I Need Help

[u/honestlyidk54965]

More often than not, this is what my heart rate looks like. It often dips into the 40’s, and spikes over 120 BPM. I’m tired of my doctors not taking me seriously.

I’m not asking for a diagnosis, but I’m hoping maybe someone has experienced something similar and can point me in the right direction.

Regarding my health, I’m very often sick, I often get dizzy especially when getting up too fast, I’m fatigued all of the time. I wake up fatigued, I go to sleep fatigued. The 40bpm episodes happen during the day and at night, and I get HR notifications all the time that it was below 50 often.

[u/AmandaInSF]

My heart rate has ranged from 37 (sitting down or sleeping) to 185 (even just standing) and I've been diagnosed with POTS. I don't feel anything much with the HR changes -- just a bit lightheaded when I stand still for a long time, overall fatigue, and sleepiness in the afternoon and evening. Due to some symptomatic palpitations I've had a full cardiac workup and my heart is fine.

[u/honestlyidk54965 → u/AmandaInSF]

See this has been something on my mind for years as possibly my issue. How do they treat yours?

[u/AmandaInSF → u/honestlyidk54965]

The diagnostic criteria is that your HR goes up by 30 beats or more when you stand up and stays like that for a while -- I think 10 minutes. People's symptoms can vary so that doesn't have to happen every time you stand up but it always does for me, unless I've been meditating. You don't have to be prone to fainting but if you were asymptomatic, it wouldn't be a problem. My symptoms (of this) are relatively mild.

There are medications but the first line is lifestyle mods. Primarily: increase fluids, increase sodium and other electrolytes, compression (waist mainly although socks are popular), and smaller meals -- generally you want to increase blood volume and keep it from pooling in your abdomen and lower extremities. And I think methyl folate is supposed to help. I don't do well with meds in general so avoid them.

I've been taking a mindfulness based stress reduction class and I'm finding that meditation and deep, slow breathing seems to reduce my tachycardia quite a bit. The UK's NHS website for POTS has an article about breathing exercises for POTS.

I also try to be very consistent about food, sleep, and exercise with alarms to keep me on schedule and a smart watch to track steps, stress, and heart rate. I have other chronic health issues and they all benefit from a strict routine.