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TACHYCARDA and PALPITATIONS with normal ECG, ECHO.

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25 year old patient with fast heart rate and palpitations since pre-teen years. EKG shows sinus tachycardia but otherwise normal. Labs normal except mildly elevated cholesterol. Thyroid within normal limits, negative for diabetes. Pt is obese with asthma and sleep apnea. Echo-cardiogram was normal. what can be the cause of the fast heart rate and palpitations?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 20 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com
I understand your concern.
Mostly in young people, the cause of palpitations is more benign.
Will it be possible for you to upload the patient's ECG? There is a condition in young people called Supra Ventricular Tachycardia ( SVT )and that can be the cause here. The ECG will give a clearer picture.
What is the patient's body weight? Because even obesity can predispose to arrhythmias and palpitations. Obesity again can be the cause of sleep apnea in the patient.
One more reason for palpitations in young patients can be, and most commonly found is anxiety.
Kindly upload the ECG.
I will advise you further once you do,
Regards.


Patient replied :

Hello, sorry for the late reply. I cannot seem to find the EKG anywhere. I can tell you that the EKG read "Normal Sinus Rhythm, Normal ECG." I currently work at Doctors Medical Center in the ER as a scribe and I did show one of the physicians there the EKG and they said it was normal as well. The cardiologist saw the ECG and did not comment on SVT. As for myself, I am 365 lbs and 6 feet 3 inches tall. Overall I am not concerned as much about the palpiations as much as the rate itself. As a young person who has a fast heart rate it is alarming especially with negative laboratory studies. My resting heart rate is usually between 100-120. The only thing I can think of is chronic inhaler use, over the years old patientI have used my albuterol inhaler 3-4 times per day for the last 10 years old patientof my life, could that have something todo with constant fast heart rate? Should I request my cardiolgist to order a chest xray to see the size of my heart and lungs? wha other studies would you recommend?


Hello
Thank you for the follow up.
Since you have already been to a cardiologist, can you tell me what exactly did he say was the cause of your resting heart rate.
You can go ahead and get the x ray done, however gross enlargement would have been picked up by your cardiologist by now.
Albuterol in rare cases affect the heart, can lead to shortness of breath and chest pain, however it is unlikely it is causing the high resting HR in your case.
When were you first diagnosed with Sleep Apnea? Because sleep apnea is a common cause of arrthythmias, and can lead to atrial fibrillation, ventricular tachycardia ( e.t.c ).
I will advise you get an ECHO test done which will give us a much clearer picture of your heart status. And also try to reduce weight. Once your obesity is taken care off, your symptoms will definitely get better.
Hope this was helpful,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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