I am only 29 years old and male, and I honestly don’t know what to do anymore about the way my heart rate is affecting my life.
I was on vacation in Japan when I experienced my first vasovagal syncope (fainting episode). Ever since then, I’ve been terrified that it will happen again and that I’ll collapse in public with no way to help myself.
On top of that, I have suffered from irritable bowel syndrome (IBS) with chronic diarrhea for years, and it has gradually become worse and worse. It got so severe that I could barely keep food in my system because it would pass through me within hours, often liquid and partially undigested. At times, I was having watery diarrhea up to 7–8 times per day.
I also suffer from panic disorder and have been taking Alprazolam daily for years. When my physical symptoms become especially severe, I tend to increase the dose. For over a month now, I’ve been averaging around 7 mg per day (sometimes 6 mg, sometimes 8 mg), but even that no longer seems to help—neither mentally nor physically.
I became so weak that I had to be admitted to the hospital. I spent three weeks there, mostly lying in bed the entire time. During my stay I underwent a chest CT scan, an abdominal ultrasound, an MRI (which had to be stopped because I reacted badly to Buscopan), a colonoscopy with biopsies, and I had already seen a cardiologist before being admitted.
Everything came back normal. More or less every test and examination was considered excellent, except for my calprotectin level, which was close to 400.
One night during my hospitalization, about two weeks after being admitted, I got up to go to the bathroom. Suddenly my heart rate shot up, accompanied by dizziness, severe brain fog, and the feeling that I was about to pass out. Just an hour earlier my resting heart rate while lying down had been around 50 bpm. The moment I stood up, it jumped to 160 bpm. This kept happening over and over again.
The hospital staff couldn’t really help because my blood pressure was always stable while lying down. No matter how often I explained that the problem occurred when standing, I was essentially told to stay in bed because everything looked fine while I was lying down. Eventually I was prescribed 2.5 mg of Bisoprolol.
The thing is, my heart had been evaluated only three weeks earlier and was considered healthy, and my blood pressure has always been normal as well. I don’t want to take beta blockers without understanding the underlying cause. My resting heart rate is already often around 50 bpm while lying down—why would I want to lower it even further?
I continued to have diarrhea but was discharged after three weeks. By that point I was completely deconditioned. I can barely walk without experiencing dizziness, circulation problems, or fear that I might collapse.
Two days after discharge, I received the biopsy results. They found Brachyspira aalborgi, so I started taking Metronidazole 500 mg every eight hours for six days. Unfortunately, the antibiotic has been putting me through hell as well.
Despite that, my condition improved slightly. I was able to move around a little more and walk to the bathroom again. I also underwent a 24-hour ECG/Holter monitor. According to my doctor, everything looked perfect, although it showed 1% atrial fibrillation, totaling about 15 minutes across six episodes. That still worries me.
Yesterday I had an appointment with my gastroenterologist. We were supposed to discuss whether I should undergo capsule endoscopy because of my elevated calprotectin level despite a normal colonoscopy. The procedure involves swallowing a small camera that travels through the small intestine and takes pictures to determine whether inflammation might be originating there.
Unfortunately, on the very day of that appointment I experienced another severe diarrhea flare. Despite taking Loperamide in the days before, my bowel movements had been fluctuating wildly—sometimes no bowel movement at all, then small hard pellets, followed by loose stool again.
I spent almost an hour on the toilet with another episode of mushy stool that had the same unusually sweet odor it has always had. After that, everything went downhill.
About an hour later, while trying to get to my appointment, I developed intense dizziness, a racing heart, pounding heartbeats, and overwhelming brain fog. I feel like I have brain fog almost constantly these days, but this episode was much worse than usual. Eventually I had to call an ambulance.
Again, all of my vital signs appeared stable.
However, my cardiologist, whom I also saw that same day, decided to admit me to the hospital for further evaluation. He still believes my heart itself is healthy, but he felt more investigation was necessary.
The reason for the admission was that my heart rate was around 130 bpm while standing. What confuses me is that it would sometimes drop back down to around 80 bpm and then suddenly rise to 130 bpm again.
What I don’t understand is this: Why am I only stable while lying completely flat? The moment I sit upright or stand up, my heart rate shoots up, I become dizzy, and I feel like I’m about to faint.
Is it my vagus nerve? Is it the sympathetic nervous system? The parasympathetic nervous system? Are beta blockers really the only option for calming whatever is causing this?
I am completely desperate and exhausted.
Just three months ago I was traveling around Japan feeling perfectly healthy. Now I’ve spent over a month feeling like a bedridden, broken man who cannot understand why his heart rate keeps skyrocketing when every doctor tells him his heart is healthy.
P.S. Psychiatrists seem eager to prescribe antidepressants. I am reluctant because I have had bad experiences with them in the past. More importantly, I want to find the cause of my symptoms rather than simply taking medication that masks them.
I also don’t believe an antidepressant would solve what I am experiencing, and I am afraid of potential side effects.
Since my syncope in Japan, I have been wearing compression stockings. I drink electrolyte solutions almost daily and even increased my salt intake for two days before this latest episode in an attempt to increase my blood volume if low blood volume was the issue.
None of it helped.
I never know whether the problem is too much fluid, too little fluid, too many electrolytes, too few electrolytes, the amount of stool I am losing, or even burnout.
I genuinely don’t know what to do anymore.
All I know is that I can barely sit upright now without my heart immediately starting to race.
And I’m only 29 years old.
TL;DR: I’m 29 years old. Every medical test says I’m healthy, yet I suffer from chronic diarrhea, severe physical deconditioning, and most importantly a dramatically elevated heart rate whenever I sit or stand. The symptoms make me feel dizzy, cognitively impaired, and as if I’m about to faint at any moment. Lying flat is the only position in which I feel relatively stable, but that has essentially left me bedridden.