and went to see him and then he prescribed me the beta blocker antenolol 50mg and had me take once a day. When the side effect occured, I went back to see him and realized that according to himself he is taking 25mg. WTF, he is 50 or something and he only takes 25mg and I am just 30 and first time taking antenolol and he gave me 50mg without telling the consequence.

My problem right now is that my resting heart rate is now 90 to 95, which is too high but when I stand up and move a bit it jumps over to 100 or sometime 110. This has happened since last week when I went to see the neurologist for nervous system damage because of this darn drug. The heart rate increased for no reason and it went up to 120 while waiting for the doctor. I was not nervous at that time but felt really hot and dizzy. Ever since that day, my heart rate has become really high. Before that my resting heart rate was 75 to 85 and while moving it jumped to 90 to 105. But now it just goes haywire.

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@learningstudent

I think I have white coat syndrome. My darn doc said my heart rate was high. Cuz whenever I see doctors I am nervous. My darn doctor did not tell me anything about the beta blocker and asked me to take it. And I did not have health concern at that time just hot flash and dizziness for a few days and went to see him and then he prescribed me the beta blocker antenolol 50mg and had me take once a day. When the side effect occured, I went back to see him and realized that according to himself he is taking 25mg. WTF, he is 50 or something and he only takes 25mg and I am just 30 and first time taking antenolol and he gave me 50mg without telling the consequence.

My problem right now is that my resting heart rate is now 90 to 95, which is too high but when I stand up and move a bit it jumps over to 100 or sometime 110. This has happened since last week when I went to see the neurologist for nervous system damage because of this darn drug. The heart rate increased for no reason and it went up to 120 while waiting for the doctor. I was not nervous at that time but felt really hot and dizzy. Ever since that day, my heart rate has become really high. Before that my resting heart rate was 75 to 85 and while moving it jumped to 90 to 105. But now it just goes haywire.

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@learningstudent, I haven't heard of "white coat syndrome" in connection with heart rate. It commonly refers to elevated blood pressure, not heart rate, when a patient visits a clinic or doctor's office. I wouldn't be mistaken if I assumed you don't trust the doctor who prescribed Atenolol, a beta blocker, for you, would I? What about your neurologist? Did s/he uncover any nerve damage? Did s/he have any advice for you or prescribe any medications or activities to ease your heart rate? Do you think it's time to get a second opinion -- first from an internist and then, if necessary, from a cardiologist? I understand your frustration at not finding a path to a stable pulse, and I hope you will be able to work with your doctors to find the way. But don't try to do it alone. Martin

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heart rate is normally controlled by Concur(bisoprolol)-beta blocker probably around 5 mg in Pakistan...possibly a weak left side of the heart too

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