Tachycardia?

I post here normally, but this response is from my boyfriend who also read over this forum post and took an interest, so this is his opinion as a medic:

The preface is that I am not a doctor and this is not medical advice, if this person wants medical advice, they should call 911 or go to their closest emergency room.

To say that you have tachycardia isn't inherently dangerous. "Tachycardia" in and of itself is just any heart rate over 100 bpm. The origins and etiology of that tachycardia are more important than just having a heart rate that is barely above 100. A resting heart rate of 95 is acceptable for any normal adult; anything between 60-100 is considered to be a "normal" resting rate. Having a resting rate 110-150 might be benign and normal variant, or it could also imply some other pathology/etiolgy that would require halter monitoring. Also, depending on how the heart rate is taken manually, the number might be skewed. The best method is to take it radially over the course of a minute.

Take that 120/80 average number out of your memory, throw it away, and never think of it again. It's a baseline "comparative" number that doesn't really mean anything when it comes to being low. And a blood pressure of 96 systolic is honestly pretty decent for a physically conditioned individual. A pulse pressure of 38mmHg is basically the same as that 120/80 anyway, and with a mean arterial pressure of 72mmHg, it doesn't concern me. It generally takes 60mmHg to adequately perfuse coronary arteries (which get perfusion during diastole, or when the heart is resting) and other vital organs.

Depending on your age and physical conditioning, a heart rate of 208 while doing sprints (or intervals, which looks to be more the case) is entirely plausible, and likely to be a result of exertional instead of pathological. The usual rule of thumb is 220 minus age to determine if a tachycardia is extrinsic or intrinsic in nature, and even then it's relative. I can't say much else without actual ECG results, and that's really where the answer is going to come from, and I don't think a halter monitor is out of the question should the tachycardias persist.

Also, if this is a new medication, perhaps it is a catalyst (or even the causative agent) for the tachycardic episodes.

It's actually hard to take a medication as pescribed and have it kill you. Lots of people take lots of medications all the time and none the worse. What I will caution is with extremely fast tachycardia causing chest pain or respiratory distress. That IS a life threat and an ambulance is needed IMMEDIATELY.

As an EMT and Health Information Administrator student, I second all of that.

Oh, and I want to stress the statement about taking manual radial pulses, TAKE IT MANUALLY! lol, automatic HRM's can be so off, as well as automatic BP monitors, especially when moving (like in the back of an ambulance, jogging, even walking). I've gotten insane readings from the smallest thing from automatic HRM and auto-BP machines, so just take the time to feel for the radial pulse (or corotid if you have trouble finding it in your wrist) and count for 60 seconds. With tachycardia, one of the the things we fear is ventricular tachycardia, where your heart is beating so fast, the chambers of your heart can't adequately fill up and perfusion is compromised, which can eventually fatigue the heart and cause cardiac failure or arrest. While 90 bpm isn't at that level, if you start experiencing symptoms like chest pain or even discomfort, arm pain, upper back pain, nausea, respiratory distress, or diaphoresis, play it safe, call an ambulance.

Seems like you have been getting some good advice. Tachycardia is not a disease, it's a symptom. As others said, it can happen from exercise, drugs, hyperthyroidism, infection, stress/anxiety, dehydration, arrhythmias, etc. As an ER doc I can say the others are right about getting concerned if you get chest pain or shortness of breath, but perhaps most importantly light-headedness or passing out. I would definitely have your doc take a hard look at your amphetamines, and would consider only engaging in light activity until you get a checkup.

First of all, relax. Tachycardia is simply a heart beat above 100, so every single one of us who works out and gets our heart rate over 100 is tachycardic while we are exercising. I'm also often tachycardic while resting due to my asthma medication. If it is medication induced, it's usually not a big deal. The only time tachycardia is a problem is when there is an underlying heart issue or it is caused by a heart issue that speeds up the electrical signal in the heart even at rest. From the sounds of it, the medication is causing your issues, so I wouldn't stress out about it until you talk to your doctor and they can make sure you have no other underlying heart conditions. The medication you are on is an amphetamine and one of the major side effects of amphetamines is increasing heart rate. Because they are known to increase heart rate, as long as your doctor clears you of other heart issues, you can still workout but you can't judge your calorie burns or exercise level by a heart rate monitor. They will over estimate calorie burns because the heart rate will be high even if you aren't burning extra calories. You should use a rate of perceived exertion scale to judge how hard you are working. The one I like is a 1-10 scale where one is laying down doing nothing and 10 is "OMG I'm about to die!" hard work. You want to work at a 5-7 on that scale.

Tachycardia is a symptom, not a diagnosis. Things like dehydration, fever, fear, anxiety, and yes, side effects from medications are all potential causes.

I would never try to diagnose you via a computer, but here are a few questions for you:

1. Are you drinking enough?

2. Have you called your pharmacist to see if your medication has tachycardia as a side effect?

3. Have you had a virus or illness lately?

4. Are you symptomatic (dizzy, fatigued, feeling palpitations) with this faster heart rate?

5. What was your heart rate before? Is this your baseline? Normal heart rates are 60-100. The true definition of tachycardia is a sustained heart rate over 100.

If you are symptomatic you need to be seen, even if that means an emergency room visit. If you're not, then make an appointment with your physician.

If your radial pulse is so weak you're having a really hard time feeling it, it sounds like your BP is dropping (you need a systolic of about 100 or more to feel a radial pulse), it sounds like you're have some vasodilation/syncope episodes when you stand up suddenly, which could also be a sign of hypoglycemia (when we have an altered mental status patient with a rapid HR but no obvious symptoms of stroke/trauma/ect, we usually think hypoglycemia as one of the causes). Maybe some diet changes would be good? More protien and fats?